The Etiology And Pathogenesis Of Pulmonary Fibrosis In The Investigation And Traditional Chinese Medicine Intervention In Clinical Studies

The first part of the paper includes the review on both the Western and Traditional Chinese medical advancement of pulmonary interstitial fibrosis, the epidemiology , pathology, clinical manifestations, pulmonary function, blood gas, and imageology of chronic obstructive pulmonary emphysema organized with pulmonary interstitial fibrosis,as well as the introduction and apprehension of my tutor's academic thought.In the second part of the paper, The clinical data of 145 patients with pulmonary interstitial fibrosis in Dongzhimen Hospital from March 1996-March 2007 were reviewed and the distribution characteristics of secondary and idiopathic pulmonary interstitial fibrosis were obtained.The occupational exposure and the contiguous history of special material were analyzed to investigate the causes of pulmonary interstitial fibrosis. The results indicated that there was remarkable significance in the two analyzed aspects of secondary and idiopathic pulmonary interstitial fibrosis ,which could be explained by my professor's conception of etiological factor"environmental toxin".The survey showed that chronic obstructive pulmonary disease with pulmonary interstitial fibrosis played the most part in the secondary pulmonary interstitial fibrosis, and the sexuality , age of onset, course of disease, tongue demonstration, pulse tracings, features of clinical manifestations of the two groups were analyzed.It showed that deficiency of both qi and yin of the lung and kidney as well as sputum and stasis obstruction of collaterals was the main pathogenesis of the pulmonary interstitial fibrosis. and the basic principle of treating pulmonary interstitial fibrosis was reinforcing qi ,nourishing yin, dissipating sputum and unblocking collaterals.In the third part, 30 cases of chronic obstructive pulmonary disease with pulmonary interstitial fibrosis treated by reinforcing qi , nourishing yin ,dissipating sputum and unblocking collaterals were observed by way of randomised and positive drug paralleled comparison. The results showed that the treated group was obviously superior to the control group in the accumulated points of main symptoms and physical signs, (P <0.01); There was significant difference before and after the treatment in the treated group in the aspect of practical frequency of salbutamol, arterial blood gas analysis and pulmonary ventilation function, while there was no difference between the two groups(P >0.05 ); No significant difference was found(P>0.05)in forced vital capacity(FVC),FEV1 %,(FEV1 / FVC % )and diffusion function of lung(DLCO),although there was a tendency of amelioration in both the groups。It concluded that the method of reinforcing qi ,nourishing yin and unblocking collaterals could obviously relieve the clinical symptoms of chronic obstructive pulmonary disease with pulmonary interstitial fibrosis, decrease the doses of bronchodilatation medication, increase oxygen partial pressure of blood, lessen carbon dioxide retention and improve pulmonary ventilation function. It furthermore proved that deficiency of both qi and yin of lung and kidney as well as phlegm and stasis obstruction of collaterals was the main pathogenesis of chronic obstructive pulmonary disease. And the Chinese medicine had good effect in intervening pulmonary interstitial fibrosis.