从“脾胃虚则九窍不通”论治变应性鼻炎  

Treatment of allergic rhinitis based on "deficiency of the spleen and stomach leading to obstruction of the nine orifices"

作　　者：黄英 龙丹 朱莹 HUANG Ying;LONG Dan;ZHU Ying(The First Clinical School of Chinese Medicine,Hunan University of Chinese Medicine,Changsha,Hunan 410208,China)

机构地区：[1]湖南中医药大学第一中医临床学院,湖南长沙410208

出　　处：《湖南中医药大学学报》2024年第5期868-872,共5页Journal of Hunan University of Chinese Medicine

基　　金：国家自然科学基金项目(81874466);全国名老中医药专家传承工作室建设项目(国中医药人教函[2022]75号)。

摘　　要：变应性鼻炎主要表现为鼻痒、鼻塞、流清涕、喷嚏等,属于中医学“鼻鼽”范畴。本文从“脾胃虚则九窍不通”理论出发分析变应性鼻炎的辨证论治,认为其标在肺,其根在脾胃,涉及肺脾肾三脏,其病机主要包括两个方面,一为“闭塞而不通”,脾虚生湿,痰湿阻窍,肺脾气虚,风寒犯窍,鼻窍不通;一为“不荣而不通”,脾失健运,清气不升,脾损肺伤,脾肾阳虚,鼻窍不荣。临证治疗应补脾健脾运脾,复生化之源,绝痰湿之根,调升降之序,固卫外之功,扶脾肾之阳,使鼻窍得通、得荣、得润、得固、得煦。Allergic rhinitis (AR), with the main manifestations of nasal itching, nasal congestion, runny nose, and sneezing, belongs to the category of "Biqiu" in Chinese medicine. This paper analyzes the pattern differentiation and treatment of AR based on the theory of “deficiency of the spleen and stomach leading to obstruction of the nine orifices”, and argues that the branch of this disease lies in the lungs while the root in the spleen and stomach. Involving the lung, spleen, and kidney, its pathogenesis mainly includes two aspects: firstly, "obstruction of the nasal orifices due to being blocked" by phlegm-dampness resulting from the spleen deficiency, or by wind-cold invasion resulting from qi deficiency of the lung and spleen;secondly, "obstruction of the nasal orifices due to lack of nourishment", which is contributed by failure of the spleen to transport clear qi (nutrients) upward, by impairment of the spleen and lung, or by yang deficiency of the spleen and kidney. As for the treatment, tonifying, strengthening, and activating the spleen should be applied, so as to restore the source of qi and blood generation, eliminate the root of phlegm-dampness production, regulate the qi movement of ascending and descending, consolidate the defensive qi, and reinforce the spleen and kidney yang, through which the nasal orifices can be unblocked, nourished, moistened, consolidated, and warmed.

关 键 词：变应性鼻炎 脾胃虚则九窍不通 肺脾肾 补脾 健脾 运脾 

分 类 号：R276.1[医药卫生—中医五官科学]