基于《幼幼集成》时段辨治规律治疗小儿慢性咳嗽的思路  

Discussion on the Treatment of Children Chronic Cough Based on the Rule of Time-segmented Differentiation and Treatment in the Grand Compendium of Pediatrics(《幼幼集成》)

作　　者：丁子超 任献青[1] 苏杭 袁振华 胥晓琦 丁樱 翟文生 DING Zichao;REN Xianqing;SU Hang;YUAN Zhenhua;XU Xiaoqi;DING Ying;ZHAI Wensheng(Medical School of Pediatrics,Henan University of Chinese Medicine,Zhengzhou,450046;The First Affiliated Hospital of Henan University of Chinese Medicine;The First Clinical Medical College,Beijing University of Chinese Medicine)

机构地区：[1]河南中医药大学儿科医学院,450046 [2]河南中医药大学第一附属医院 [3]北京中医药大学第一临床医学院

出　　处：《中医杂志》2023年第10期1004-1007,共4页Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金(U2004107);河南省特色骨干学科中医学学科建设项目(STG-ZYX01-202105)。

摘　　要：慢性咳嗽是儿科临床常见病症。根据《幼幼集成·咳嗽证治》时段辨证论治规律,结合子午流注理论,将小儿慢性咳嗽分为五更、清晨、午前、午后、黄昏五个时段。治疗应本于肺脾而兼顾他脏,其中五更甚属食积肺虚,方选保和丸合玉屏风散消积益气;清晨甚属痰火升动,方选清宁散合清金化痰汤降气化痰;午前甚为胃火热盛,方选橘皮汤合清胃散清火降逆;午后甚属阴水虚亏,方选清燥救肺汤滋阴生津;黄昏甚为火浮于肺,方选麦味地黄丸合黄连阿胶汤扶阴散热,为治疗小儿慢性咳嗽提供新思路。Chronic cough is a common symptom in pediatrics.Based on the treatment law of time-segmented syndrome differentiation in The Grand Compendium of Pediatrics·Treatment of Cough(《幼幼集成·咳嗽证治》)and the theory of midnight-noon and ebb-flow doctrine,children's chronic cough is divided into five periods,which are the predawn,early morning,noon,afternoon and dusk.It is suggested to treat the lungs and spleen mainly while taking care of other organs.If the condition is aggravated at the predawn,it is mainly caused by food accumulation and lung deficiency,for which Baohe Pill(保和丸)plus Yupingfeng Powder(玉屏风散)is suggested to dissipate accumulation and boost qi.If aggravated in the early morning,the condition is mainly caused by phlegm fire rising,and Qingning Powder(清宁散)with Qingjin Huatan Decoction(清金化痰汤)can be used to direct qi downward and dissolve phlegm.For condition aggravated at noon,stomach fire and exuberant heat is the main pathogenesis,and Jupi Decoction(橘皮汤)with Qingwei Powder(清胃散)is suggested to clear fire and direct counterflow downward.If there is aggravation in the afternoon,the main pathogenesis is yin-water depletion,and Qingzao Jiufei Decoction(清燥救肺汤)can be used to nourish yin and promote fluid production.In terms of aggravation at the dusk,fire floating in the lung is the main cause,which can be treated with the method of reinforcing yin and dissipating heat with Maiwei Dihuang Pill(麦味地黄丸)with Huanglian Ejiao Decoction(黄连阿胶汤).All the above provide a new idea for clinical treatment of chronic cough in children.

关 键 词：慢性咳嗽 《幼幼集成》 子午流注 时间医学 

分 类 号：R272[医药卫生—中医儿科学]