Blood stasis is the etiology of many cardiopulmonary diseases and is also an important pathological product. With the progress of modern pathophysiological research, it seems that the pathological changes of oxidative stress damage and inflammatory response in these diseases can hardly be summarized by a single “blood stasis” etiology. In the light of the understanding of “poison” and the clinical characteristics of disease pathogenesis in Chinese medicine, some scholars have proposed the understanding of the etiology and pathogenesis of cardiovascular and cerebral thrombotic diseases due to the interplay of poison and stasis. In our clinical practice, based on the understanding of the etiology of poisonous evil in traditional Chinese medicine, combined with the research progress of modern pathology of COPD, we propose the hypothesis that stasis and poison are one of the etiology and pathogenesis of COPD. 1. Stasis and toxicity are one of the main causes of COPD. In the pathogenesis of COPD, “phlegm” and “deficiency” are the classical etiological mechanisms, while patients suffer from hypoxia, increased blood viscosity and subsequent formation of micro-thrombosis in the lungs, which is classified as “blood stasis blocking the lung” in traditional Chinese medicine. This is classified as “blood stasis blocking the lung” in traditional Chinese medicine. Blood stasis as one of the etiological mechanisms of COPD has also gained wide consensus. Guided by this understanding, a series of treatments and effective prescriptions have been developed, such as benefitting Qi and invigorating Blood and regulating Qi and Blood. However, some clinical characteristics of COPD seem to be difficult to be explained by “stasis”, “phlegm”, or “deficiency” alone: for example, in the acute exacerbation of COPD, the disease is characterized by rapid onset, rapid changes in the condition, or a straightforward middle-grade disease. For example, in the acute exacerbation of COPD, the disease is characterized by rapid onset, rapid changes in the internal organs, critical symptoms, and in some severe cases, pulmonary encephalopathy and coma may appear soon; or in the stable phase of COPD, the disease is persistent and difficult to treat, with progressive decline in lung function, emphysema, formation of pulmonary alveoli and injury to several internal organs. The characteristics of these clinical manifestations are similar to those of the “toxic” evil in Chinese medicine. Therefore, we believe that in addition to “stasis”, “phlegm” and “deficiency”, COPD is also caused by “poison”. The pathogenesis of COPD is based on “stasis”, “phlegm” and “deficiency”. Some small samples of clinical observations have shown that blood activation and detoxification prescriptions have some clinical efficacy in the prevention and treatment of COPD. Toxic evil as a cause of disease has the following meanings in ancient Chinese medical literature: First, it is a generic term for all disease-causing evil. For example, the ancient book “Medical words” says: “Evil qi is also poison”. All disease-causing factors are classified as “poison”; secondly, it refers specifically to certain toxic disease-causing substances, such as medicine poison, snake poison, food poisoning and so on. In the Shennong Ben Cao Jing, it is said that “medicine has five flavors: acid, salty, sweet, bitter, and pungent, and four gases: cold, hot, warm, and cool, and poisonous or non-poisonous”. In the “Treatise on the Origin of Diseases”, Chao Yuanfang of the Sui dynasty already recorded the symptoms of compulsion poisoning, food poisoning, snake and animal poisoning and miscellaneous poisonous diseases; the third one refers to the “epidemic poison” which is highly contagious and epidemic. The fourth refers to the extreme of the evil qi, which has a biased hyperactivity or has been brewed for a long time and turned into poison. The fourth refers to the extreme of the evil qi, some partial hyperactivity or long-standing, into poison. At this time, the condition is more acute, critical, heavy and rotten muscle and flesh. In addition, according to its source, poisonous evil can be divided into external and internal poison. External toxins are mostly related to the six evil spirits and involve pathogenic microbial infections. Internal toxicity is both a pathological product and a new cause of disease, mostly due to internal injuries of emotion and will, dietary disorders and other factors that damage the functions of the internal organs, resulting in abnormal metabolism of qi, blood and fluid, and the retention of phlegm and dampness or blood stasis in the body, which accumulates and turns into toxicity. Common internal toxins such as stasis toxin, phlegm toxin and dampness toxin. The clinical characteristics of toxicity in the course of COPD are obvious, mainly in the following aspects: (1) in acute exacerbation, the disease is characterized by rapid onset, rapid changes in the condition, and dangerous condition; (2) in the stable phase, the disease is characterized by long, lingering and difficult to treat, repeated aggravation, continuous decline in lung function, gradual deterioration of blood gas analysis index, and continuous progress of airway obstruction; (3) its intensity, often damaging the muscle and injuring the flesh. (3) its aggressiveness, often damage the muscles and flesh, manifesting as a variety of comorbidities, emphysema, alveoli formation, airway cilia damage and invasion of multiple systems, multiple organs and multiple internal organs, with different clinical manifestations and complex and variable symptoms; (4) both cause disease, poisonous evil rarely causes disease alone, foreign poisonous evil is mostly attached to the six evil spirits, endogenous poisonous evil is often attached to phlegm, blood stasis and other pathological products, in clinical clinical manifestations of its attached disease evil is more common, while poisonous evil The clinical manifestations of the toxic evil itself are not obvious. 2. The interconnection of stasis and toxin during the pathological evolution of COPD. ”Stasis” and “poison” can be both pathological products and causative factors of the disease. COPD patients have obstructive ventilatory dysfunction, gas trapping, alveolar cavity enlargement, vascular wall damage and alveolar wall fibrosis. damage, alveolar wall fibrosis, reduced capillary beds, hyperplatelet function, increased coagulation tendency, increased blood viscosity, and a pronounced propensity to thrombosis. Thrombosis is closely related to the inflammatory response, and the two are causal and mutually reinforcing. On the one hand, excessive release of inflammatory factors can induce platelet adhesion and aggregation, leading to thrombosis; on the other hand, thrombosis is one of the main reasons for initiating the inflammatory response. Recent studies have shown that platelets themselves are inflammatory cells, involved in inflammatory cell chemotaxis, adhesion and infiltration, leading to tissue damage. When platelets are activated, they not only lead to microthrombosis of small pulmonary arteries through the classical endogenous coagulation system, but also promote pulmonary vasoconstriction through the release of platelet activating factor, 5-hydroxytryptamine, thromboxane A2, histamine and other vasoactive substances (endotoxicity), which together lead to the formation and development of pulmonary hypertension, thus aggravating the pathological changes of COPD. Thus, it can be seen that external toxins offending the lungs and internal toxins continuing to grow are important causes of “stasis”, which in turn can lead to the continuous production and accumulation of endogenous toxins. 3. The formation of blood stasis in the process of pathological evolution. As stated in “The True Tradition of Medicine: Qi and Blood”, “The body of a human being is the circulation of Qi and Blood, and Qi cannot be harmonized without Blood, and Blood cannot be transported without Qi. Dysfunction of Qi and Blood leads to the formation of Blood stasis, which mainly manifests itself in the following forms: (1) deficiency causing stasis; (2) stagnation causing stasis; (3) stasis caused by long-standing disease entering the ligaments. “Qi is the marshal of blood, and when Qi moves, blood moves”. If the lung qi is deficient, it is unable to push the blood to run, which leads to stagnation of blood flow, resulting in qi deficiency and blood stasis; if the disease progresses, spleen qi deficiency occurs, resulting in insufficient biochemistry of qi and blood, which can further aggravate blood stasis. If the lung qi is congested by external evil, it cannot be directed towards the 100 channels and does not govern the joints, which may cause the heart channel to run poorly and even stagnation of the blood channel. If the blood is warmed, it moves, but if it is cold, it clots. If there is a deficiency of Yang Qi, Yang Qi cannot warm the blood and it becomes stagnant. If the patient is emotionally uncomfortable, the liver is dysfunctional and liver qi is stagnant, blood stagnation can also be seen. COPD patients have a long and repeated course of illness, which affects the flow of blood and leads to blood stasis. As Ye Tianshi said: “The initial disease is in the qi, and the prolonged disease is from stasis”. 4, the pathological evolution of the formation of poisoning. The poisonous evil can come from outside or from inside. Since the lung is the main gas and the division of respiration, air pollution, smoking, harmful dust, pathogenic microorganisms and other toxic substances can enter through the mouth and nose with respiration; chronic cough and asthma diseases have been said to “gather in the stomach and about the lung”, indicating that the lung and stomach are closely related, and the lung and the large intestine are coterminous, so although the toxic evil enters from the mouth by the stomach and intestines, it can also enter the lung through the meridian. For example, ingestion of allergens can lead to coughing and asthma, and the poison of amiodarone can lead to pulmonary fibrosis, etc. These are all external poisons. Toxicity can also arise from within, as various causes lead to dysfunction of the internal organs, malfunction of Qi, blood and fluid, resulting in blood stasis, phlegm and dampness, which can turn into toxicity over time. In addition, the six evil spirits and epidemics can also continue to produce internal toxins after they invade the body. The lung is the source of water. If the lung is not functioning properly and cannot regulate the water channels, then phlegm and beverages will be generated internally; the lung and the large intestine are adjacent to each other. All of the above pathological changes can accumulate over time and produce toxicity. 5. The clinical manifestations of the pathological evolution of stasis toxin causing disease. As we can see above, we need to grasp the clinical manifestations of stasis toxin in the process of COPD in order to provide a theoretical basis for clinical identification of stasis toxin. Stasis and toxin are mutually causal and affect each other. We have searched the literature on “stasis and toxicity” separately and found that there are many papers discussing stasis or toxicity separately, but few papers discussing “stasis and toxicity” in detail. In our opinion, because of the duality and dependence of the poisonous evil, the clinical manifestations of stasis toxicity are mainly the clinical manifestations of the “stasis” to which the poisonous evil is attached. Based on the understanding of the clinical signs of “stasis” and “toxin” in the relevant literature, combined with the clinical manifestations and clinical practice of COPD, the clinical signs of “stasis” and “toxin” are The clinical symptoms and signs of COPD caused by “stasis” and “toxin” are mainly coughing for a long time, shortness of breath, fatigue, tingling and chest tightness, or hemoptysis, blue and purple nails on the lips and claws, obscure or sallow face, or even syncope and coma, purple tongue with petechiae, petechiae or purple-red, thick or greasy tongue coating, tortuous veins under the tongue, astringent, knotted or no pulse, etc.; secondly, the skin and nails are wrong, and the skin is wrong, and the skin and nails are wrong. The second thing is that the skin and nail are wrong, mania and forgetfulness, bruises, etc. These are all common clinical manifestations of COPD patients, but with different degrees of severity. It can be seen that “stasis” and “toxin” cause the disease, and the two often exist together. “Poison” is dependent on “stasis”. Although it is not easy to identify the poisonous evil from the specific clinical signs, it can be grasped as a whole from the characteristics of the poisonous evil in the progression of COPD. 6. Treatment of COPD from stasis and toxicity. Since there are pathogenic factors of stasis and toxicity in the development of COPD disease, we should keep to the disease mechanism and treat the disease with evidence. There are many prescriptions and medicines for removing blood stasis, and the commonly used ones include the method of benefiting Qi and invigorating Blood, the method of moving Qi and invigorating Blood, and the method of warming Yang and invigorating Blood. Clinically used drugs for promoting blood circulation and eliminating blood stasis include Chuanxiong, Radix Paeoniae, Angelicae Sinensis, Salviae Miltiorrhiza, Safflower, etc. The treatment of detoxification is also recorded in many Chinese traditional medicine texts, such as “New Compilation of Experimental Formulas”, “Medical Forest Correction”, “Detoxification of Blood and Blood”, “Pox Section”, “Wang’s formula – Detoxification Drink”, “Mycotic Sore Treatment”, “Detoxification Drink” and other prescriptions to activate blood and detoxify blood. If COPD patients have CO2 retention and clear orifice obscured symptoms, we can also apply the method of opening and detoxifying the orifice, while paying attention to the function of the lung as the main propagator and purgative. In Su Wen? It is like pus, as big as a bullet, coming out of the mouth or nose, but if it does not come out, it hurts the lungs, and if it hurts the lungs, it kills. In the process of COPD treatment, expectorant detoxification is an effective method. Clinically, it is often used to add flavor of mandarin soup, Qingjinhua phlegm soup, Guaguaguaguo Allium and Allium soup, “Qianjin” reed stem soup and so on. The lung and large intestine are in phase with each other, so detoxification of the internal organs is also a treatment method, which is often used with the addition and subtraction of Chengqi-type prescriptions.