汤伟教授推药结合治疗儿童哮喘经验  

Professor Tang Wei's Experience in Treating Childhood Asthma with TuinaCombined with Traditional Chinese Medicine

作　　者：龙倩 王慧娟 马清华 毛嘉雯 王文星 陈碧婵 汤伟[2] Long Qian;Wang Huijuan;Ma Qinghua;Mao Jiawen;Wang Wenxing;Chen Bichan;Tang Wei(The First Traditional Chinese Medicine Clinical College,Hunan University of Chinese Medicine,Changsha 410007,China;The First Hospital Affilated to Hunan University of Chinese Medicine,Changsha 410007,China)

机构地区：[1]湖南中医药大学第一中医临床学院,湖南长沙410007 [2]湖南中医药大学第一附属医院,湖南长沙410007

出　　处：《亚太传统医药》2025年第2期43-47,共5页Asia-Pacific Traditional Medicine

基　　金：湖南省中医药管理局重点课题(A2023009);湖南省“十四五”第一批中医领军人才和学科带头人培养项目(湘中医药〔2022〕4号);湖南省卫生健康委高层次人才学科带头人(湘卫函〔2024〕43号);国家中医药管理局第七批全国老中医药专家学术继承人项目(国中医药人教函〔2022〕76号)。

摘　　要：哮喘是儿科常见疾病之一,汤伟教授临床治疗该病以祛邪祛痰、调理脏腑、固本强基为治疗重点,强调分期论治,辨证施推,推药结合。发作期以祛除邪气为法,此期“药主推辅”,推拿以“清”为主,中药用定喘汤或三拗汤为主方以降气平喘,快速控制哮喘发作态势;迁延期以祛邪调脏为法,此期“推药并举”,推拿以“和”为主,中药以止嗽散为主方,增强宣肺止咳化痰之疗效;缓解期以补益脏腑为法,此期“重推轻药”或“只推舍药”,推拿以“补”为主,中药以人参五味子汤或肾气丸加减,旨在补肺健脾益肾,调理三脏之功能。重视节气保健推拿,固本强基,借力三伏推、三九推,扶助正气,固护阳气,以改善哮喘患儿特殊体质。其“辨证施推、推药结合、节气推拿”的临证思想,为临床治疗儿童哮喘提供新思路。Asthma is one of the common diseases in pediatrics.Professor Tang Wei's clinical treatment of this disease focuses on expelling pathogenic factors and eliminating phlegm,regulating zang-fu organs,and strengthening the body.In the acute attack period,the method is to get rid of the evil qi,in this period,“the main medicine and push the auxiliary”,tuina to“clear”as the main,Chinese herbal medicine to set the dingchuan decoction or San'ao decoction as the main formula to lower the qi to calm asthma,to emphasize rapid control of asthma attack posture.The method of relocating the extension is to dispel the evil spirits and regulate the organs.In the chronic duration period,the method is to dispel the evil and regulate the organs,in this period,“tuina and traditional Chinese medicine therapies are used simultaneously”,tuina to“harmony”as the main,Chinese herbal medicine is based on the formula of zhisou san,to enhance the therapeutic effect of promoting the lungs,relieving cough and resolving phlegm.In the remission period,the method is to benefit the bowels,in this period,“heavy push light medicine”or“only push shed medicine”,tuina to“complement”the main,Chinese herbal medicine with renshen wuweizi decoction and shenqi pill plus reduction,it aims to tonify the lungs,strengthen the spleen and benefit the kidneys,and regulate the functions of the three organs.At the same time,the importance of the festival health care massage,the purpose is to consolidate the foundation,and take advantage of the tuina in the hottest days of the summer and the coldest days of the year to support the positive qi and take care of the yang qi,to improve the special physique of children with asthma.“Identifying the type of evidence and applying tuina,tuina combined with traditional Chinese medicine,tuina for special festivals”provides new ideas for clinical treatment of childhood asthma.

关 键 词：儿童哮喘 推药结合 辨证施推 汤伟 临证经验 

分 类 号：R256.12[医药卫生—中医内科学]