从“风药开玄”探析咳嗽变异型哮喘的辨治思路  

Analysis of the Diagnostic and Treatment Approach for Cough Variant Asthma Based on the Concept of"Wind Medicinal Opening Sweat Pores"

作　　者：周晓青 陈佳玲 周林水[2] 王真[2] ZHOU Xiaoqing;CHEN Jialing;ZHOU Linshui;WANG Zhen(The First Clinical Medical School of Zhejiang Chinese Medical University,Hangzhou,310053;The First Affiliated Hospital of Zhejiang Chinese Medical University/Zhejiang Provincial Hospital of Traditional Chinese Medicine)

机构地区：[1]浙江中医药大学第一临床医学院,浙江省杭州市310053 [2]浙江中医药大学附属第一医院/浙江省中医院

出　　处：《中医杂志》2025年第8期800-803,共4页Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金(82174302);浙江省中医药科技计划项目(2022ZA063)。

摘　　要：玄府乃气机升降出入、精血津液流通、脏腑得以濡养的总司,贵在畅通,忌于壅滞。咳嗽变异型哮喘属中医“风咳”范畴,玄府开阖升降失司贯穿其发病全程。聚焦于咳嗽变异型哮喘病程演变中玄府失司的动态变化,归纳为玄府失枢、玄府失通、玄府失养三阶段。治疗上以“风药开玄”为核心,始动期以启玄祛风,宣肺理气;进展期以畅玄散风,肃肺消滞;转归期以养玄御风,补肺固本分以施治,以期为咳嗽变异型哮喘临床诊治提供思路。Sweat pore serves as the central regulator for ascending,descending,exiting and entering of qi movement,the circulation of essence,blood,and body fluids,and the nourishment of zang-fu organs.Its proper function depends on maintaining smooth flow and avoiding stagnation.Cough variant asthma(CVA),in traditional Chinese medicine,falls under the"wind cough"category.The dysfunction of sweat pores'opening,closing,ascending,and descending is integral to the pathogenesis of CVA.This article focused on the dynamic changes in sweat pores'dysfunction throughout the progression of CVA,categorized into three stages,i.e.loss of pivot function,blockage of sweat pores,and lack of nourishment.The treatment approach centers on"wind medicinal opening sweat pores",so for the initial stage,the focus is on activating sweat pores and dispelling wind,diffusing the lungs and rectifying qi;for the progression stage,the strategy shifts to unblocking sweat pores and dispersing wind,clearing lung stagnation and resolving obstructions;for the resolution stage,the emphasis is on nourishing sweat pores and defending against wind,strengthening the lungs and consolidating the body's foundation.This approach provides a systematic approach to the clinical diagnosis and treatment of CVA.

关 键 词：咳嗽变异型哮喘 玄府 风药 

分 类 号：R256.12[医药卫生—中医内科学]