儿童腺样体肥大中医病因病机及治疗进展探讨  

Etiology,Pathogenesis and Treatment Progress of Traditional Chinese Medicine in Children with Adenoid Hypertrophy

作　　者：蒲文焱 姜之炎[1] PU Wenyan;JIANG Zhiyan(Longhua Hospital,Shanghai University of Chinese Medicine,Shanghai 200030,China)

机构地区：[1]上海中医药大学附属龙华医院,上海200030

出　　处：《辽宁中医药大学学报》2024年第6期93-98,共6页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(8217150152);上海市中医药三年行动计划(2021—2023)项目(ZY〔2021-2023〕-0209-05);上海申康医院发展中心临床科技创新项目(SHDC12021102)。

摘　　要：腺样体肥大(adenoid hypertrophy,AH)是常见的儿童五官科疾病,多因过敏、反复感染等导致,久而失治可导致睡眠呼吸障碍、生长发育等问题。阐明AH的病因病机对提高中医临证辨治至关重要。该文系统总结近年来AH相关中医研究,在古代医家脾虚、痰湿、风热论治的基础上,将其病因病机进一步总结为脏腑虚损兼夹外邪、肺脾肾不足、痰湿阻窍、痰瘀互结等;总体而言,以虚为本、痰瘀为标。治疗上,以补虚泻实为主,或分期而治,或运脾补肺、清热化痰,化痰散瘀通窍贯穿始终,配合推拿、中药雾化、灼烙、熏鼻、雷火灸、点刺刮痧等特色外治,以期综合调理本虚标实之机。通过系统综述AH相关中医病因病机及治疗现状,旨在加深中医治疗AH的认识与思考,为AH的中医综合治疗提供理论依据。Adenoid hypertrophy(AH)is a common pediatric otorhinolaryngological disease,often resulting from allergies,recurrent infections,and other factors.Prolonged untreated cases can lead to problems with sleep-disordered breathing and growth and development.Elucidating the pathogenesis of AH is crucial for improving the diagnosis and treatment in clinical traditional Chinese medicine(TCM).This paper systematically summarizes recent TCM studies related to AH.Building upon the traditional TCM theory of spleen deficiency,phlegm-dampness,and wind-heat patterns,the pathogenesis of AH is further summarized as a combination of internal deficiency and external pathogenic factors,lung-spleen-kidney insufficiency,phlegm-dampness obstructing the orifices,and phlegm-stasis mutual binding.Overall,the treatment is based on reinforcing the deficiency and resolving the excess,with strategies including staging treatment,tonifying the spleen and lung,clearing heat and transforming phlegm,and resolving phlegm and eliminating stasis to unblock the orifices.This is consistently combined with characteristic external therapies such as massage,herbal atomization,scarring therapy,nasal fumigation,thunder-fire needling,and acupotomy,aiming to comprehensively regulate the interaction between the root deficiency and the branch excess.Through a systematic review of the TCM pathogenesis and current treatment status of AH,the goal is to further enhance the understanding and thinking of AH in TCM and provide a theoretical basis for the comprehensive TCM treatment of AH.

关 键 词：腺样体肥大 中医药治疗 内治 外治 中医内外合治 

分 类 号：R272[医药卫生—中医儿科学] R276.1[医药卫生—中医学]