Professor Zhang Shukan 's Clinical Experience In Treating Pulmonary Interstitial Fibrosis

Objective:Pulmonary interstitial fibrosis (PIF) was one of the complicated diseases listed by the world health organization (WTO) and the common final due to a variety of causes giving rise to interstitial lung disease, which used to appear mostly in the elderly. With entering the aging society gradually in recent years, the incidence of PIF has increased year by year. For high mortality and refractory and the lack of effective treatment and drugs of PIF, modern medicine embroiled in an embarrassing. In recent years, traditional Chinese medicine (TCM) has acquired good curative effect in treating PIF, especially in improving the quality of life and prolonging survival time, so domestic scholars have paid more attention to take advantage of TCM for PIF treatment, and there were much more studies on PIF, which contributed to the boom of theories and treatment methods of TCM on PIF. My mentor professor Zhang Shunan has engage in medicine practice for nearly 30 years and accumulated abundant clinical experiences in treating various respiratory diseases by TCM and combining TCM and western medicine. In particularly, he formed unique insights for the treatment of PIF. His understanding of TCM theories and clinical experience on PIF were summarized in this paper.Methods:Thesis mainly in this article was divided into two parts.The first part was mainly to summarize related knowledge and research of TCM scholars on PIF and western scholars on IPF by the method of literature collection. The second part was mainly to summarize professor Zhang Shunan’ knowledge of nomenclature, etiology and pathogenesis, therapeutic principles and methods, and prescriptions and medications of PIF and concerned clinical treatment experiences, by reading over and studying articles about for PIF wrote by professor Zhang Shunan and collecting and analyzing typical cases of PIF treated by him in the out-patient departments.Results:On the basis of reading up classical works of TCM and by combining with knowledge of modern medicine, professor Zhang Shunan compared consumptive lung disease in TCM with PIF in modern medicine from the aspects of etiology, nature of disease, pathological morphology, clinical manifestation, evolution process and prognosis, and thought that they have much in common and PIF can be brought into the category of "Fei Wei" in TCM. He put forward that the root cause of PIF was body fluid deficiency due to lung dryness and deficiency and cold of lung qi, which can induced by exogenous pathogenic factors such as heat, cold and dampness, emotional disorders and excessive exhaustion, in addition, blood stasis run through each stage of this disease in varying degrees. And he considered that PIF was mainly manifested as asthenia symptom and belong to syndrome of primary asthenia-secondary sthenia. The syndrome of primary asthenia was varied from syndrome of yin deficiency, qi deficiency to yang deficiency and it mainly related to the lung, spleen and kidney. However, the syndrome of secondary sthenia was mostly manifested as blood stasis, phlegm and heat-toxic. Therefore the syndrome of deficiency of the lung and kidney and qi deficiency and blood stasis were seen much in clinic. For the treatment of PIF, he agreed with the principle of treating slowly and in early stage, syndrome differentiation combined with disease and dialectical co. Based on the understanding of basic pathogenesis of "Fei Wei", he advocated the therapeutic principles of "relieving the secondary in an urgent case and removing the primary in a chronic case", and focused on the overall and individualized treatment, and insisted on dispelling exogenous pathogen was given priority to in the acute phase and accompanied by clearing heat, removing fire, eliminating phlegm, depriving dampness, removing blood stasis and relieving internal pathogenic fire and toxin to treat the secondary cause. On the contrary, tonify deficiency was given priority to in the remission stage and assisted by supplementing qi and nourishing yin, regulating the lung and kidney and promoting blood circulation to remove blood stasis to treat the primary cause, which was regarded as basic therapeutic methods by professor Zhang Shunan in clinic. Based drug prescription:astragalus membranaceus, pseudostellaria root, dwarf lilyturf, fructus schisandrae qi and nourishing Yin, Perilla, asters for gas, fructus schisandrae, dogwood, gas and asthma, notoginseng, achyranthes, promoting blood circulation to remove blood stasis, along with the card to add and subtract.Conclusions:The symptoms of PIF were insidious in onset, mainly characterized by shortness of breath, chest distress, dry cough and reducing activity tolerance, most of which the etiology was still unclear. Due to the lack of effective treatment and drugs, PIF was a refractory disease. Professor zhang shunan thought PIF was associated with the category of "Fei Wei" in TCM, which was caused by body fluid deficiency due to lung dryness and deficiency and cold of lung qi. And he considered that PIF was mainly manifested as asthenia symptom and belong to syndrome of primary asthenia-secondary sthenia. The principle of overall and individualized treatment was taken seriously by Professor zhang shunan and the "regulating the lung and kidney, supplementing qi and nourishing yin and promoting blood circulation to remove blood stasis to treat the primary cause" was regarded as the basic therapeutic methods by him in clinic as the basic prescription and revising it with symptoms, which obtained a good curative effect.