Professor Xue Hanrong's Clinical Experience In Differentiating And Treating Bronchiectasis

Purpose:From the aspects of etiology,pathogenesis,differentiation,syndrome differentiation and treatment,medication experience and treatment points of traditional Chinese medicine,this paper summarizes the more perfect experience of the tutor in treating bronchiectasis.Methods:Based on the classical books of traditional Chinese medicine,this paper summarizes them through clinical study,collection and analysis of the tutor's medical records,combined with the related works and literature of the tutor.Result:1.In terms of etiology and pathogenesis,the root is qi and yang deficiency,the branch is phlegm,dampness,heat,blood stasis and cold evil,which can be further transformed.For example,heat injures fluid and becomes dry,or liver depression becomes fire,or cold mainly has the nature of convergence and leads toretained fluid,or dampness injures body's yang qi and leads to yang deficiency,or overstrain causing qi deficiency,or deficiency of body fluid and psychological overstrain leads to blood deficiency.In the acute stage,stagnation of phlegm-heat is the premise of damaging Yin due to phlegm-heat,damaging Yin due to phlegm-heat is the precursor of stagnation of phlegm-heat and blood stasis,and blocking pathogenic Qi on the body surface can aggravate stagnation of heat;in thechronic stage,deficiency of the lung is the main cause,and finally the deficiency of the lung,spleen and kidney.2.The idea of differentiating the qi and blood of lung,the exterior and interior of lung,and the lung from other viscus and meridians was put forward.3.According to the acute stage and chronic stage to treat by stages.In the acute stage with interior syndrome as the main type,the syndrome of phlegm-heat stagnation of lung is treated with Qingqi-phlegm decoction,the syndrome of phlegm-heat injury of Yin is treated with Qingjin Huatan decoction,the syndrome of phlegm-heat and blood stasis is treated with Qianjin Weigan decoction,the syndrome of liver-fire and lung-heat is treated with Huangqin Xiebai powder and Daige powder,and the syndrome of qi deficiency without blood intake is treated with Shenling Baizhu powder plus other medicines with Qi-invigorating and astringency and hemostasis;in the acute stage of exterior and interior syndromes,the symptoms of wind on the exterior and heat on the interior are treated with Maxing Shigan decoction and Qingjin Huatan decoction or Qingjin Huatan decoction,the symptoms of cold on the exterior and heat on the interior are treated with Xiaoqinglong Jiagypsum decoction or Dingchuan decoction;in the chronic period with interior syndrome as the main type,the syndrome of deficiency of lung and spleen is treated with Shenling Baizhu powder or Linggui Zhugan decoction or Shashen Maidong decoction,the syndrome of Qiyang weakness is treated with Yiqi Wenyang Huwei decoction,the syndrome of blood stasis and Qi depression is treated with Guizhi Fuling pill plus Xingqi medicine,the syndrome of blood deficiency and Yangfu is treated with Suanzaoren Decoction plus Qianyang medicine;in the chronic stage of exterior and interior symptoms,the syndrome of Qi deficiency combined with interior symptom is treated with Maxing Shenling Baizhupowder,and the syndrome of Qiyang deficiency combined with superficial symptom is treated with Maxing Buyuan decoction.4.Traditional Chinese medicine is selected and applied according to the level of qi and blood.The medicines with qi intake are ephedra or platycodon grandiflorum with almonds,magnoliae with xanthium;the medicines with blood intake are agrimony with sophora japonica or rhizoma impatiens,sanguisorba officinalis with cattail pollen;the medicines with both qi and blood intake are houttuynia cordata with buckwheat,radix asteris with flos farfarae,folia perillae acutae with perilla seed.5.The tutor is good at using the therapeutic method of reinforcing earth to generate metal and removing dampness to dispel the lingering dampness evil,soothing and clearing liver to prevent stagnation of liver-qi and removing blood stasis,the method of clearing heat and supplementing qi is more than enough to prevent qi from turning into fire,the method of dispersing and supplementing qi to prevent evil qi from closing the exterior and turning into heat,and the method of lifting and supplementing qi to prevent stagnation of yang-qi.Conclusion:1.The etiology and pathogenesis of bronchiectasis are as follows:phlegm,dampness,heat,blood stasis and cold are the main pathogenic factors in acute stage;Qi-Yang deficiency is the main pathogenic factor in chronic stage,which can lead to the deficiency of lung,spleen and kidney.2.Treating by stages,taking the deficiency and excess of exterior and interior as the outline and the syndrome differentiation of zang-fu organs as the objective.Emphasis should be laid on sorting medicines according to qi and blood,and using the methods of reinforcing earth to generate metal,soothing and clearing liver,clearing and tonifying,propagating and tonifying,and promoting and tonifying to improve clinical efficacy.