202 1 key examination center of traditional Chinese medicine: lung disease in internal medicine of traditional Chinese medicine

Internal medicine of traditional Chinese medicine is a clinical discipline that expounds the etiology, pathogenesis, syndrome differentiation and treatment, prognosis and rehabilitation of internal medicine diseases through the theory of traditional Chinese medicine and clinical thinking methods of traditional Chinese medicine. It plays a bridge role between the basic theory of traditional Chinese medicine and clinical disciplines. The basic theoretical knowledge of TCM can only be deeply understood and mastered in the teaching and clinical practice of TCM internal medicine; All clinical disciplines of traditional Chinese medicine must be based on internal medicine of traditional Chinese medicine, so as to be better familiar with the characteristics and skills of this discipline and be applied to clinic more flexibly. Therefore, the internal medicine of traditional Chinese medicine is the most important thing in the current examination and future clinic.

Over the years, the score of pulmonary diseases and syndromes in examinations was about 16, accounting for about 19%. It is necessary to examine the etiology and pathogenesis, historical evolution, key points of syndrome differentiation, disease differentiation, syndrome differentiation and prescription, similar syndrome and prescription or the differentiation of the same disease. Key examination: cough, asthma, asthma, lung carbuncle. We are here to summarize the important knowledge points of key diseases, hoping to help everyone.

First of all, catching a cold

1. Song? Ren Zhai Zhi Fang was first put forward? A cold? The name of the disease.

2. Etiology and pathogenesis: wind pathogen is the main cause, and the pathogenesis is the instability of lung and Wei, and the loss of balance between Wei and Wei.

3. Location: Rowen.

4. Treatment based on syndrome differentiation:

Wind-cold bundle table? Warming the heart and relieving exterior syndrome: Jing Fang Datang Biao or Jing Fang Baidu Powder;

Wind and heat violate the table? Chill and remove Yinqiao powder or onion, black bean and orange stalk soup;

Summer-dampness injury table? Clearing summer heat and removing dampness? Add a new mellow drink;

Qi deficiency and cold? Yiqi Jiebiao Shensu Drink;

Yin deficiency and cold? Ziyin Jiebiao decoction;

Yang deficiency and cold? Mahuang Fuzi Asarum Decoction helps yang to relieve exterior syndrome.

Second, cough.

1. In the Book of Clear Moon, Zhang Jingyue divided cough into two categories: external factors and internal injuries.

2. External factors: exogenous pathogenic factors such as wind-cold or wind-heat, or inhalation of smoke, pollen, animal dander, odor gas, etc.

3. Internal factors: improper diet, overeating and cold, or eating sour, salty and sweet fat, or eating seaweed hair; Emotional stimulation; Weak body (mostly kidneys), or weak after illness (mostly lungs).

4. Pathogenesis: evil is committed in the lung, the lung fails to publicize, and the lung qi goes up.

5. Location of disease: lung, which is related to liver, spleen and kidney for a long time.

6. Treatment principle: the treatment of exogenous cough should be based on eliminating evil and benefiting the lungs, and evil is safe. Drug use should be handled lightly, and it is necessary to guide the situation and spread the lung qi. Generally, exogenous cough should be avoided, and astringent drugs should not be used prematurely. Pay attention to phlegm and qi, and phlegm will be qi.

7. Syndrome Differentiation and Treatment: Cold attacking the lungs? Dispelling wind and cold, dispersing lung and relieving cough? Third, soup combined with cough relieving powder;

Wind-heat invading the lungs? Dispelling wind and clearing heat, dispersing lung and relieving cough? Mulberry chrysanthemum beverage;

Wind dryness hurts the lungs? Dispelling wind and clearing lung, moistening dryness and relieving cough? Mulberry soup or Su Xing powder;

Phlegm and dampness accumulate in the lungs? Dry phlegm, regulate qi and relieve cough? Chen Erweiping mixed Sanzi Yangqin decoction;

Phlegm-heat stagnation in lung? Clearing heat and dispersing lung, resolving phlegm and relieving cough? Jinqing Huatan Decoction;

Liver qi and lung qi? Clearing lung and purging liver, resolving phlegm and relieving cough? Daijie powder combined with Qin Huang Allium macrostemon powder;

Lung yin deficiency? Nourishing yin and moistening lung, resolving phlegm and relieving cough? Radix Adenophorae and Radix Ophiopogonis Decoction.

Third, asthma.

1. Zhu Danxi pioneered the name asthma. Put forward? Are you in a hurry to attack evil spirits instead of righting them? .

2. Pathogenesis: phlegm is the root of rewelding, phlegm blocks the airway, and the lung loses function.

3. Location of disease: mainly in lung, closely related to spleen and kidney.

4. Pathological factors: phlegm is the main factor, and phlegm is stored in the lungs.

5. Incentives: such as climate, diet, mood, fatigue, etc. , especially climate change. In Qing Dynasty, Li Zhongzi summarized the main points of asthma as? Is there a feeling that the outside is out of date, the inside is choking and the diaphragm is sticky with phlegm? .

6. Identification: wheezing refers to vocal speech, and wheezing in the throat can be heard during the attack; Asthma refers to breathing, mainly dyspnea. Wheezing must be accompanied by wheezing, but wheezing is not necessarily accompanied by wheezing.

7. Treatment based on syndrome differentiation:

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Cold asthma, dispersing lung and dispelling cold, resolving phlegm and relieving asthma? Shegan Mahuang Decoction or Xiaoqinglong Decoction;

Hot asthma, clearing heat and dispersing lung, resolving phlegm and relieving asthma? Dingchuan decoction or Yuemaifu plus Banxia decoction;

Cold bag and hot asthma? Relieve exterior, dispel cold, resolve phlegm and clear heat? Xiaoqinglong plus gypsum soup or Houpu Mahuang soup;

Wind phlegm and asthma? Sanzi Yangqin Decoction;

Can deficiency asthma tonify lung and kidney, reduce qi and eliminate phlegm? Pingchuan Guben decoction;

Asthma out of danger syndrome? Tonifying the lung and kidney, strengthening the body resistance and consolidating the foundation? Huiyang first-aid soup or Shengmai drink;

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Deficiency of lung and spleen? Strengthening the spleen and benefiting qi, supplementing the soil and producing gold? Six gentlemen's soup;

Deficiency of lung and kidney? Bufei Yishen? Shengmai Dihuang decoction combined with Liu Jun decoction.

Fourth, asthma syndrome.

1. Jing Yue Quan Shu classifies asthma as deficiency and excess, and puts forward a syndrome differentiation program for asthma. ? People with asthma are evil, and evil spirits are also real; Asthma due to deficiency is innocent, so is Yuan Qi's deficiency. ?

2. Location of disease: mainly in lung and kidney, involving liver and spleen.

3. Pathological nature: Asthma with excess is in lung, while asthma with deficiency is responsible for lung and kidney.

4. In the severe stage of asthma syndrome, not only the lung and kidney are deficient, but also the heart is often involved when the solitary yang is about to take off. The face, lips and nails are blue and purple, and even serious situations such as sweating, yin death and yang death appear.

5. Treatment: relieving asthma and treating lung, mainly eliminating evil and benefiting qi; Deficiency asthma is treated in lung and kidney, mainly nourishing and absorbing.

6. Treatment based on syndrome differentiation:

Empirical dyspnea

Cold and lungs? Xuanfei Sanhan Mahuang Decoction combined with Gai Hua Powder;

Exterior cold and lung heat? Clearing exterior and interior, resolving phlegm and relieving asthma? Maxingshi dry soup;

Phlegm-heat stagnation in lung? Clearing heat and resolving phlegm, dispersing lung and relieving asthma? Mulberry bark soup;

Turbidity blocking lung? Resolving phlegm, lowering inverse, dispersing lung and relieving asthma? Erchen decoction combined with Sanzi Yangqin decoction;

Lung qi stagnation? Open depression and reduce qi, relieve asthma and grind five drinks;

Water drinks soul? Warming yang and promoting diuresis, purging lung and relieving asthma? Zhenwu decoction and jujube Xie Fei soup;

Deficiency asthma

Lung qi deficiency and consumption? Bufei Yiqi Yangyin? Shengmai powder combined with Bufei decoction;

Kidney deficiency is not good? Bushen Qina Jinkui Shenqi Pill and Shen Ge Powder;

Are you panting? Help the yang to take off and revitalize the society? Shenfu soup with black tin and gecko powder.

Five, lung distension

1. Concept: Pneumonia is a disease in which many chronic lung diseases recur and persist, resulting in fullness and inability to converge. The clinical manifestations are chest fullness, chest tightness, shortness of breath, cough with excessive phlegm, irritability, palpitation, dull complexion, cyanosis of labia, abdominal distension, edema of limbs and so on. In severe cases, severe syndromes such as coma, convulsion, bleeding and asthma may occur.

2. Basic pathogenesis: deficiency of essence in excess of substance, deficiency of lung, kidney, heart and spleen as the basis, phlegm and blood stasis as the basis, mutual influence, mutual cause and effect, induced by exogenous pathogenic factors, leading to airway congestion, lung flatulence, unable to converge, resulting in flatulence. The key is that the lungs are full and cannot converge. Spleen and kidney are involved for a long time and affect the heart in the later stage.

3. Treatment based on syndrome differentiation:

Drinking in the cold? Warming the lungs and dispelling cold, lowering the inverse and resolving phlegm? Xiaoqinglong decoction;

Phlegm turbid lung? Eliminating phlegm and reducing qi, invigorating spleen and benefiting lung? Suzi Jiangqi Decoction combined with Sanzi Yangqin Decoction;

Phlegm-heat stagnation in lung? Clearing lung and resolving phlegm, lowering adverse qi and relieving asthma? Adding Banxia decoction or Mulberry bark decoction into Yueniang;

Too much phlegm? Huatan Kaiqiao, Xifeng Ditan Decoction combined with Angong Niuhuang Pill or Zhibaodan;

Phlegm and blood stasis blocking lung? Eliminating phlegm and removing blood stasis, purging lung and relieving asthma? Granule jujube Xie Fei decoction combined with Guizhi Fuling pill;

Yang deficiency and flooding? Warming kidney and strengthening spleen, drinking water? Zhenwu decoction combined with Wuling powder;

Qi deficiency of lung and kidney? Tonifying lung and kidney, reducing qi and relieving asthma? Shen Ge Sanhe Buxu Decoction or Pingchuan Guben Decoction combined with Bufei Decoction.