慢性鼻窦炎中医病机探析  

Pathogenesis of Chronic Sinusitis in Traditional Chinese Medicine

作　　者：杨晓倩 朱镇华[2] YANG Xiaoqian;ZHU Zhenhua(Hunan University of Chinese Medicine,Hunan Province,Changsha 410007,China;Department of Otolaryngology,Head and Neck Surgery,The First Hospital Affiliated to Hunan University of Chinese Medicine,Hunan Province,Changsha 410007,China)

机构地区：[1]湖南中医药大学,湖南长沙410007 [2]湖南中医药大学第一附属医院耳鼻咽喉头颈外科,湖南长沙410007

出　　处：《光明中医》2024年第12期2368-2370,共3页GUANGMING JOURNAL OF CHINESE MEDICINE

基　　金：中医医院“中医特色诊疗中心”建设项目(No.湘中医药[2022]6号);“十四五”第一批中医药学科带头人培养项目(No.湘中医药[2022]4号);湖南特色中医药防治新冠肺炎诊疗指南的制定与有效制剂的研发(No.2022SK2125);中央补助中医药专项资金(No.湘财预[2021]359号)。

摘　　要：慢性鼻窦炎是耳鼻喉科临床常见病、多发病,属中医“鼻渊”范畴,其病因病机复杂,具有一定难治性。现代医学研究表明,慢性鼻窦炎发病与鼻腔鼻窦解剖结构异常、黏液纤毛清除功能障碍、组织重塑、鼻腔鼻窦微生物菌群多样性失衡、上皮屏障功能障碍、上皮细胞先天免疫功能缺陷等相关。这些发病机制与中医病机“不通则痛”“不荣则痛”关系密切。可将慢性鼻窦炎病机特点概括为“不通”与“不荣”,鼻窍脉络壅阻,鼻失宣通,是鼻渊形成的关键环节;正虚托邪无力,邪滞鼻窍,亦是鼻渊为病的重要因素。基于现代医学研究进一步探析慢性鼻窦炎的中医病机,对于中医临床精准辨证、针对性有效治疗,具有重要的启示与指导作用。Chronic sinusitis is a common and frequently occurring disease in otolaryngology.It belongs to the category of"profuse nasal discharge"in TCM.Its etiology and pathogenesis are complex and difficult to treat.Modern medical studies have shown that the incidence of chronic sinusitis is related to the abnormal anatomical structure of the nasal sinuses,the dysfunction of mucociliary clearance,tissue remodeling,the imbalance of microbial diversity in the nasal sinuses,epithelial barrier dysfunction,the defects of epithelial innate immune function,and so on.The pathogenesis of chronic sinusitis can be summarized as"stagnation leading to pain",obstruction of the nasal orifice,the vessels and collaterals,which are the key links in the formation of nasosinusitis.The asthenic healthy qi cannot defend pathogen,pathogen stagnation of nasal orifice,which is also play an important role in the occurrence of nasosinusitis.Further exploring of the pathogenesis of chronic sinusitis in TCM based on modern medical research has important enlightenment and guidance for accurate syndrome differentiation and effective targeted treatment.

关 键 词：鼻渊 慢性鼻窦炎 中医病机 不通则痛 不荣则痛 

分 类 号：R276.1[医药卫生—中医五官科学]