基于“扶阳”思想论治慢性阻塞性肺疾病诊治思路浅析

A Brief Analysis of Treatment Strategies for Chronic Obstructive Pulmonary Disease Based on the “Fu Yang” Concept

摘要: 慢性阻塞性肺疾病(COPD)作为一种以持续性气流受限为特征的慢性呼吸系统疾病，其防治仍是当代医学面临的重大挑战。本文立足于中医“扶阳”理论体系，从学术层面探讨COPD的中医病因病机与诊疗路径。本文指出，COPD的核心病机在于肺、脾、肾三焦阳气亏虚，致三焦气化失常，水液代谢障碍，终成痰浊、瘀血等病理产物蕴结肺络的“本虚标实”之候。基于《内经》“阳气者，若天与日”及郑钦安“阳主阴从”的理论基础，本文构建了以“扶阳散寒、温化水饮”为基本原则的诊疗体系，提出以附子、干姜等为主药的温阳方剂辨证论治方案，并系统整合针灸、穴位敷贴及“冬病夏治”等特色疗法，形成多维度的综合治疗策略。本研究为深化扶阳理论在COPD领域的应用提供了诊治思路，对完善中医治疗COPD的诊疗体系具有重要理论价值。

Abstract: Chronic obstructive pulmonary disease (COPD), a chronic respiratory disorder characterized by persistent airflow limitation, remains a significant challenge in contemporary medical practice. This study explores the etiology, pathogenesis, and therapeutic approaches of COPD from the perspective of Traditional Chinese Medicine (TCM) “Yang-nourishing” theory. The core pathogenesis involves deficiency of Yang energy in the lungs, spleen, and triple-jiao (spleen, stomach, and kidney), leading to impaired qi transformation and fluid metabolism disorders. This ultimately results in pathological products such as phlegm-turbidity and blood stasis accumulating in lung collaterals, forming a “deficiency root with excess manifestation” syndrome. Building on the TCM principles from the *Huangdi Neijing* (“Yang energy is like the sky and the sun”) and Zheng Qinan’s “Yang governs, Yin follows,” this study establishes a diagnostic and therapeutic framework based on “Yang-nourishing and cold-dispelling, warming and fluid-resolving” principles. It proposes a syndrome differentiation and treatment protocol using warming Yang formulas with Aconite root and dried ginger as primary herbs, while systematically integrating specialized therapies including acupuncture, acupoint moxibustion, and “winter disease summer treatment.” This multidimensional comprehensive strategy provides diagnostic and therapeutic insights for advancing Yang-nourishing theory in COPD management, offering significant theoretical value for improving TCM’s diagnostic and therapeutic systems for COPD.