变应性支气管肺曲霉病中西医结合诊疗专家共识（2026版）
该共识由中国中西医结合学会变态反应专业委员会组织多学科专家制定，界定ABPA诊断标准、临床分型与长期管理方案，强调环境控制和高危人群筛查。西医以糖皮质激素和抗真菌药为基础，生物制剂如奥马珠单抗为新兴选择；中医通过辨证论治结合中成药与针刺增强疗效。
要点
- ABPA在哮喘患者中发生率1.0%-3.5%，在囊性纤维化患者中7%-15%。
- 强调环境控制和高危人群筛查，规范诊断标准与临床分型。
- 西医以激素和抗真菌药为基础，中医辨证结合中成药与针刺。
核心结论
- 共识系统提出ABPA中西医结合诊断与治疗策略，旨在规范临床实践并发挥中西药协同优势。
研究设计与样本
- 由中国中西医结合学会变态反应专业委员会组织多学科专家制定的专家共识。
主要发现
- ABPA在哮喘患者中发生率为1.0%-3.5%，在囊性纤维化患者中为7%-15%。
- 临床表现包括反复支气管阻塞、咳嗽、肺部浸润和支气管扩张。
关键数值与推荐
- 共识定义了ABPA的诊断标准、临床分型和长期管理方案。
- 西医治疗以糖皮质激素和抗真菌药物为基础，生物制剂如奥马珠单抗为新兴选择。
- 中医通过辨证论治针对「风邪犯肺」「痰瘀互结」等证型，结合中成药和针刺增强疗效。
临床怎么用
- 临床应重视高危人群筛查和环境控制，按共识标准诊断ABPA。
- 治疗采用中西医结合策略，西医以激素和抗真菌药为基础，中医辨证施治。
以上解读依据论文摘要（全文未开放获取或许可不允许翻译转载）。
原文
Zhonghua Yi Xue Za Zhi. 2026 May 12;106(17):1678-1695. doi: 10.3760/cma.j.cn112137-20260101-00001. ABSTRACT Allergic bronchopulmonary aspergillosis (ABPA) is a hypersensitivity lung disease triggered by sensitization to Aspergillus fumigatus or other Aspergillus species, with 1.0%-3.5% incidence in asthma patients and 7%-15% incidence in cystic fibrosis patients. It is more common in patients with asthma or cystic fibrosis. Clinical manifestations include recurrent bronchial obstruction, cough, pulmonary infiltrates, and bronchiectasis. However, its actual incidence is likely underestimated due to complex diagnostic criteria and insufficient clinical awareness. To standardize the integrated traditional Chinese and western medicine practice for ABPA, exert the advantage of synergistic efficacy of Chinese and western medicine, and improve the comprehensive diagnostic and therapeutic level, the Professional Committee of Allergy of the Chinese Association of Integrated Traditional and western Medicine organized multidisciplinary experts to formulate this consensus. This consensus defines diagnostic criteria, clinical classification and long-term management plans of ABPA, emphasizes the importance of environmental control and screening in high-risk populations, and systematically outlines an integrated diagnosis and treatment strategy combining western and traditional Chinese medicine. Western medicine is based on corticosteroids and antifungal agents, with biologics such as omalizumab representing an emerging option, while traditional Chinese medicine contributes through syndrome differentiation and treatment-addressing patterns such as "wind invading the lung" and "phlegm-stasis binding"-combined with proprietary Chinese medicines and acupuncture to enhance efficacy, with the aim of providing standardized guidance for clinical practice. PMID: 42103676 | DOI: 10.3760/cma.j.cn112137-20260101-00001
引用
- 指南共识 · 支气管扩张与结核：Expert consensus on the diagnosis and treatment of allergic bronchopulmonary aspergillosis with integrated traditional Chinese and western medicine (2026 edition)
供执业医师工作参考，不替代临床判断；数值与分级以指南原文为准。