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中医学习笔记:肺痈

  • 2026-01-08 06:14:07
中医学习笔记:肺痈

肺痈

概念：肺叶生疮，发生脓疡的一种病证，以咳嗽、胸痛、发热、咯吐腥臭浊痰，甚则脓血相兼为主要临床表现。注意：主症有咳嗽咯血。
病机：热伤肺气，蒸液成痰，热壅血瘀，血败肉腐。
病性：主要表现为邪盛得实热证候，脓疡溃破则见阴伤气耗之象。
病位：肺。
证型：

1、初期

症状：恶寒发热，咳嗽，咯白色黏痰，痰量日益增多，胸痛，咳则痛甚，呼吸不利，口干鼻燥，舌苔薄黄，脉浮数而滑。
治法：疏风散热，清肺化痰。
代表方：银翘散

2、成痈期

症状：身热转甚，时时振寒，继而壮热，汗出烦躁，咳嗽气急，胸满作痛，转侧不利，咳吐痰浊，呈黄绿色，自觉喉间有腥味，口干咽燥，舌苔黄腻，脉滑数。
治法：清肺解毒，化瘀消痈。
代表方：千金苇茎汤合如金解毒散，犀黄丸。

3、溃脓期

症状：咳吐大量脓血痰，或如米粥，腥臭异常，时有咯血，胸中烦满而痛，甚则气喘不能卧，身热面赤，烦渴喜饮，舌红苔黄腻，脉滑数或数实。
治法：排脓解毒
代表方：加味桔梗汤，桔梗白散

4、恢复期

症状：身热渐退，咳嗽减轻，咳吐脓痰减少，臭味亦淡，痰液转为清晰，食纳好转。或有胸胁隐痛，难以久卧，气短，自汗盗汗，午后潮热，心烦，口燥咽干，面色无华，形体消瘦，精神萎靡，舌红或淡红，苔薄，脉细或细数无力。
治法：益气养阴清肺
代表方：沙参清肺汤合竹叶石膏汤/桔梗杏仁煎
歌诀：（肺痈初成与溃恢）肺痈初期银翘散，成痈苇茎如解黄，溃脓加味桔梗白，恢复沙清桔竹安。
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  1. CONNECT:[ UseTime:0.000460s ] mysql:host=127.0.0.1;port=3306;dbname=no_67808;charset=utf8mb4
  2. SHOW FULL COLUMNS FROM `fenlei` [ RunTime:0.000821s ]
  3. SELECT * FROM `fenlei` WHERE `fid` = 0 [ RunTime:0.000255s ]
  4. SELECT * FROM `fenlei` WHERE `fid` = 63 [ RunTime:0.000227s ]
  5. SHOW FULL COLUMNS FROM `set` [ RunTime:0.000504s ]
  6. SELECT * FROM `set` [ RunTime:0.000187s ]
  7. SHOW FULL COLUMNS FROM `article` [ RunTime:0.000524s ]
  8. SELECT * FROM `article` WHERE `id` = 458810 LIMIT 1 [ RunTime:0.000381s ]
  9. UPDATE `article` SET `lasttime` = 1767899634 WHERE `id` = 458810 [ RunTime:0.001820s ]
  10. SELECT * FROM `fenlei` WHERE `id` = 65 LIMIT 1 [ RunTime:0.000211s ]
  11. SELECT * FROM `article` WHERE `id` < 458810 ORDER BY `id` DESC LIMIT 1 [ RunTime:0.000399s ]
  12. SELECT * FROM `article` WHERE `id` > 458810 ORDER BY `id` ASC LIMIT 1 [ RunTime:0.002954s ]
  13. SELECT * FROM `article` WHERE `id` < 458810 ORDER BY `id` DESC LIMIT 10 [ RunTime:0.001427s ]
  14. SELECT * FROM `article` WHERE `id` < 458810 ORDER BY `id` DESC LIMIT 10,10 [ RunTime:0.000677s ]
  15. SELECT * FROM `article` WHERE `id` < 458810 ORDER BY `id` DESC LIMIT 20,10 [ RunTime:0.000786s ]
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