试从痹证“五体合五脏”论述结缔组织疾病相关性间质性肺疾病的关系

Try to discuss the relationship between connective tissue disease and interstitial lung disease from the “five body and five zan-organs” of arthromyodynial

关键词:  痹证  五体合五脏  五体痹  五脏痹  结缔组织疾病相关性间质性肺疾病

Key words:  arthromyodynia  five body and five organs  five body arthralgia  obstructed visceral pain  CTD-ILD

摘要:

中医学认为“风寒湿三气杂至合而为痹也”，所谓“痹”即“痹证”，由五体痹和五脏痹组成。结缔组织疾病（CTD），中医又称风湿病，属“五体痹”范畴。间质性肺疾病（ILD）为常见呼吸系统疾病，属中医学“肺痹”、“肺痿”、“咳嗽”、“肺胀”等范畴。肺脏受邪，气血失调，痰瘀互结，壅滞肺络，即可发为肺痹。虚、痰、瘀贯穿疾病始终。肺痹属五脏痹，为五体痹受邪深入发展而来。五体痹与五脏痹的发病关系以及证候表现体现了“五体合五脏”的理论思想，五体痹不愈，复感外邪，疾病传变入里，导致五脏痹。五体痹可导致五脏痹，五脏痹之间亦可相互传变。CTD是引起ILD的常见病因，五体痹不愈，内舍其合，继而引发多种呼吸系统损害，逐渐形成肺痹。近年来，随着社会工业化的进步，CTD相关ILD发病率明显上升。文章试从痹证“五体合五脏”论述CTD-ILD的关系，以求增强对CTD以及ILD的认识，为临床上诊疗开拓思路，提供指导。

Abstract:

Traditional Chinese medicine believes that “pathogenic wind,pathogenic cold and dampness evil three together as arthromyodynia” and rthromyodynia includes five body arthralgia and obstructed visceral pain.Connective tissue disease that Chinese medicine also known as rheumatism,in the traditional medicine is generally attributed to the category of five body arthralgia.Interstitial lung disease is a common disease in respiratory system,which belongs to the traditional Chinese medicine“pulmonary arthralgia”,“pulmonary paralysis”,“cough”,“lung distension”category,phlegm,blood stasis and deficiency through the whole process of the disease,lung qi and blood running sluggish,phlegm and blood stasis,block pulmonary collateral,which can lead pulmonary arthralgia.Lung paralysis attributable to obstructed visceral pain,obstructed visceral pain is a serious stage of the arthromyodynia,which is the further development of five body impediment.Five body arthralgia and obstructed visceral pain in the pathogenesis and syndrome reflects the five internal organs theory,five body arthralgia does not heal,complex sense of evil,resulting in obstructed visceral pain.Five body arthralgia can lead to a variety of organs rheumatism,and also mutual change between obstructed visceral pain.Connective tissue disease is a common cause of interstitial lung disease,when arthralgia syndrome secondary to a variety of respiratory system injury,the pulmonary arthralgia may present.In recent years,connective tissue disease associated interstitial lung disease with the industrialization society improvement and development of medicine incidence rate increased significantly.This article tries try to discuss the relationship between connective tissue disease and interstitial lung disease from the“five body and five zang-organs”of arthromyodynia.