基于“玄府理论”探讨小儿肺炎喘嗽的论治经验  

Exploring the experience of treatment for children with pneumonia with dyspneic cough based on"Xuanfu theory"

作　　者：孙文慧 宋用福 孔一卜 王永吉[2] SUN Wenhui;SONG Yongfu;KONG Yibu;WANG Yongji(Changchun University of Traditional Chinese Medicine,Changchun 130117,China;The AffiliatedHospital of Changchun University of Traditional Chinese Medicine,Changchun 130022,China)

机构地区：[1]长春中医药大学,长春130117 [2]长春中医药大学附属医院儿童诊疗中心儿童内一科,长春130022

出　　处：《中国中西医结合儿科学》2024年第6期544-548,共5页Chinese Pediatrics of Integrated Traditional and Western Medicine

基　　金：吉林省科技发展计划项目(20220401062YY)。

摘　　要：肺炎喘嗽是儿科常见肺系疾病之一,相当于西医学中的小儿肺炎。目前,西医以抗病原体、对症支持治疗为主,但随着病原体的不断增加与变异,抗生素耐药逐渐增加,抗生素带来的毒副作用亦令人担忧。采用中医药治疗小儿肺炎喘嗽日益得到人们认可与青睐,探寻更多有效的中医药治疗小儿肺炎喘嗽的方法与手段尤为重要。小儿肺炎喘嗽与玄府理论联系密切。玄府细微幽玄,遍布整个肺系,是肺组织的重要组成部分,肺脏功能亦通过玄府得以实现,玄府以开通为顺、闭阖为逆,肺炎喘嗽其微观本质是肺系玄府的病变。文章基于玄府理论结合临床实践经验,探讨小儿肺炎喘嗽与玄府理论的相关性,提出玄府郁闭是小儿肺炎喘嗽的基本病机,小儿肺炎喘嗽的治疗当以开玄为基本治则,并且认为开玄法贯穿小儿肺炎喘嗽治疗的始终。对于小儿肺炎喘嗽发生时出现的气郁、痰阻、血瘀、气血津液亏虚的基本病理变化,指出在临床治疗时,可根据病情辨证选用宣肺开玄、清热开玄、化痰开玄、祛瘀开玄和补虚开玄等法,希冀为小儿肺炎喘嗽的临床诊疗提供新的思路。Objective Pneumonia with dyspneic cough is one of the common pulmonary diseases in pediatrics,which is equivalent to pediatric pneumonia in western medicine.At present,western medicine focuses on anti-pathogenic and symptomatic support treatment,but with the continuous increase and variation of pathogens,antibiotic resistance is gradually increasing,and the toxic side effects caused by antibiotics are also worrying.The use of traditional Chinese medicine in the treatment of children with pneumonia with dyspneic cough is gaining increasing acknowledgement and favor,so it is particularly important to explore more and effective methods and means to treat pneumonia with dyspneic cough in children.Pneumonia with dyspneic cough in children is closely related to Xuanfu theory.Xuanfu is tiny and spreads all over the lungs,which is an important part of lung tissue,and the lung functions through Xuanfu.The opening of Xuanfu means the normal condition,and the closing of Xuanfu means the abnormal condition.The microscopic nature of pneumonia with dyspneic cough is the lesion of Xuanfu.Based on the Xuanfu theory and clinical experience,this paper discusses the correlation between Xuanfu theory and pneumonia with dyspneic cough in children.It points out that the closing of Xuanfu is the basic pathogenesis of pediatric pneumonia with dyspneic cough,and the basic principle of treatment for pediatric pneumonia with dyspneic cough should be the opening of Xuanfu.It is also believed that the Xuanfu-opening method should be used through the whole process of the treatment for pneumonia with dyspneic cough in children.As for the basic pathological changes of qi stagnation,phlegm obstruction,blood stasis and deficiency of qi,blood and body fluid in children with pneumonia with dyspneic cough,it is pointed out that the following methods can be used in clinical treatment according to the differentiation of disease symptoms:ventilating lung to open Xuan,clearing heat to open Xuan,resolving phlegm to open Xuan,removing blood stasis to open

关 键 词：肺炎喘嗽 玄府 儿童 

分 类 号：R725.6[医药卫生—儿科]