付义教授从内外合邪论治顽咳经验举隅  

Experience of Professor Fu Yi in Treating Persistent Cough from the Perspective of Internal and External Combined Pathogens

作　　者：张楠[1,2] 王梦瑾 张业清 苏克雷[1,2] 徐瑾[1,2] 李朝娟 付义[4] ZHANG Nan;WANG Mengjin;ZHANG Yeqing;SU Kelei;XU Jin;LI Chaojuan;FU Yi(Department of Respiratory and Critical Care Medicine,Integrated Traditional Chinese and Western Medicine Hospital Affiliated to Nanjing University of Chinese Medicine,Jiangxi Province,Nanjing 210028,China;Jiangsu Province Academy of Traditional Chinese Medicine,Jiangxi Province,Nanjing 210028,China;Department of Traditional Chinese Medicine,Gaoyou Hospital of Traditional Chinese Medicine,Jiangxi Province,Yangzhou 225600,China;Department of Pulmonary Disease,Kunming Municipal Hospital of Traditional Chinese Medicine,Yunnan Province,Kunming 650011,China)

机构地区：[1]南京中医药大学附属中西医结合医院呼吸与危重症医学科,江苏南京210028 [2]江苏省中医药研究院,江苏南京210028 [3]高邮市中医医院中医科,江苏扬州225600 [4]昆明市中医医院肺病科,云南昆明650011

出　　处：《中国中医药现代远程教育》2023年第23期77-80,共4页Chinese Medicine Modern Distance Education of China

基　　金：江苏省老年健康科研项目【No.LR2021008】。

摘　　要：文章介绍了付义教授辨治顽固性咳嗽的临证经验,付义教授认为顽咳多为“内外合邪”,常系内伤基础上复受外邪,或表现为体质偏颇致邪气从化,或与内生邪气杂合,此种状态较之单纯外感或内伤咳嗽更加顽固难治;外邪主要是外感六淫及时疫戾气,以风、寒、火、燥居多;而内邪指由脏腑功能失调、气血违和所产生的内生邪气,其中以寒、痰、瘀为主。付义教授在临床诊治过程中非常强调四诊资料收集的完整和准确,认为如此方能识别内外状态;临证从“内外合邪”入手,安内攘外、内外兼治,每获良效。This article introduced Professor Fu Yi’s clinical experience in the treatment of persistent cough.Professor Fu Yi believes that persistent cough is mostly“internal and external pathogens”,which is often caused by external pathogens on the basis of internal injury,or manifested as a partial constitution leading to the assimilation of pathogens,or mixed with internal pathogens,which is more stubborn and difficult to treat than simple external or internal injury cough.The tutor believes that the external pathogens mainly refers to the six exogenous pathogens and the current epidemic,which are mainly wind,cold,fire and dryness,while the internal pathogens refers to the internal pathogens generated by the dysfunction of viscera and the conflict between qi and blood,which is mainly cold,phlegm and blood stasis.In the process of clinical diagnosis and treatment,the tutor attached great importance to the integrity and accuracy of the collection of the four diagnoses,so as to distinguish the internal and external conditions.The clinical diagnosis starts with the“combination of internal and external pathogens”,and treats both internal and external,with good results every time.

关 键 词：顽固性咳嗽 内外合邪 付义 临证经验 中医药疗法 

分 类 号：R249[医药卫生—中医临床基础] R256.11[医药卫生—中医学]