从湿论治过敏性哮喘的理论与思路探究  

Exploring thetheory and ideas of treating allergic asthma from dampness

作　　者：郑俐慈 吴蕾 池逸和[2] 肖晶旻 林琳 陈远彬 ZHENG Lici;WU Lei;CHI Yihe(State Key Laboratory of Dampness Syndrome of Chinese Medicine(The Second Clinic Medical College,Guangzhou University of Chinese Medicine),Guangzhou Guangdong 510120,China;The Second Clinic Medical College,Guangzhou University of Chinese Medicine/Guangdong Provincial Hospital of Chinese Medicine,Guangzhou Guangdong 510120,China;Guangdonghong Kong-Macao Joint Laboratory for Research of Traditional Chinese Medicine and Immune Diseases(The Second Clinic Medical College,Guangzhou University of Chinese Medicine),Guangzhou Guangdong 510120,China)

机构地区：[1]省部共建中医湿证国家重点实验室(广州中医药大学第二附属医院),广东广州510120 [2]广州中医药大学第二临床医学院/广东省中医院,广东广州510120 [3]粤港澳中医药与免疫疾病研究联合实验室(广州中医药大学第二附属医院),广东广州510120 [4]广东省中医证候临床研究重点实验室(广州中医药大学第二附属医院),广东广州510120

出　　处：《四川中医》2024年第7期30-35,共6页Journal of Sichuan of Traditional Chinese Medicine

基　　金：省部共建中医湿证国家重点实验室项目(编号:SZ2021ZZ42、SZ2023ZZ11);广东省科技创新战略专项资金(粤港澳联合实验室)项目(编号:2020B1212030006);广东省中医药局中医药科研项目(编号:20233020);广东省中医院周仲瑛学术经验传承工作室(中医二院[2014]89号);广东省中医药局林琳省名中医传承工作室(粤中医办函[2023]108号);广东省中医院中医药科学技术研究专项(编号:YN2022MS02)。

摘　　要：本文重点阐述“从湿论治过敏性哮喘”的理论依据和思路。过敏性哮喘患者常常久居湿地,反复吸入或接触尘螨、真菌等湿性过敏原,外湿兼夹风、寒、热等外感淫邪经皮毛或口鼻入,为哮喘发作的诱因;或有先天禀赋特殊者,嗜食酸咸甘肥或鱼虾蟹等发物,或久病耗气伤元者,脾土受损,肺肾失养,津液运化功能失调而生内湿,湿聚成痰饮,壅阻气机,上犯于肺,肺失宣降,肺气上逆,气道挛急,发为哮喘。“湿邪”贯穿于过敏性哮喘发病的全过程,“伏湿为第一夙根,伏痰为第二夙根”。其核心病机主要是“肺脾肾虚,湿邪遏阻”,治疗上应以“固本祛湿”为大法,分期论治,明晰主次缓急,随证治之。急性发作期以攻邪为要、少佐扶正,以宣肺平喘,识寒辨热,祛湿化痰为则;慢性持续期兼顾扶正祛邪,匡扶肺脾肾正气,祛湿化浊,双管齐下;临床缓解期以扶正固本祛湿,补肺调脾护肾为重。This article mainly focuses on explaining the basic of theory of“dampness cause asthma”in the treatment of allergic asthma.Patients with allergic asthma often live in wetlands for a long time,and repeatedly inhale or contact with dust mites,fungi and other wet allergens.External dampness carring wind,cold,heat and other external pathogens invades the body through the skin,mouth or nose and becomes a trigger of the cause of disease.For those with special innate constitutions,excessively intake of sour,salty,sweet,fatty food,or fish,shrimp,crabs,or those with long course of asthma and detriment qi and yuan,might lead to deficiency in spleen,lung and kidney qi.Their dysfunction can result in abnormal body fluid,and cause internal dampness.These seriously affect body fluid transportation,with restrained fluid transferring into phlegm and obstructing the airway and the lung.The lung could not disperse and descend,and the lung qi on the reverse,which cause airway clonus,and ultimately lead to asthma.Dampness runs through the whole process of allergic asthma.In other words,dampness is the first root,and phlegm is the second root.The core pathogenesis is mainly“Triple deficiency of the lung spleen and kidney with dampness obstruction”,treatment should be based on“Secure healthy and dispel dampness”.Therefore,allergic asthma should be treated according to the stage,with clear priorities and treatment according to the evidence.In the acute episode stage,it is necessary to put eliminating the pathogenic factors in the first place,with less support to cultivate the positive,diffuse the lung and relieve cough and dyspnea,to identify cold and heat,and remove dampness and phlegm.In the chronic persistent stage,the treatment should take both strengthening healthy qi and eliminating the pathogen into account.Replenish the lung,spleen and kidney,dispel the dampness and remove the turbidity.In the clinical remission stage,the main treatment is to reinforce healthy qi,tonify the lung,spleen and kidney and dissolve dampne

关 键 词：过敏性哮喘 湿邪 中医理论 思路 经验 

分 类 号：R562.25[医药卫生—呼吸系统]