[1]白月洁,王子涵,李传乾,等.基于“阴病发于肉”理论分期辨治慢性持续期哮喘[J].陕西中医,2026,(4):507-511.[doi:DOI:10.3969/j.issn.1000-7369.2026.04.014]
　BAI Yuejie,WANG Zihan,LI Chuanqian,et al.Staged treatment based on pattern differentiation for chronic persistent asthma guided by the theory of “Yin diseases originating from the flesh”[J].,2026,(4):507-511.[doi:DOI:10.3969/j.issn.1000-7369.2026.04.014]
点击复制

基于“阴病发于肉”理论分期辨治慢性持续期哮喘

《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2026年4期
页码:
507-511
栏目:
学术探讨
出版日期:
2026-04-05

文章信息/Info

Title:
Staged treatment based on pattern differentiation for chronic persistent asthma guided by the theory of “Yin diseases originating from the flesh”
作者:
白月洁1; 王子涵2; 李传乾1; 李睿1; 宋爽1; 朱雪3; 张心月1
（1.山东中医药大学，山东 济南 250355；2.首都医科大学附属北京友谊医院，北京 100050；3.山东中医药大学附属医院，山东 济南 250014）
Author(s):
BAI Yuejie1; WANG Zihan2; LI Chuanqian1; LI Rui1; SONG Shuang1; ZHU Xue3; ZHANG Xinyue1
（1.Shandong University of Traditional Chinese Medicine,Jinan 250355，China；2.Beijing Friendship Hospital,Capital Medical University,Beijing 100050，China；3.Affiliated Hospital of Shandong University of Traditional Chinese Medicine，Jinan 250014，China）
关键词:
支气管哮喘; 阴病发于肉; 慢性持续期; 气道重塑; 分期辨治; 痰瘀互结
Keywords:
Bronchial asthma; Yin diseases originate in the flesh; Chronic persistent stage; Airway remodeling; Staged diagnosis and treatment; Phlegm-stasis interaction
分类号:
R 256.12
DOI:
DOI:10.3969/j.issn.1000-7369.2026.04.014
文献标志码:
A
摘要:
基于“阴病发于肉”理论，探讨慢性持续期哮喘的病机演变与分期辨治体系。慢性持续期哮喘属中医学“哮病”范畴，其病机迁延、症状反复，病变深及气道肌肉腠理，与“阴病发于肉”的理论内涵相符。文章首先梳理该理论的渊源与内涵，拓展“肉”的范畴至气道腠肉，阐明其与脾肺经络的关联；进而提出慢性持续期哮喘“发于肉”的三期分型：初期为湿浊困肉证，以气道肌肉挛急、黏膜水肿为主；中期为痰瘀痹肉证，痰瘀互结致气道肌肉肥厚与重塑；后期为虚风动肉证，因气阴两虚、虚风内动而气道失濡拘急。针对各期病机，构建相应的辨治框架：初期以化湿运脾、解痉舒肉为主，方用三拗汤合二陈汤加减；中期治以涤痰祛瘀、散结通肉，方选血府逐瘀汤合三子养亲汤化裁；后期则益气滋阴、息风定肉，以玉屏风散合生脉散为基础方随症加减。旨在通过“形气同治”的辨证思路，丰富慢性持续期哮喘的中医治疗理论，为临床提供新的辨治路径。
Abstract:
Based on the theory of “Yin diseases originate in the flesh”,this article explores the pathogenesis progression and staged diagnosis and treatment system for chronic persistent asthma.Chronic persistent asthma falls under the category of “asthmatic disease” in traditional Chinese medicine (TCM).Its pathogenesis is prolonged,symptoms are recurrent,and the pathological changes deeply involve the muscles and interstices of the airways,which aligns with the theoretical connotation of “Yin diseases originate in the flesh”.The article first reviews the origin and implications of this theory,expanding the concept of “flesh” to include the muscle and interstitial tissues of the airways and clarifying their relationship with the spleen and lung meridians.It then proposes a three-stage classification of chronic persistent asthma based on the theory of “originating in the flesh”.The early stage is characterized by damp-turbidity encumbering the flesh,primarily manifesting as airway muscle spasm and mucosal edema.The middle stage involves phlegm-stasis obstructing the flesh,where phlegm and stasis interact leading to airway muscle hypertrophy and remodeling.The late stage is marked by deficiency-wind agitating the flesh,resulting from dual deficiency of Qi and Yin and internal stirring of deficiency-wind,causing loss of moistening and contracture of the airways.Corresponding diagnostic and therapeutic frameworks are constructed for each stage:in the early stage,the focus is on resolving dampness,fortifying the spleen,relieving spasm,and relaxing the flesh,primarily using modified San’ao Tang and Erchen Tang.In the middle stage,the treatment aims to expel phlegm,remove stasis,dissipate nodules,and unblock the flesh,mainly using modified Xuefu Zhuyu Tang and Sanzi Yangqin Tang.In the late stage,the strategy involves boosting Qi,nourishing Yin,extinguishing wind,and stabilizing the flesh,using modified Yupingfeng power and Shengmai power as the base formulas.This article aims to enrich the TCM treatment theory for chronic persistent asthma and provide a new diagnostic and therapeutic pathway for clinical practice through the dialectical approach of “simultaneously treating form and Qi”.

参考文献/References:

[1]施姣,肖维,周新哲.哮喘患儿血清FSTL1、ANGPTL4表达及临床意义[J].陕西医学杂志,2025,54(12):1703-1706，1716.
[2]刘温丽,史艳平,张金虎.支气管哮喘的中医研究进展[J].陕西中医,2018,39(6):812-814.
[3]周妍,张旻.中国《支气管哮喘防治指南（2024年版）》解读[J].诊断学理论与实践,2025,24(4):415-422.
[4]朱子童,晏军.基于“脾为之卫”理论探讨支气管哮喘之病机演变及分期辨证论治[J].中国医药导报,2025,22(31):132-135，141.
[5]李凯,兰瑞恒,吕明圣,等.基于痰气病机从肺脾同调防治支气管哮喘[J].中国中医基础医学杂志,2025,31(3):529-532.
[6]董宝强,张峰,富昱,等.论足太阴经络与三焦系统的关系[J].中华中医药学刊,2023,41(6):6-9.
[7]谢程,王和生,刘兰英,等.针灸治疗慢性持续期哮喘的临床选穴规律分析[J].中医临床研究,2021,13(26):22-26.
[8]彭青春.常用中医外治法防治支气管哮喘缓解期的现代文献研究[D].长沙：湖南中医药大学,2021.
[9]牛宏田,薛小娜,胡可馨,等.基于“阴病治阳”理论探讨推拿手阳明大肠经治疗膝骨关节炎经验[J].北京中医药,2025,44(10):1355-1358.
[10]黄舒然,姚宏凤,丁海拔,等.参苓白术散联合沙美特罗氟替卡松治疗支气管哮喘慢性持续期疗效及对患者机体氧化-抗氧化平衡的影响[J].陕西中医,2023,44(6):730-733，737.
[11]于国竞,李杰,于汶仟,等.从“卫虚脏损”论治慢性气道炎症性疾病中的激素抵抗[J].环球中医药,2025,18(9):1865-1868.
[12]于国竞,李杰,于汶仟,等.从“痰湿内停、三焦失司”探讨线粒体功能障碍与支气管哮喘的关系[J].湖北中医药大学学报,2024,26(6):53-56.
[13]王旭辉,孙英,胡海波,等.从湿论治支气管哮喘探析[J].光明中医,2023,38(1):60-63.
[14]李冀,邓夏烨,胡晓阳,等.基于“肥人多痰湿”理论探讨肥胖型哮喘的辨治特点[J].中医药学报,2021,49(5):61-64.
[15]邢琼琼,周荣易,席乐迎,等.宿根理论在哮喘病机中的应用[J].南京中医药大学学报,2024,40(6):645-652.
[16]李可可,吴亚萍,柯诗文,等.国医大师洪广祥基于“血不利则为水”治疗支气管哮喘经验浅析[J].中华中医药杂志,2025,40(5):2184-2187.
[17]辛玲杰,贾新华.从痰瘀阻络探讨哮喘小气道病变的机制及治疗[J].山东中医杂志,2022,41(8):823-826，852.
[18]杨敏,戴和森,黄平富.双样本孟德尔随机化研究哮喘与气虚表型的相关性[J].中医临床研究,2025,17(20):1-10.
[19]张延君,刘菊,孔祥才,等.三拗汤联合沙丁胺醇对咳嗽变异型哮喘患者的临床疗效[J].中成药,2023,45(12):3954-3958.
[20]谢亚丽.小青龙加石膏汤合二陈汤对慢性支气管哮喘的影响[J].黑龙江医药科学,2022,45(3):136-137.
[21]弓雪峰,崔红生,陈秋仪,等.血府逐瘀汤治疗胸闷变异性哮喘的临床运用探析[J].中国中医基础医学杂志,2023,29(4):660-662，671.
[22]李磊,董延妍,李媛,等.基于气血-自噬功能关系探讨调理气血恢复自噬功能治疗慢性阻塞性肺疾病[J].辽宁中医药大学学报,2025,27(8):29-34.
[23]卢利莎,朱雪妮,蔡晓平.三子养亲汤联合沙美特罗替卡松治疗支气管哮喘疗效观察及对小气道功能的影响[J].新中医,2025,57(12):44-48.
[24]程思益,张志杰,张诗瑜,等.基于GRADE证据质量评级的玉屏风散治疗支气管哮喘系统评价[J].中国中医基础医学杂志,2025,31(4):678-684.
[25]李斌武,马彦俏,冯卿.加味生脉散联合铺灸法治疗慢性持续期肥胖型哮喘临床研究[J].新中医,2024,56(15):19-23.

相似文献/References:

[1]吕明辉,贾艳平,元国红.清热涤痰定喘汤联合穴位贴敷治疗儿童支气管哮喘安全性及疗效分析[J].陕西中医,2019,(1):25.
　LV Minghui,JIA Yanping,YUAN Guohong..Safety and efficacy of Qingre Ditan Dingchuan decoction combined with acupoint sticking in the treatment of bronchial asthma in children[J].,2019,(4):25.
[2]李红芬,毕玲莉,张茂华.小青龙汤联合糖皮质激素对支气管哮喘患儿气道重塑 及相关炎症因子的影响[J].陕西中医,2019,(5):631.
　LI Hongfen,BI Lingli,ZHANG Maohua..Effects of Xiaoqinglong decoction combined with glucocorticoid on airway remodeling and related inflammatory factors in children with bronchial asthma[J].,2019,(4):631.
[3]唐徐韵,陈盼碧△.穴位埋线治疗支气管哮喘的实验研究探讨*[J].陕西中医,2019,(12):1789.
[4]冷 静,王艳梅,李 慧△.理肺化瘀方治疗支气管哮喘疗效及对患者血清内IgG、IgA、IgM的变化研究*[J].陕西中医,2020,(5):618.[doi:DOI:10.3969/j.issn.10007369.2020.05.018]
　LENG Jing,WANG YanMei,LI Hui..Lifei Huayu decoction in the treatment of bronchial asthma and the change of serum IgG,IgA,IgM in patients[J].,2020,(4):618.[doi:DOI:10.3969/j.issn.10007369.2020.05.018]
[5]王兰香,李卫红,周 瑾,等.消积豁痰汤加减联合糖皮质激素治疗老年支气管哮喘临床研究[J].陕西中医,2021,(6):724.[doi:DOI:10.3969/j.issn.1000-7369.2020.06.011]
[6]何 蕊,程玉峰,李艳彬.射干麻黄汤加减对支气管哮喘疗效及患者炎症反应的影响[J].陕西中医,2021,(9):1211.[doi:DOI:10.3969/j.issn.1000-7369.2020.09.015]
　HE Rui,CHENG Yufeng,LI Yanbin.Effect of modified Shegan Mahuang decoction on bronchial asthma and inflammation[J].,2021,(4):1211.[doi:DOI:10.3969/j.issn.1000-7369.2020.09.015]
[7]高 辉,刘 恭,韩仙菊.黄芩素上调miR-625-5p表达干预支气管哮喘小鼠的机制研究[J].陕西中医,2022,(7):838.[doi:DOI:10.3969/j.issn.1000-7369.2022.07.005]
　GAO Hui,LIU Gong,HAN Xianju.The mechanism of baicalein up-regulating miR-625-5p expression in bronchial asthma mice[J].,2022,(4):838.[doi:DOI:10.3969/j.issn.1000-7369.2022.07.005]
[8]孟玲玉,黄 燕,包海鹏,等.加味过敏煎对支气管哮喘大鼠嗜酸性粒细胞凋亡及Fas、Bcl-2调节作用的研究[J].陕西中医,2023,(5):562.[doi:DOI:10.3969/j.issn.1000-7369.2023.05.004]
　MENG Lingyu,HUANG Yan,BAO Haipeng,et al.Research of Jiawei Guomin decoction on eosinophil apoptosis and the regulation mechanism of Fas,Bcl-2 in bronchial asthma rats[J].,2023,(4):562.[doi:DOI:10.3969/j.issn.1000-7369.2023.05.004]
[9]王 伟,马丽华,鞠 上.投杯汤治疗支气管哮喘疗效及对患者气道重塑和气道炎症的影响[J].陕西中医,2023,(8):1047.[doi:DOI:10.3969/j.issn.1000-7369.2023.08.011]
　WANG Wei,MA Lihua,JU Shang.Effect of Toubei decoction on bronchial asthma and its influence on airway remodeling and inflammation[J].,2023,(4):1047.[doi:DOI:10.3969/j.issn.1000-7369.2023.08.011]
[10]季雅楠,田春燕,郭丹丹,等.基于PI3K/Akt信号通路探讨中医药治疗支气管哮喘研究进展[J].陕西中医,2023,(12):1827.[doi:DOI:10.3969/j.issn.1000-7369.2023.12.036]
　JI Yanan,TIAN Chunyan,GUO Dandan,et al.Progress in the treatment of bronchial asthma with traditional Chinese medicine based on PI3K/Akt signaling pathway[J].,2023,(4):1827.[doi:DOI:10.3969/j.issn.1000-7369.2023.12.036]

备注/Memo

备注/Memo:
国家自然科学基金资助项目(82104799)
更新日期/Last Update: 2026-04-05