中医杂志

探讨应用四妙丸加减治疗肺结节的临证经验。认为肺结节的产生以脾胃内伤为本，湿热弥散，氤氲体内为核心病机特点，湿热瘀搏结而酿成有形实邪，而调治肺结节的根本在于改善机体“湿、热、瘀”内环境，纠正患者偏颇体质。四妙丸可发挥清热燥湿、泄浊解毒、活血利水通经之效，化肺结节湿热瘀血结聚之有形实邪。同时重视补土生金、顾护脾胃、解毒散结，临证灵活化裁，共同消除肺结节形成和发展的病理因素，防止向恶性疾病发展，为临床从清热祛湿角度辨治肺结节提供思路。

This paper discussed the clinical experience of using Simiao Pills(四妙丸) modifications in treatment of pulmonary nodules. It is believed that the generation of pulmonary nodules is rooted in the internal damage of spleen and stomach, while the diffusion of damp-heat in the body is the core pathogenesis, and the contention and binding of damp, heat and stasis leads to the formation of tangible excess pathogen. The fundamental principle for regulating pulmonary nodules is to improve the internal environment of “damp, heat and stasis” of the body and correct the patients' unbalanced constitution. Simiao Pills has the function of clearing heat and drying dampness, purging turbidity and resolving toxins, activating blood, promoting urination and unblocking channels and can be used to dispel the tangible excess pathogen which is induced by the dampness-heat and blood stasis accumulation in pulmonary nodules.It is also advised to put focus on banking up earth to generate metal, protecting the spleen and stomach, resolving toxins and dissipating masses, and to adjust the formula flexibly according to the syndromes. All these mentioned above together can eliminate the pathological factors of the formulation and development of pulmonary nodules, and prevent the progression into malignant diseases, thereby providing a new idea for the clinical differentiation and treatment of pulmonary nodules from the perspective of clearing heat and dispelling dampness.