基于“虚气留滞”理论探讨肺结节术后的病机及辨治，以拓展其诊疗思路。认为虚气留滞是肺结节的关键病机。“虚 气”为致病之本，以肺脾两虚为本；“留滞”为罹病之标，主要指滞气、痰瘀、浊毒等病理产物积聚肺络。肺结节术后患者的 病机特点为术后大气下陷，虚气加重，而气滞、痰瘀、浊毒虽减犹存。基于“虚气留滞”病机特点的肺结节术后治则当补虚升 陷，开郁通滞。补虚以“健脾益肺”为首，升陷以升补“胸中大气”为重，开郁以“理气调肝”为要，通滞以“化痰瘀、祛浊 毒”为主。“虚气留滞”病机理论契合肺结节术后的病机规律以及证候变化，可动态、系统地指导肺结节术后的临床诊疗。

This study explored the pathogenesis and treatment of postoperative pulmonary nodules from the perspective of deficient qi resulting into retention of pathogens，thus to expand the approach to its diagnosis and treatment. It is believed that deficient qi resulting into retention of pathogens contributes to the key pathogenesis of pulmonary nodules. As the root cause of the disease，deficient qi usually involves the deficiency of the lung and spleen. And as the incidental manifestations， retention of pathogens refers to the accumulation of pathological products such as stagnated qi， phlegm-stasis， and turbid toxins in the lung collaterals. The pathogenesis of postoperative pulmonary nodules is characterized by the collapse of pectoral qi，aggravated deficient qi，and the lingering presence of the relieved qi stagnation，phlegm-stasis，and turbid toxins. Based on the pathogenesis of deficient qi resulting into retention of pathogens， the treatment principles for postoperative pulmonary nodules should focus on tonifying deficiency and lifting collapse，and relieving qi stagnation and unblocking obstruction. Tonifying deficiency needs to prioritize strengthening the spleen and nourishing the lung to go first，lifting collapse aims at elevating the pectoral qi，relieving qi stagnation focuses on regulating qi and harmonizing the liver，and unblocking obstruction mainly involves resolving phlegm-stasis and eliminating turbid toxins. The pathogenesis of deficient qi resulting into retention of pathogens aligns with the pathological features and syndrome evolution of postoperative pulmonary nodules，and will provide dynamic and systematic guidance for its clinical diagnosis and treatment.

R256.1

国家中医药管理局监测统计项目（编号：YGZXKT2024344）