经方辨治小儿咳嗽变异性哮喘研究进展  

Classic Prescription in Treating Cough Variant Asthma in Children

作　　者：王杨 张琳[1] 刘铭泽 王振亮[1] WANG Yang;ZHANG Lin;LIU Mingze;WANG Zhenliang(Henan University of Chinese Medicine,Zhengzhou Henan China 450046)

机构地区：[1]河南中医药大学,河南郑州450046

出　　处：《中医学报》2024年第10期2133-2138,共6页Acta Chinese Medicine

基　　金：国家自然科学基金项目(81072716);郑州市协同创新专项项目(2023XTCX049)。

摘　　要：经方药味精炼,配伍严谨,在治疗小儿咳嗽变异性哮喘方面具有独特的优势。遵仲景“观其脉证,知犯何逆,随证治之”的辨证思维可知,表邪侵袭、痰饮内阻、正虚不足为小儿咳嗽变异性哮喘的主要病机。临证时,外寒内饮寒者,治以小青龙汤解表散寒,温肺化饮;痰饮阻肺,肺失宣降,咽喉不利者,治以射干麻黄汤温化痰饮,下气祛痰;风热侵袭,痰热蕴肺者,治以麻黄杏仁甘草石膏汤辛凉解表,化痰止咳;营卫不和,肺气不利者,治以桂枝加厚朴杏子汤调和营卫,解肌祛风,化痰利气;三焦不利,肺气不降者,治以小柴胡汤疏利三焦,扶正祛邪;久病致虚,耗伤肾气,不能纳气者,则治以金匮肾气丸温补肾气,固本培元。The classic prescription is good at ingenious combination of medicinal,which has unique advantages in the treatment of pediatric cough variant asthma.According to Zhongjing′s dialectical thinking of"observing the pulse and syndrome to know what is wrong and treating it based on them",the invasion of external evil factor,internal resistance of Phlegm and Zheng Qi deficiency are the main pathogenesis of cough variant asthma in children.In clinical practice,patients with outside Coldness and inside Phlegm syndrome are treated with Xiaoqinglong Decoction to dispel the Coldness and warm the Lung to dissolve Phlegm.Patients with Phlegm obstructing Lung with sore throat are treated with Shegan Maihuang Decoction to dissolve and dispel the Phlegm with warming and Qi descending method.Patients invaded by Wind and Heat with Phlegm and Heat accumulating in the Lung are treated with Mahuang Xingren Gancao Shigao Decoction to relieve the external syndrome with pungent and cool character,to dissolve Phlegm and relieve cough;Patients who suffer from disharmony between Ying Qi and Wei Qi induced Lung Qi activity dysfunction are treated with Guizhi plus Houpo Xingzi Decoction to regulate Ying Qi and Wei Qi,to sweet and dispel Wind and to dissolve Phlegm and improve Qi activity.Patients with Three Jiao dysfunction and Lung Qi descending dysfunction are treated with Xiao Chai Hu Decoction to soothe the Qi of Three Jiao and help the Zhengqi and dispel the evil factor;Patients who are sick for a long time and suffer from Kidney deficiency induced Kidney inducing Qi dysfunction are treated with Jingui Kidney Qi Pill to warm and replenish Kidney Qi and to consolidate the foundation of man and then cultivate the Yuan Qi.

关 键 词：小儿咳嗽变异性哮喘 小青龙汤 射干麻黄汤 麻黄杏仁甘草石膏汤 桂枝加厚朴杏子汤 小柴胡汤 金匮肾气丸 经方 

分 类 号：R256.12[医药卫生—中医内科学]