基于“培土生金”法探讨COPD (脾肾两虚型)的临证推求
Study on Clinical Diagnosis of COPD (Deficiency of Spleen and Kidney) Based on the Method of “Reinforcing Earth (Spleen) to Generate Metal (Lung)”

慢性阻塞性肺疾病(Chronic Obstructive Pulmonary Disease, COPD)是一种以持续性气流受限为特征的可预防和治疗的疾病，气流受限呈进行性发展，其发病机制与氧化应激、炎症反应、自身免疫及蛋白酶–抗蛋白酶失衡有关。COPD常发生在中老年人群，“培土生金”法是徐学义教授在诊疗COPD的过程中总结出来的经验法则，经过长期的临床及实验研究发现“培土生金 ”法能够治疗气道炎症性疾病，它对脾肾两虚型COPD患者具有较好的疗效。徐学义教授是贵州中医药大学第一附属医院国医堂主任医师，从事临床、教学工作40余年，他主张“五行生化”理论，认为“培土生金”法对COPD疾病的治疗具有独特作用，在临床中运用广泛，笔者有幸拜入徐学义教授门下，在跟师学习过程中感受颇深，本文基于“培土生金”理论，结合徐学义教授对肺系疾病的辨证施治及用药特点，初步探讨运用“培土生金”法治疗COPD的临床新用。
Chronic obstructive pulmonary disease (COPD) is a preventable and treatable disease characterized by persistent airflow limitation, and its pathogenesis is related to oxidative stress, inflammatory response, autoimmunity and protease-antiprotease imbalance. COPD often occurs in middle-aged and elderly people. “Reinforcing earth (spleen) to generate metal (lung)” method is a rule of thumb summed up by Professor Xu Xueyi in the process of diagnosing and treating COPD. After long-term clinical and experimental research, it is found that “reinforcing earth (spleen) to generate metal (lung)” method can treat airway inflammatory diseases, and it has a good effect on COPD patients with spleen and kidney deficiency. Professor Xu Xueyi is the chief physician of the First Affiliated Hospital of Guizhou University of Chinese Medicine. He has been engaged in clinical and teaching work for more than 40 years. He advocates the theory of “five elements of biochemistry” and believes that “reinforcing earth (spleen) to generate metal (lung)” method has a unique role in the treatment of COPD disease and is widely used in clinical practice. Based on the theory of “reinforcing earth (spleen) to generate metal (lung)”, combined with Professor Xu Xueyi’s syndrome differentiation and medication characteristics of pulmonary diseases, this paper discusses the new clinical application of “reinforcing earth (spleen) to generate metal (lung)” in the treatment of COPD.