从三焦气化理论探析特发性炎性肌病合并肺间质病变中医病机与治法
[关键词]特发性炎性肌病；肺间质病变；三焦气化；肺络痹阻；痰瘀；病机 [中图分类号]R255.6；R256.1 [文献标志码]A [文章编号]doi：10.3969/j.issn.1674-070X.2025.11.021
TCM pathogenesis and therapeutic methods of idiopathic inflammatory myopathy complicated with interstitial lung disease from the perspective of sanjiao qi transformation theory
GAO Jing， JI Wei* Affiliated Hospital of Nanjing University of Chinese Medicine，Nanjing， Jiangsu 21oo29， China
[Abstract]Basedonthesanjiaoqi transformationtheory，thisstudyexplores theetiologyandpathogenesisofidiopathic inflammatorymyopathycomplicatedwithintersitiallungdiseasefromtheperspectiveofTCM.Itisbelievedthattherootliesin thedeficiencyfteung，spleenandideyhileeanifestatiosaeharacedyeecsiveaccuulaionofeg， bloodstasis，andheat-toxinSincesanjaoisthechannelforthecirculationofqi，blood，andbodyfluids，itsimpairedqi transformationfunctioncanleadtoaviciousccleofpegm，bloodsasis，andheattoxin，whichbstructsthelateralvelsf thezang-fuorgansandtisses，therebyexacerbatingthedisease.Theqitransformationof thesanjiaoiscloselyrelatedtolung function：impaireddifusionintheupperjiaoresultsinlungqistagnationanddisharmonybetweentheYing-nutrientsandWeidefence;impairedtransportationinthemiddlejiaoleadstospleendeficiencydampnessretention，andendogenousphlegm production;andimpairedcontainmentinthelowerjiaocauseskidneyfailingintoreceiveqiandupwardqirebelion.Taking diseaseprogresionastheaxis，idiopathicinflammatorymyopathycomplicatedwithinterstiallungdiseaseisdividedintoree stages：theinflammatorystage，thefibroustissueproliferationstage，andthepulmonaryinterstitialfibrosisstage.Consideringthe dynamicevolutionofthepathogenesisanddiseaseprogresion，acomprehensiveanalysisproposesthefollowingtreatment principles：ineifammatorystage，cearingatanddetoxifing，aswellasdispersinglungqiandelimnatingpatogenicfactor， shouldbeprioritized;inthefibroustisseproiferationstage，removing bloodstasisandresovingphlegm，alongwithclearngnd unblockingthelungcoaterals，arerecommended;andinthepulmonaryinterstialfibrosisstage，dispersingaccuulatins， unblockingobstructioandtonifingtelungandidneyareadvisedMreover，troughoutthetreatmentproes，itisucialto closelymonitorthkeypathologicalfactorsofdeficiencyplegm，bloodstasis，andheattoxinimingtoestorethesmoothfloof sanjiao and regulate the overall qi movement in the body.
[Keywords]idiopathicinflammatorymyopathy;nterstitiallungdisease；sanjiaoqitransformation;lungcolateralobstruction; phlegm and blood stasis; pathogenesis
特发性炎性肌病（idiopathicinflammatorymy-opathies，IM）是一组以四肢近端对称性肌无力、肌痛伴或不伴特异性皮疹为主要临床特征的系统性自身免疫性疾病，可累及全身多脏器系统，其中肺间质病变（intersititial lung disease，ILD）是IIM累及肺脏最常见的临床表现。（剩余10177字）
