中医杂志

总结王晞星教授从“五脏致咳”辨治免疫检查点抑制剂相关性肺炎（CIP）的临证经验。CIP以咳嗽为常见主症，基于“五脏致咳”认为药毒引动癌毒导致五脏失和，进而肺气宣降失常是其核心病机，治疗当调和五脏以恢复肺气正常宣降功能。临证可将CIP分为肺阴亏虚、肺脾两虚兼痰湿、肝火犯肺、肺肾阴虚四种证型，分别拟定柴麦金络润肺汤以滋阴润肺、芪桂培土化饮汤以健脾补肺兼化湿祛痰、柴丹疏郁润金汤以泻肝清肺、地脉金水相生汤以滋肾润肺。

This paper summarizes Professor WANG Xixing's clinical experience in treating immune checkpoint inhibitor-related pneumonitis(CIP) based on the theory of "cough attributed to the five zang （脏） organs". Cough is a common predominant symptom of CIP. According to the theory of "cough attributed to the five zang organs", drug toxicity triggers cancer toxin, leading to disharmony among the five zang organs, and then lung failing to diffuse and govern descent as the core pathogenesis. Therefore, treatment should focus on harmonizing the five zang organs to restore the normal function of lung qi to diffuse and govern descent. In clinical practice, CIP can be classified into four syn‑drome patterns, including lung yin depletion, deficiency of both the lung and the spleen with phlegm-dampness, liver fire harassing the lung, and lung-kidney yin deficiency. Correspondingly, Chaimai Jinluo Runfei Decoction （柴麦金络润肺汤） is used to nourish yin and moisten the lung; Qigui Peitu Huayin Decoction （芪桂培土化饮汤） is used to fortify the spleen and tonify the lung, resolve dampness and dispel phlegm; Chaidan Shuyu Runjin Decoction （柴丹疏郁润金汤） is used to drain liver and clear the lung; and Dimai Jinshui Xiangsheng Decoction （地脉金水相生汤） is used to nourish the kidney and moisten the lung.