从正虚邪恋论治小儿慢性咳嗽经验  

Experience in Treating Children Chronic Cough based on the Theory of Healthy Qi Deficiency and Pathogenic Qi Retention

作　　者：张淑孜 于轶文 邢琼琼 苏杭[1] 丁子超 袁振华 丁樱[1,2] 于素平[1] 任献青[1,2] ZHANG Shuzi;YU Yiwen;XING Qiongqiong;SU Hang;DING Zichao;YUAN Zhenhua;DING Ying;YU Suping;REN Xianqing(Department of Pediatrics,The First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou,450000;College of Pediatrics,Henan University of Chinese Medicine;The First Clinical Medical College,Beijing University of Chinese Medicine)

机构地区：[1]河南中医药大学第一附属医院儿科医院,河南省郑州市450000 [2]河南中医药大学儿科医学院 [3]北京中医药大学第一临床医学院

出　　处：《中医杂志》2024年第24期2589-2592,2597,共5页Journal of Traditional Chinese Medicine

基　　金：河南省中原英才计划(育才系列)项目(豫组通[2021]44号);河南省中医药科学研究专项(2021JDZY002)。

摘　　要：认为正虚邪恋导致气机升降失常是小儿慢性咳嗽的主要病机,其中以肺脾肾三脏虚损为发病之本,痰饮、食积、郁火留恋体内为发病之标。临证主张以扶正补气、祛邪调气为治疗大法,方用玉屏风散为基础方。针对肺气虚证,方以玉屏风散加减以补肺固表治本;肺脾气虚证,方以玉屏风散合参苓白术散加减以补肺健脾、补运兼施;肺肾气虚证,方以玉屏风散合苏子降气汤加减以补肺益肾、纳气归元。同时兼用祛痰、消食导滞、疏肝泻火等法清除有形实邪,以期标本同治,气机升降如常则咳嗽自止。The main pathogenesis of chronic cough in children is the disorder of ascending and descending of qi movement caused by healthy qi deficiency and pathogenic qi retention.The deficiency of lung,spleen,and kidney is the root of the disease,and the retention of phlegm-fluid,food accumulation,and fire from constraint is the branch pathogenesis of the disease.In the treatment,we should reinforce and tonify healthy qi,dispel pathogen and regulate qi,with Yupingfeng Powder(玉屏风散)as the basic prescription.For lung qi deficiency syndrome,modified Yupingfeng Powder could be used for supplementing lung to consolidate the exterior;for lung and spleen qi deficiency syndrome,modified Yupingfeng Powder plus Shenling Baizhu Powder(参苓白术散)could be used for supplementing lung and fortifying the spleen,treating with both supplementation and transformation;for lung kidney qi deficiency syndrome,modified Yupingfeng Powder combined with Suzi Jiangqi Decoction(苏子降气汤)could be used for supplementing lung and replenishing kidneys,absorbing qi to the root.All the above prescriptions could combine the method of dis⁃pelling phlegm,promoting digestion and guiding out food stagnation,soothing the liver and draining fire to remove the solid pathogens,in order to treat the root and branch simultaneously,and the cough will stop if the ascending and de⁃scending of qi movement recover as usual.

关 键 词：慢性咳嗽 正虚邪恋 气机升降 儿童 

分 类 号：R272[医药卫生—中医儿科学] R249[医药卫生—中医学]