唐迎港 蔺婷 蒋益兰 王贤文 何迎春

    〔摘要〕 從五行制化失调理论探析肺积病机及临证辨治。肺积包括临床常见的肺结节及肺癌，肺积病变的病位主要在肺，与脾、肾、肝密切相关;主要病理因素为虚、痰、瘀、毒;病理性质为本虚标实，虚实夹杂，肺虚为本，并见脾虚或肾虚，有形实邪结聚为标;基本病机为肺虚蕴毒，制化失调，痰浊凝聚，瘀血内结;病情进展的关键病机为肺虚蕴毒，脏腑失调，湿邪夹毒，或湿邪夹癌毒，或瘀毒胶着，随气流行，循脉入络，痼结虚藏。其基本治法为攻补兼施、解毒散结、痰瘀同治。肺结节临证予分期论治;肺癌临证予益肺健脾补肾以培育根本，祛痰化瘀散结以根除痼结，行气利湿解毒以防治传舍，泻肺化饮息风以治标缓急，从而恢复五藏间协调平衡状态，防止疾病传变。从五行整体思路分析肺积病机及辨治，可资临床应用。

    〔关键词〕 五行制化失调;肺积;肺结节;肺癌;攻补兼施;解毒散结;痰瘀同治

    〔中图分类号〕R256.1? ? ? ?〔文献标志码〕A? ? ? ? 〔文章编号〕doi：10.3969/j.issn.1674-070X.2023.06.025

    〔Abstract〕 To explore the pathogenesis， pattern identification and treatment of pulmonary masses from the theory of “imbalanced mutual generation and restriction among the five elements”. Pulmonary masses often manifest as pulmonary nodules and lung cancer in clinic， of which the disease location is mainly in the lung and is closely related to the spleen， kidneys， and liver. With the main pathological factors of deficiency， phlegm， blood stasis and toxin， the pathological nature of this disease is mixed deficiency in root and excess in manifestation. Lung deficiency is the root and spleen or kidney deficiency is also present ......