基于《黄帝内经》“胆、肺移热”思想辨治儿童鼻渊  

Diagnosis and treatment of pediatric sinusitis based on"the transmission of heat from gallbladder and lung"idea in Huangdi Neijing

作　　者：潘文青 袁振华 王浩林 邢琼琼 丁子超 段伊蔓 任献青[1,2] PAN Wenqing;YUAN Zhenhua;WANG Haolin;XING Qiongqiong;DING Zichao;DUAN Yiman;REN Xianqing(School of Pediatrics,Henan University of Chinese Medicine,Zhengzhou 450099,China;Pediatric Hospital of the First Affiliated Hospital,Henan University of Chinese Medicine,Zhengzhou 450099,China;Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China)

机构地区：[1]河南中医药大学儿科医学院,郑州450099 [2]河南中医药大学第一附属医院儿科医院 [3]北京中医药大学东直门医院

出　　处：《北京中医药大学学报》2025年第3期312-317,共6页Journal of Beijing University of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(No.82205186);河南省中原英才计划(豫组通〔2021〕44号);河南省中医学“双一流”创建科学研究专项(No.HSRP-DFCTCM-2023-8-39)。

摘　　要：鼻渊是儿童常见的鼻部疾病,其病程缠绵难愈,发病既责之于鼻窍不利,又与胆、肺功能失常密切相关。本文从《黄帝内经》探源溯流,并结合儿童的生理、病理特点,认为儿童鼻渊的核心病机为胆、肺之热移脑犯鼻,其中,风邪与热邪留滞,郁而化浊是其常见的发病诱因;邪气留恋,伤阴耗气是导致病情迁延不愈的内在因素。在临床治疗上,强调根据鼻渊的病程长短、病邪轻重论治,即外邪未去,宜疏风清热、辛散通窍;内火炽盛,应清金制木、泻火通窍;久病余邪未尽,肝肾阴虚于下,当壮水制火、滋阴润窍;邪热已去,涕漏日久,而致气随津泄,肺脾气虚于上,应培土生金、益气通窍。“胆、肺移热”辨治儿童鼻渊可减少鼻渊复发、减轻症状,以期为中医药治疗本病拓宽思路。Sinusitis is a prevalent nasal disease in children,characterized by chronic and difficult-to-treat symptoms.Its onset is related to nasal stagnation,gallbladder and lung dysfunctions.This article explores the root cause based on Huangdi Neijing by considering the physiological and pathological characteristics of children.The core pathogenesis of pediatric sinusitis is the transmission of heat from the gallbladder and lung to the brain and nose,disrupting normal nasal function.Wind and heat pathogens often persist,accumulate,and transform into turbid qi,which are common triggers of the disease.Evil qi retention and yin depletion are internal factors that cause the prolonged and unhealed condition of the disease.This article emphasizes individualized treatment approaches based on disease duration and the severity of pathogenic factors.If external pathogens remain uncleared,treatment should focus on dispelling wind,clearing heat,dispersing with pungent medicinals,and dredging nasal orifices.If internal fire is exuberant,clearing lung qi,inhibiting hyperactive liver yang,and clearing exuberant fire should be used to relieve stagnation.In chronic cases with residual pathogens and liver-kidney yin deficiency,nourishing yin,clearing fire,and moistening the nasal orifices are essential.When exuberant heat has subsided,but the symptom of a persistent runny nose continues,leading to the loss of healthy qi and damage to the lung and spleen,treatments that tonify the spleen,benefit the lung,and reinforce healthy qi should be adopted to relieve stagnation.These treatments aim to restore the balance of the body′s vital qi by addressing both the lingering symptoms and the underlying weakness of the lung and spleen.The diagnosis and treatment of pediatric sinusitis based on the theory of"the transmission of heat from gallbladder and lung"can help reduce the recurrence of sinusitis and alleviate symptoms,with the aim of broadening the approach of traditional Chinese medicine in treating this condition.

关 键 词：鼻渊 黄帝内经 胆、肺移热 扶正祛邪 通鼻开窍 

分 类 号：R276.1[医药卫生—中医五官科学]