通讯作者: 王其美, 94082238@qq.com

DOI：10.12201/bmr.202602.00072

Exploring the Pathogenesis, Syndrome Differentiation and Treatment of Idiopathic Pulmonary Fibrosis Based on the Theory of ascending lucidity and descending turbidity

• 摘要：基于《黄帝内经》“升清降浊”理论，系统阐释其在特发性肺纤维化（Idiopathic Pulmonary Fibrosis,IPF）发病机制与辨治体系中的理论内核及应用价值。“升清降浊”作为中医调节人体气机、运化精微、排泄糟粕的法则，其失衡状态直接关乎肺脏宣发肃降功能失常，是IPF病理演变的关键。本文提出IPF“清浊相干”的发病观，从升降失司致清阳不升、浊阴不降，寒热互结酿生痰瘀浊毒，五脏运化失调累及肺脏清浊代谢三个维度，深入剖析经典理论与IPF病理进程的内在关联，明确其病因病机本质为“清浊相干，脏腑失司”。临床上立足该理论构建分期论治体系，以“调畅枢机、上下分治”为核心治则，根据疾病进展阶段辨证用药。本文通过挖掘经典理论的现代医学契合点，不仅丰富了IPF中医病因病机的理论内涵，更为中医药治疗IPF提供了坚实的理论支撑与诊疗思路。

  关键词： 特发性肺纤维化；清浊相干；辨证论治；病因病机；; ; ; 

   

  Abstract: Based on the theory of ascending lucidity and descending turbidity from Huangdi Neijing (Yellow Emperors Internal Classic), this paper systematically elaborates on its theoretical core and application value in the pathogenesis, syndrome differentiation and treatment of idiopathic pulmonary fibrosis (IPF). As a fundamental principle in traditional Chinese medicine for regulating human qi movement, transporting refined nutrients, and excreting waste, the imbalance of ascending lucidity and descending turbidity is directly related to the dysfunction of the lungs dispersing and descending functions, and serves as a key link in the pathological progression of IPF. This paper proposes the pathogenesis viewpoint of intermingling of lucidity and turbidity for IPF, and deeply analyzes the inherent correlation between the classic traditional Chinese medicine theory and the pathological process of IPF from three dimensions: disordered ascent and descent leading to failure of lucid yang to ascend and turbid yin to descend; intermingling of cold and heat generating phlegm, blood stasis and turbid toxins; and dysfunction of the five zang-organs impairing the lungs metabolism of lucidity and turbidity. It clarifies that the essence of its etiology and pathogenesis lies in intermingling of lucidity and turbidity, and dysfunction of zang-organs. Clinically, a stage-based treatment system is constructed based on this theory, with regulating the pivot and treating upper and lower parts separately as the core therapeutic principle, and syndrome differentiation-based medication is performed according to the disease progression stage. A typical medical case is attached to demonstrate the clinical practice guided by the theory of ascending lucidity and descending turbidity. By exploring the modern medical relevance of this classic TCM theory, this paper not only enriches the theoretical connotation of the traditional Chinese medicine etiology and pathogenesis of IPF, but also provides a solid theoretical support and practical diagnosis and treatment approach for traditional Chinese medicine intervention in IPF.

  Key words: Idiopathic pulmonary fibrosis; imbalance of ascending lucidity and descending turbidity; Syndrome differentiation and treatment; Etiology and pathogenesis

  提交时间：2026-02-15

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• 序号	提交日期	编号	操作
  1	2026-02-03	10.12201/bmr.202602.00072V1	下载

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