多元思辨模式在咳嗽诊疗实践中的应用与体会  

Practice and experience of therapeutic strategy in the treatment of cough based on multivariate speculative pattern

作　　者：陶方泽 周小敏 张玲 朱尔春 张宇静 TAO Fang-ze;ZHOU Xiao-min;ZHANG Ling;ZHU Er-chun;ZHANG Yu-jing(Nanjing Hospital of Traditional Chinese Medicine,Nanjing 210001,China;Nanjing Red-Cross Hospital,Nanjing 210001,China;Huai'an Tongren Hospital,Huaian 223001,China;The Affiliated Huaian Hospital of Xuzhou Medical University,Huaian 223002,China;Ningbo Beilun District Hospital of Traditional Chinese Medicine,Ningbo 315800,China)

机构地区：[1]南京市中医院,南京210001 [2]南京市红十字医院,南京210001 [3]淮安同仁医院,淮安223001 [4]徐州医科大学附属淮安医院中医科,淮安223002 [5]宁波市北仑区中医院,宁波315800

出　　处：《中华中医药杂志》2021年第1期204-207,共4页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：南京市中医药青年人才培养计划(No.宁卫中医[2020]4号);浙江省中医药科技计划项目(No.2020ZA107)。

摘　　要：咳嗽是一种常见病、多发病,中西医治疗一般都不难,但是咳嗽变异性哮喘、慢性阻塞性肺疾病及喉源性咳嗽等慢性肺系疾病病程较长,西医治疗比较棘手且取效不易。文章旨在通过3则咳嗽验案,介绍"审症(抓主症)-辨人(体质)-诊病-识证(方证)"四位一体的多元思辨模式在咳嗽诊疗实践中的应用,首当抓主症,次辨体质,明确诊断,从方证入手,谨守病机,遣方用药常以经方和后世经典方化裁治疗咳嗽,衷中参西,圆机活法,该思路和方法对于指导中医临证施治具有重要的参考价值。Cough is a common and frequently-occurring disease,and it is not difficult to treat with traditional Chinese and Western medicine.However,for chronic lung diseases such as cough variant asthma,chronic obstructive pulmonary disease and laryngeal cough,the treatment with western medicine is more difficult.This article reported three proven cough diseases cases which were treated by the way of’symptoms analysis-patients(physique)distinguish-disease diagnosis-type judgment(formulasyndrome)’.Firstly grasp the main symptoms,the second is to identify the constitution,make a clear diagnosis,start from the prescriptions and syndromes,observe the pathogenesis,dispatch prescriptions,start with the prescriptions,guard the pathogenesis,and use the prescriptions and classic prescriptions to treat coughs,intergrating Chinese and Western medicine.This idea and method has important reference value for guiding the clinical treatment of traditional Chinese medicine.

关 键 词：多元思辨模式 方证辨证 咳嗽 咳嗽变异性哮喘 慢性阻塞性肺疾病 喉源性咳嗽 验案 

分 类 号：R256.11[医药卫生—中医内科学]