经方治疗膀胱咳辑要  

An experience summary of treating a bladder cough with classical prescriptions

作　　者：白晓辉 陈剑坤 李际强 BAI Xiaohui;CHEN Jiankun;LI Jiqiang(The Second School of Clinical Medicine,Guangzhou University of Chinese Medicine,Guangzhou 510006,China;The Third Department of Comprehensive Medicine,University Town Hospital,the Second Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510006,China)

机构地区：[1]广州中医药大学第二临床医学院,广州510006 [2]广州中医药大学第二附属医院大学城医院综合三科,广州510006

出　　处：《吉林中医药》2021年第12期1594-1596,共3页Jilin Journal of Chinese Medicine

基　　金：广东省科技厅项目(2017ZC0160)。

摘　　要：膀胱咳的典型临床表现为“咳则遗尿”,其病位除肺与膀胱外,与脾、肾、三焦也有密切关系。治疗膀胱咳应首辨虚实,实者为邪气阻滞,三焦气机不利;虚者为肺脾肾虚,膀胱失约。根据病机将膀胱咳分为三型:三焦不利,气机逆乱,小柴胡汤、柴胡加龙骨牡蛎汤主之;肺寒水饮,膀胱不利,甘草干姜汤、苓甘五味姜辛汤、五苓散、苓桂术甘汤、小青龙汤主之;肺脾肾虚,气化失常,黄芪建中汤、金匮肾气丸主之。在临床上应用经方辨证治疗,疗效较好。The typical clinical manifestation of a bladder cough is“enuresis when coughing”.Besides the lungs and bladder,its affected location is also closely related to the spleen,kidneys and sanjiao.The top priority in the treatment of a bladder cough lies in first distinguishing between its deficiency syndrome and excess syndrome,which is respectively the disorders of qi movement in sanjiao due to the blockade of pathogenic qi,and the bladder retention failure due to the deficiency of lungs,spleen and kidneys.According to its varying pathogenesis,the disease can be divided into three types.The first one is manifested as the disorder and disturbance of qi movement due to the qi transformation failure in sanjiao,which should be mainly treated with Xiao Chaihu Decoction,Chaihu-Longgu Muli Decoction.The second is manifested as the retention of lung qi due to cold fluid,dribbling and retention of urine due to the bladder failure,which should be mainly treated with Gancao Ganjiang Decoction,Linggan Wuwei Jiangxin Decoction,Wuling San,Ling Gui Zhu Gan Decoction,Xiao Qinglong Decoction.The third type is manifested as the qi transforming disorders due to the deficiency of lungs,spleen and kidneys,which should be mainly treated with Huangqi Jianzhong Decoction and Jinkui Shenqi Pills.In conclusion,the clinical application of those classical prescriptions on the basis of syndrome differentiation can achieve a better effect for the treatment of the disease.

关 键 词：膀胱咳 咳则遗尿 三焦不利 肺寒水饮 肺脾肾虚 

分 类 号：R256.11[医药卫生—中医内科学]