Pulmonary fibrosis is the common ending of the interstitial lung disease that is caused by various reasons when it develops to the advanced stage, the main symptoms are recessive progressive dyspnea, often accompanied by cough and cyanosis, etc. It always leads to heart and lung failure then causes death in the end-stage, it has poor prognosis. Although the TCM treatment is in the stage of exploration, but it has shown good prospects. According to the pathogen and pathogenesis, as well as the turnover characteristics, we name this disease “consumptive lung disease”.
In the initial stage of this disease, the pathogenesis is the stagnation and toxicum obstructs at lungs, the lung collaterals are blocked, there exist Qi and Yin deficiency also, the treatment should be relieve toxicity, activate blood circulation, dredging collaterals, and promote Qi and nourish Yin. The commonly used herbs include: Jin Yin Hua, Lian Qiao, Huang Qin, Bai Hua She She Cao, Pu Gong Ying, Shui Zhi, Wu Gong, Dan Shen, Tao Ren, Chuan Xiong, Di Long, Tai Zi Shen, roasted Pi Pa Ye, Yi Yi Ren, etc.
During the middle stage, the influence of toxicity goes down slowly, but the Qi and Yin deficiency becomes obvious gradually, healthy energy is asthenic and evil sthenic, the stasis and toxicity blocks the collaterals, collaterals deficiency and not be nourished, these are the key pathogenesis. Therefore, the treatment is unblocking and reinforcement synchronously, benefiting Qi and nourishing Yin are the priority, meanwhile, activating blood circulation, removing stasis, clearing heat and relieving toxicity to anti-asthma, specifically, removing Jin Yin Hua, Lian Qiao, Pu Gong Ying, adding Dang Shen, Huang Qi, Bai Zhu, Fu Ling, Mai Men Dong, etc. For the previously untreated patients who are applied of high-dose glucocorticoid therapy, the Yin deficiency and heat blocks internal are more evident, thus, nourishing Yin and clearing heat are the selected method.
In the advanced stage, the pathogenesis moves to kidney, we may add the herbs with function of reinforcing kidney and improving the qi-receiving, for instance, Dong Chong Xia Cao, E Guan Shi, Ge Jie, etc. If the kidney Yang is impacted, we should add the herbs with function of warming kidney and benefiting Yang, for example, Fu Zi, Rou Gui, Bu Gu Zhi, etc. If there is kidney Yin deficiency, adding Nu Zhen Zi, Han Lian Cao, Shan Zhu Yu, etc. To emphasize, during the entire process, blood stagnation is always the key of the pathogenesis, hence, activating blood circulation and removing stagnation should be used all along, hereby, we choose Shui Zhi, Wu Gong, Di Long, which can activating blood circulation and dredging the collaterals, insect medicine’s application is one of the important features in the treatment described.
Key words: Pulmonary Fibrosis, Traditional Chinese medicine Differentiation
Writer: Cuie Zheng, Ya Kong, Shitao Li
Shangdong TCM University Affiliated Hospital (250011)
Shandong TCM University
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