1.北京中医药大学第三附属医院,北京市朝阳区安定门外小关街51号,100029
2.北京中医药大学
3.北京中医药大学东直门医院
hshcui@sina.com
收稿:2022-11-22,
修回:2023-02-23,
纸质出版:2023-07-02
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张艺,崔红生,吕明圣等.基于伏风理论辨治咳嗽变异性哮喘的思路[J].中医杂志,2023,64(13):1391-1395.
ZHANG Yi,CUI Hongsheng,LYU Mingsheng,et al.Pathogenesis, Differentiation and Treatment of Cough Variant Asthma from Perspective of Latent Wind[J].Journal of Traditional Chinese Medicine,2023,64(13):1391-1395.
张艺,崔红生,吕明圣等.基于伏风理论辨治咳嗽变异性哮喘的思路[J].中医杂志,2023,64(13):1391-1395. DOI: 10.13288/j.11-2166/r.2023.13.016.
ZHANG Yi,CUI Hongsheng,LYU Mingsheng,et al.Pathogenesis, Differentiation and Treatment of Cough Variant Asthma from Perspective of Latent Wind[J].Journal of Traditional Chinese Medicine,2023,64(13):1391-1395. DOI: 10.13288/j.11-2166/r.2023.13.016.
基于伏风及其致病特点,认为风伏肺络,遇感引动,同气相求,伏风妄动导致肺气逆乱、宣肃失司是咳嗽变异性哮喘的主要病机。伏风内藏是关键病机,遇感引动是始发诱因,多种伏风夹杂和风合他邪、深伏肺络是导致病情加重和迁延难愈的重要原因,伏风化燥伤阴是病机转归。根据伏风来源的不同,可分为外来伏风、内生伏风与先天伏风三类。治疗以透散伏风、祛除外风为基本原则,具体治以透邪兼固表、调肝和调体,并辅以祛湿化痰、活血化瘀、调理肺脾肾等治法。伏风久潜于肺,易致风伏阴伤,自拟桑梅止咳汤加减治疗以疏风透邪、养阴清热、熄风止痉,达止咳目的。
According to the latent wind and its pathogenic characteristics, it is believed that latent wind in the lung collaterals being aroused by stimuli and the reckless movement of latent wind due to seeking for same
qi
will lead to the counterflow of lung
qi
and the failure to diffuse and purify, which is the main pathogenesis of cough variant asthma (CVA). Internal storing of latent wind is the key pathogenesis, and being aroused by stimuli is the initial cause, while complex of multiple latent wind, combined pathogens of wind and others, and latent pathogens in the deep lung collaterals are important reasons for the aggravation of the disease and protracted recovery; latent wind transforming into dryness and damaging
yin
is the turning point and outcome. Lantent wind can be categorized into external, internal and congenital types according to the sources. The basic treatment principle is penetrating and dissipating the latent wind, and expelling external wind. Specifically, it is suggested to penetrate pathogens together with consolidating the exterior, regulate the liver and the body, and take supplementing methods such as dispelling dampness and dissolving phlegm, activating blood and dissolving stasis, regulating the lung, spleen and kidney. Latent wind subdues in the lung can easily cause wind latent damaing
yin
. Self-made
Sangmei Zhike Decoction
(桑梅止咳汤) in its modification can be used to scatter wind and penetrate pathogen, nourish
yin
and clear heat, extinguish wind and arrest convulsion, and relieve cough.
中华医学会呼吸病学分会哮喘学组 . 咳嗽的诊断与治疗指南(2021) [J]. 中华结核和呼吸杂志 , 2022 , 45 ( 1 ): 13 - 46 .
周新 , 张旻 . 中国支气管哮喘防治指南(2020年版)解读 [J]. 诊断学理论与实践 , 2021 , 20 ( 2 ): 138 - 143 .
YI F , JIANG Z , LI H , et al . Small airway dysfunction in cough variant asthma:prevalence, clinical,and pathophy-siological features [J]. Front Physiol , 2022 , 12 : 761622 . doi: 10.3389/fphys.2021.761622.eCollection 2021 http://dx.doi.org/10.3389/fphys.2021.761622.eCollection2021 .
LIN J , WANG W , CHEN P , et al . Prevalence and risk factors of asthma in mainland China :the CARE study [J]. Respir Med , 2018 , 137 : 48 - 54 . doi: 10.1016/j.rmed. 2018.02.010 http://dx.doi.org/10.1016/j.rmed.2018.02.010 .
ANTONIU SA , MIHAESCU T , DONNER CF . Pharmacotherapy of cough-variant asthma [J]. Expert Opin Pharmacother , 2007 , 8 ( 17 ): 3021 - 3028 .
REDDEL HK , BACHARIER LB , BATEMAN ED , et al . Global initiative for asthma strategy 2021: executive summary and rationale for key changes [J]. Am J Respir Crit Care Med , 2022 , 205 ( 1 ): 17 - 35 .
汪受传 . 从风论治儿童过敏性疾病 [J]. 中医杂志 , 2016 , 57 ( 20 ): 1728 - 1731 .
王月娇 , 马健 . 从伏邪理论探讨咳嗽变异性哮喘的辨治 [J]. 中华中医药杂志 , 2017 , 32 ( 12 ): 5402 - 5403 .
曾逸笛 , 葛资宇 , 童骄 , 等 . 从肝论治咳嗽变异性哮喘 [J]. 中华中医药学刊 , 2012 , 30 ( 11 ): 2532 - 2534 .
张鑫 . 中医伏邪理论研究 [D]. 济南 : 山东中医药大学 , 2006 .
施烽峰 , 石强 . 伏风初探 [J]. 江西中医药 , 2022 , 53 ( 7 ): 13 - 16 .
邹建华 , 汪受传 , 陶嘉磊 . 汪受传从伏风论治小儿湿疹经验 [J]. 中华中医药杂志 , 2018 , 33 ( 7 ): 2888 - 2890 .
王静 . 运用升降散从伏风论治咳嗽变异性哮喘 [J]. 中国民间疗法 , 2021 , 29 ( 16 ): 54 - 56 .
史锁芳 . 从“厥阴病欲解时”探讨乌梅丸证治特点 [J]. 南京中医药大学学报 , 2019 , 35 ( 2 ): 121 - 123 .
胡丹丹 , 倪诚 . 从调体脱敏透达伏邪论治过敏性疾病的学术研究 [J]. 天津中医药 , 2022 , 39 ( 3 ): 316 - 319 .
王志超 , 李晶 . 从风论治咳嗽变异性哮喘 [J]. 世界中西医结合杂志 , 2018 , 13 ( 2 ): 289 - 291 .
兰丹丹 , 贾新华 . 从风痰瘀论治咳嗽变异性哮喘 [J]. 云南中医中药杂志 , 2018 , 39 ( 2 ): 5 - 8 .
崔红生 , 弓雪峰 , 毕伟博 , 等 . 透邪外达法在肺系疾病治疗中的运用 [J]. 中医杂志 , 2020 , 61 ( 10 ): 896 - 899 .
王振宇 , 姚海强 , 王琦 . 辨体-辨病-辨证诊疗模式的临床运用 [J]. 中医杂志 , 2016 , 57 ( 22 ): 1921 - 1924 .
董振华 , 季元 , 范爱平 . 祝谌予经验集 [M]. 北京 : 人民卫生出版社 , 2012 : 29 .
王卓 , 薛珊珊 , 吴拥军 . 干祖望“宽猛相济”治疗变应性鼻炎经验探骊 [J]. 湖北中医药大学学报 , 2022 , 24 ( 5 ): 119 - 121 .
崔红生 , 姚海强 , 王济 , 等 . 国医大师王琦教授从体-病-证三维角度辨治过敏性哮喘经验 [J]. 中华中医药杂志 , 2018 , 33 ( 1 ): 130 - 132 .
王琦 , 倪诚 . 王琦方药应用31论 [M]. 北京 : 中国中医药出版社 , 2012 : 80 .
崔红生 , 张诗瑜 , 毕伟博 , 等 . 和调枢机法治疗咳嗽变异性哮喘 [J]. 中医杂志 , 2022 , 63 ( 9 ): 894 - 896 .
刘圣康 , 崔红生 , 王成鑫 , 等 . 从风与湿论治咳嗽变异性哮喘 [J]. 环球中医药 , 2020 , 13 ( 4 ): 663 - 665 .
中华中医药学会 . 中医体质分类与判定(ZYYXH/T157-2009) [J]. 世界中西医结合杂志 , 2009 , 4 ( 4 ): 303 - 304 .
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