滞热型体质小儿反复呼吸道感染中医诊治体会  

Experience in diagnosis and treatment of recurrent respiratory tract infections in children with stagnation fever

作　　者：陶燕芳[1] 王秀坤[1] 潘善伟[1] 刘殿玉[1] Tao Yanfang;Wang Xiukun;Pan Shanwei;Liu Dianyu

机构地区：[1]苏州大学附属儿童医院,江苏苏州215000

出　　处：《中医临床研究》2019年第36期26-27,51,共3页Clinical Journal Of Chinese Medicine

基　　金：国家自然科学基金-青年项目,项目编号-81300423,“组蛋白乙酰转移酶2A(KAT2A)在儿童急性白血病中的作用机制研究”。

摘　　要：小儿反复呼吸道感染是儿科常见病、多发病。随着社会的发展,人们生活习惯和生活方式的改变,空气质量的不断下降,其发病率逐年上升。汪受传等人将其病因归纳为禀赋不足,体质虚弱;喂养不当,调护失宜;少见风日,不耐风寒;用药不当,损伤正气;正虚邪伏,遇感乃发等五个方面。强调辨证重在明察邪正消长的变化,感染期以邪实为主,迁延期正虚邪恋,恢复期以正虚为主。因为感染期及迁延期相对较短,恢复期较长,故大多医家及论著均较重视恢复期的治疗。但是笔者在临床工作中,收治的患儿大多以急性发作为主,且很多患儿表证较轻或无明显表证,单用解表法往往不能获得满意的疗效。遂寻求文献帮助,发现胃肠积热为小儿反复呼吸道感染的一个重要原因。滞热型反复呼吸道感染患儿的临床表现除呼吸道感染症状以外,还有易头汗出,手足心热,口臭,烦躁易怒,夜卧不安,小便色黄,大便干粗,舌红苔黄厚,脉滑或脉数,指纹紫滞等。采用《医宗金鉴》双解通圣散加减治疗滞热型反复呼吸道感染患儿,处方如下:荆芥、防风、薄荷、连翘、川芎、炒白术、栀子、黄芩、桔梗、蝉蜕、甘草。再根据患儿表、里、寒、热之轻重,邪正之消长加减用药,达到满意的治疗效果。Recurrent respiratory tract infections in children is a common and frequently-occurring disease in pediatrics.With the development of society,changes in people's living habits and lifestyles,and the continuous decline in air quality,its incidence has increased year by year.Wang Shouchuan and others summarized the cause of deficiency as insufficiency of natural endowment,weak constitution,improper feeding,inadequate care,lack of outdoor activities,not resistant to cold,improper medication,damage to vital Qi and hidden pathogen.Emphasis is placed on dialectical emphasis on the rising and falling of vital Qi and pathogen.The infection period is dominated by excess of pathogenic Qi,the prolonged period is dominated by vital energy deficiency with evil-lingering,and the recovery period is dominated by deficiency of vital Qi.Because the infection period and the prolongation period are relatively short and the recovery period is longer,most doctors and professors pay more attention to the treatment during the recovery period.However,in the clinical work,most of the children admitted to the clinic mainly suffer from acute attacks,and many children have no obvious symptoms.The single-use solution method often fails to obtain satisfactory results.So I seek literature help and find that gastrointestinal heat accumulation is an important cause of repeated respiratory infections in children.In addition to respiratory symptoms,children with stagnation of heat and respiratory tract infections have symptoms of sweating,sweating of hands and feet,bad breath,irritability,night restlessness,yellow urine,dry stool,red tongue,slip or fast pulse,fingerprint purple stagnation,etc.Shuangjie Tongsheng Powder(双解通圣散)recorded in Yizong Jinjian can be used to treat children with stagnation of heat and recurrent respiratory tract infection,the prescriptions are as follows:Nepeta,Fangfeng,Mint,Forsythia,Chuanxiong,Atractylodes Rhizome,Scorpion,Astragalus,Campanulaceae,Pestle Licorice.According to the condition of the child,the medica

关 键 词：反复呼吸道感染 滞热型体质 中医 

分 类 号：R256.11[医药卫生—中医内科学]