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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:

Jing Fang Datang Biao or Jing Fang Baidu Powder;

Wind-heat attacking exterior pungent and cool exterior Yinqiao powder or onion, black bean and orange stalk soup;

Summer dampness hurts the body, clearing away heat and relieving summer heat, eliminating dampness and relieving exterior syndrome, adding a new aromatic drink;

Su Shen decoction for qi deficiency and cold, benefiting qi and relieving exterior syndrome;

Yin deficiency and cold nature nourish yin and relieve exterior syndrome;

Mahuang Fuzi xixin Decoction is used for treating cold due to yang deficiency, and it can help 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. Treatment based on syndrome differentiation: wind-cold attacks the lung, dispersing wind and dispelling cold, and dispersing lung and relieving cough with San 'ao Decoction and Zhisou Powder;

Wind-heat invading lung, dispelling wind and clearing heat, dispersing lung and relieving cough, Sangju drink;

Wind dryness hurts the lungs, dispelling wind and clearing the lungs, moistening dryness and relieving cough. Mulberry soup or Su Xing powder;

Phlegm and dampness accumulate in lung, eliminate dampness and phlegm, regulate qi and relieve cough, Chen Erweiping powder, Sanzi Yangqin decoction;

Phlegm-heat stagnation, clearing away lung-heat and calming lung, resolving phlegm and relieving cough, and clearing gold and resolving phlegm decoction;

Liver fire invading lung, clearing lung and purging liver, resolving phlegm and relieving cough, Daige powder, Qin Huang Congbai powder;

Deficiency of lung yin, nourishing yin and moistening lung, resolving phlegm and relieving cough, Shashen Maidong 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:

interlude

Cold asthma, dispersing lung and dispelling cold, resolving phlegm and relieving asthma, shooting dry Mahuang decoction or Xiaoqinglong decoction;

Hot asthma, clearing away heat and dispersing lung, resolving phlegm, relieving asthma or Yuemecca Banxia decoction;

Cold-packed hot asthma, relieving exterior syndrome, dispelling cold, resolving phlegm and clearing heat, Xiaoqinglong plus gypsum soup or Houpu Mahuang soup;

Wind phlegm asthma? Sanzi Yangqin Decoction for expelling wind and resolving phlegm, lowering qi and relieving asthma;

Deficiency of asthma, tonifying lung and kidney, lowering qi and resolving phlegm, relieving asthma and consolidating this decoction;

Relieving asthma syndrome, tonifying lung and kidney, strengthening the body resistance, strengthening the body resistance and eliminating pathogenic factors, and restoring yang first aid soup or shengmai drink;

descend

Liujunzi decoction with deficiency of lung and spleen, invigorating spleen and qi, and benefiting soil and producing gold;

Dihuang decoction with deficiency of both lung and kidney, tonifying lung and kidney and promoting pulse, alloy water and 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, lung, lung cold? Mahuang decoction combined with Gai Hua powder;

External cold and lung heat relieve exterior and interior, expectorant and antiasthmatic Maxingshi dry soup;

Mulberry bark soup with phlegm-heat stagnation, clearing lung-heat, resolving phlegm, dispersing lung-heat and relieving asthma;

Phlegm and turbidity block the lung, reduce phlegm and reverse, and promote lung and relieve asthma with Erchen decoction and Sanzi Yangqin decoction;

Stagnation of lung qi can relieve depression and reduce qi, relieve asthma and grind five drinks;

Zhenwu decoction for warming heart and promoting diuresis, purging lung and relieving asthma combined with Zanzibar jujube and purging lung decoction;

Deficiency asthma

Does lung qi deficiency consume lung qi and nourish yin? Shengmai powder combined with Bufei decoction;

Kidney deficiency does not collect kidney qi? Jinkui Shenqi Pill and Shen Ge Powder;

Asthma deficiency, strengthening yang and strengthening the body, taking Zhenshe Shenqi Shenfu Decoction, taking 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:

Drink Xiaoqinglong decoction to warm the lungs and dispel cold, and the external cold will reduce the adverse flow and resolve phlegm;

Suzi Jiangqi Decoction combined with Sanzi Yangqin Decoction, which can block lung by phlegm, reduce phlegm and qi, strengthen spleen and benefit lung;

Phlegm-heat stagnation, clearing away lung-heat, resolving phlegm, lowering adverse qi and relieving asthma, and adding Banxia decoction or Mulberry bark decoction;

Phlegm is fascinating, clearing phlegm, inducing resuscitation and calming the wind? Ditan decoction combined with angong Niuhuang pill or zhibaodan;

Phlegm and blood stasis block lung, resolve phlegm and remove blood stasis, purge lung and relieve asthma, jujube Xie Fei decoction combined with Guizhi Fuling pill;

Yang deficiency, water temperature, kidney and spleen strengthening, drinking Lishui Zhenwu decoction and Wuling powder;

Deficiency of both lung and kidney, tonifying lung and kidney, lowering qi and relieving asthma, Shen Ge Sanhe Buxu Decoction or Pingchuan Guben Decoction combined with Bufei Decoction.