湿热咳嗽并见背冷症病机及辨治探讨  

Discussion on pathogenesis,syndrome differentiation and treatment of damp-heat cough with back chill

作　　者：李佳珊 史利卿[2] 季坤[2] 马建岭[2] 李扭扭[2] 林彬 宋欢[1] 杨凯[1] LI Jia-shan;SHI Li-qing;JI Kun;MA Jian-ling;LI Niu-niu;LIN Bin;SONG Huan;YANG Kai(Beijing University of Chinese Medicine,Beijing 100029,China;Dongfang Hospital,Beijing University of Chinese Medicine,Beijing 100078,China;Beijing Center for Online Education,Beijing 100013,China)

机构地区：[1]北京中医药大学,北京100029 [2]北京中医药大学东方医院,北京100078 [3]北京中医在线教育中心,北京100013

出　　处：《中华中医药杂志》2020年第5期2450-2452,共3页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家自然科学基金项目(No.81373588);北京市自然科学基金面上项目(No.7192115);北京市自然科学基金青年项目(No.7184224)。

摘　　要：湿热咳嗽为慢性咳嗽临床常见证型之一,常伴见背冷症。其病因病机多外感、内生湿热之邪,阻于中焦,上干于肺,肺失宣降,肺气上逆而咳,湿热之邪黏腻难化,化为伏邪,留伏于肺,每因外邪引动,发作反复,迁延不愈而久咳。湿热困阻于中焦,郁闭于上焦,肺阳被郁,不得宣发布散于肌表,或湿热内伏日久,耗伤肺脾之阳气,阳虚失于温煦,故见背冷。其临床表现除咳嗽、咽痒、脘痞腹胀、但欲饮水不欲咽、口苦口黏等湿热咳嗽典型表现外,兼见背部两肩胛骨之间,如巴掌大小部位,怕冷怕风,受凉致咳,得温则缓之背冷症状。其病位主要在肺,与脾、胃关系密切;病性多寒热虚实夹杂;治以宣肺止咳、清热化湿。Damp-heat cough,as one of the clinical common type of syndrome of chronic cough,is often seen with back chill.The pathogenesis of damp-heat cough is endogenous and exogenous damp-heat trapped in the middle burner,accumulate in lung,stagnate lung qi,and affect the dispersing and descending function of lung.Due to the stickness and retention of damp and heat evils,damp-heat cough recures and prolongs to develop chronic cough.Damp-heat block the flow of qi,obstacle lung yang,get cold feeling in the back.Besides,damp as a kind of yin evil,if stay for long,damage the warming function of yang-qi,which can cause back chill.The main clinical manifestations of damp-heat cough with back chill are not only cough,pharyngeal itching,abdominal distension,thirsty but not to swallow for drinking the water,bitter and sticky slimy sensation in mouth,but also with a palm-size cold feeling of sensation between the shoulder blades,afraid of cold and wind while adore warm,worsen by cold,improved by warm.The location of cough with back chill is mainly in the lung,combined with spleen-stomach,and the pathological nature of cough with back chill is deficiency complicated with excess,cold and hot mixed.The main treatment is diffusing the lung and suppressing cough,clearing heat and removing dampness.

关 键 词：慢性咳嗽 湿热咳嗽 背冷症 病机 治法方药 

分 类 号：R256.11[医药卫生—中医内科学]