荣毅 曲畅 李国勤

[摘要] 李国勤教授认为支气管扩张症临床上可分为急性发作期和迁延缓解期。急性发作期可分为痰热壅肺、肝火犯肺、热伤肺络等证;缓解期可分为肺气阴两虚、肺脾两虚等证。治疗上急性期以清热化痰、清肝凉血、清热养阴为主，缓解期以益气养阴、润肺止咳、健脾化痰、活血化瘀为主。李国勤教授治疗上分期辨治，擅用清法，兼顾血证，顾护脾胃，辅以扶正，临床上获得了较好的疗效。

[关键词] 支气管扩张症;分期辨治;李国勤;名医经验

[中图分类号] R562.22          [文献标识码] A          [文章编号] 1673-7210（2019）03（a）-0120-04

[Abstract] Professor Li Guoqin proposes that bronchiectasis can be divided into acute exacerbation stage and clinical remission stage. Acute exacerbation stage can be divided into syndrome of phlegm-heat obstructing lung， syndrome of liver fire invading lung， syndrome of lung collaterals injured by heat， and so on; clinical remission period can be divided into syndrome of deficiency of both qi and yin of lung， deficiency of both lung and spleen， and so on. Aimed at the treatment of acute stage， he mainly uses the methods of clearing heat and dissipating phlegm， clearing liver and cooling blood， clearing heat and nourishing yin. Aimed at remission stage， he mainly uses the methods of benefiting qi and nourishing yin， moistening lung for arresting cough， invigorating the spleen and eliminating phlegm， promoting blood circulation for removing blood stasis. Professor Li Guoqin uses treatment based on different stages， he is good at clearing method， gives consideration to blood syndrome， takes care of the spleen and stomach， supplemented by strengthening vital qi， and he has achieved a good effect in clinic.

[Key words] Bronchiectasis; Treatment based on different stages; Li Guoqin; Experience of famous doctor

支氣管扩张症是一种常见的慢性呼吸系统疾病，是由于支气管及其周围肺组织慢性化脓性炎症和纤维化，使支气管壁的肌肉和弹性组织破坏，导致支气管变形及持久扩张[1]。临床表现为持续或反复性咳嗽、咳痰，有时伴有咯血，可导致呼吸功能障碍及慢性肺源性心脏病[2]，其主要致病因素为支气管感染、阻塞和牵拉，部分有先天遗传因素，患者多有麻疹、百日咳或支气管肺炎等病史[3]。西医治疗上以祛痰、抗感染、解痉为主，必要时可外科手术治疗，其主要治疗目标是减少发作，减轻症状，提高生活质量和减少未来的并发症[4]。本病病程长，病变不可逆转，由于反复感染，不仅严重影响患者的生活质量，并进一步影响患者的心理状况，导致抑郁、焦虑的出现[5]。支气管扩张症在中医中无此病名，一般认为属于“咳嗽”“咯血”“肺痈”等范畴。李国勤教授是北京市第四批名老中医专家指导老师，从医40余年，擅长中西医结合治疗呼吸系统疑难病症。……