1.南京中医药大学附属医院,江苏省南京市秦淮区汉中路155号,210029
2.南京中医药大学中医儿科学研究所/儿童健康与中医药省高校重点实验室
wscnj@njucm.edu.cn
收稿:2024-09-07,
修回:2024-12-29,
纸质出版:2025-05-17
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卢志远,林丽丽,戴启刚等.调气止咳法分期辨治儿童百日咳[J].中医杂志,2025,66(10):1060-1064.
LU Zhiyuan,LIN Lili,DAI Qigang,et al.Staged-Based Differentiation and Treatment of Pediatric Pertussis by Regulating Qi and Relieving Cough[J].Journal of Traditional Chinese Medicine,2025,66(10):1060-1064.
卢志远,林丽丽,戴启刚等.调气止咳法分期辨治儿童百日咳[J].中医杂志,2025,66(10):1060-1064. DOI: 10.13288/j.11-2166/r.2025.10.014.
LU Zhiyuan,LIN Lili,DAI Qigang,et al.Staged-Based Differentiation and Treatment of Pediatric Pertussis by Regulating Qi and Relieving Cough[J].Journal of Traditional Chinese Medicine,2025,66(10):1060-1064. DOI: 10.13288/j.11-2166/r.2025.10.014.
认为儿童百日咳的基本病机为肺气失调,主张运用调气止咳法治疗。临证将该病分为初咳期、痉咳期、久咳期三期进行辨证论治。初咳期病机为感受疫毒、肺气失宣,治宜解表散邪、宣肺止咳,寒证予三拗汤加味,热证予自拟方清气宣肺汤;痉咳期病机为痰火胶结、肺失清肃,治宜涤痰通络、泻肺止咳,轻症予自拟方通络泻肺汤,重症予麻杏石甘汤合千金苇茎汤加减;久咳期病机为气阴耗伤、肺虚邪伏,治宜益气养阴、润肺止咳兼清余邪,肺阴亏虚证予沙参麦冬汤加减,肺脾气虚证予自拟方健脾固肺汤。
It is considered that the fundamental pathogenesis of pediatric pertussis lies in the dysfunction of lung
qi
, and it is advocated to treat the disease with the method of regulating
qi
and relieving cough. Clinically, the disease is divided into three stages for syndrome differentiation and treatment, initial coughing stage, spasmodic coughing stage, and prolonged coughing stage. In the initial coughing stage, the pathogenesis involves invasion by external pathogens and failure of lung
qi
to disperse; the treatment principle is to release the exterior, expel pathogens, ventilate the lungs, and relieve cough. For cold patterns, modified
San'ao Decoction
(三拗汤) is prescribed; for heat type, a self-formulated
Qingqi Xuanfei Decoction
(清气宣肺汤) is used. In the spasmodic coughing stage, the pathogenesis is the congealing of phlegm and fire with impaired lung purification; the treatment focuses on eliminating phlegm, dredging the meridians, purging the lungs, and relieving cough. Mild cases are treated with a self-formulated
Tongluo Xiefei Decoction
(通络泻肺汤), while
severe cases are treated with a modified combination of
Maxing Shigan Decoction
(麻杏石甘汤) and
Qianjin Weijing Decoction
(千金苇茎汤). In the prolonged coughing stage, the pathogenesis involves the depletion of
qi
and
yin
and latent pathogens in a weakened lung; the treatment aims to tonify
qi
, nourish
yin
, moisten the lungs, and eliminate residual pathogens. For lung
yin
deficiency, modified
Shashen Maidong Decoction
(沙参麦冬汤) is used; for lung-spleen
qi
deficiency, a self-formulated
Jianpi Gufei Decoction
(健脾固肺汤) is prescribed.
王天有 , 申昆玲 , 沈颖 . 诸福棠实用儿科学 [M]. 9版 . 北京 : 人民卫生出版社 , 2022 : 1112 - 1117 .
张倩 , 吴丹 , 郑徽 , 等 . 中国2022年百日咳流行病学特征 [J]. 中国疫苗和免疫 , 2024 , 30 ( 1 ): 34 - 38 .
韩亚楠 , 杨秋雁 , 王利红 , 等 . 131例儿童百日咳住院病例临床特征及重症危险因素分析 [J]. 现代疾病预防控制 , 2025 , 36 ( 4 ): 269 - 274 .
中华医学会感染病学分会儿科感染学组 , 国家卫生健康委能力建设和继续教育儿科专委会感染组 , 中国临床实践指南联盟方法学专委会 , 等 . 中国百日咳诊疗与预防指南(2024版) [J]. 中华医学杂志 , 2024 , 104 ( 15 ): 1258 - 1279 .
FENG Y , CHIU CH , HEININGER U , et al . Emerging macrolide resistance in Bordetella pertussis in mainland China:findings and warning from the global pertussis initiative [J]. Lancet Reg Health West Pac , 2021 , 8 : 100098 . doi: 10.1016/j.lanwpc.2021.100098 http://dx.doi.org/10.1016/j.lanwpc.2021.100098 .
夏齐 , 王昕 . 百日咳中医治疗述评 [J]. 中国中西医结合儿科学 , 2023 , 15 ( 2 ): 170 - 173 .
汪受传 , 艾军 . 儿科温病证治 [M]. 北京 : 中国中医药出版社 , 2022 : 275 - 285 .
国家卫生健康委办公厅 , 国家中医药局综合司 . 百日咳诊疗方案(2023年版) [EB/OL].( 2023-12-28 )[ 2024-09-07 ]. http://www.nhc.gov.cn/ylyjs/pqt/202312/75cfff-021a484d0c9c200f85f2bf746b/files/f732266b89ab427289ab37b886158a1c.pdf http://www.nhc.gov.cn/ylyjs/pqt/202312/75cfff-021a484d0c9c200f85f2bf746b/files/f732266b89ab427289ab37b886158a1c.pdf .
汪受传 . 从风论治儿童过敏性疾病 [J]. 中医杂志 , 2016 , 57 ( 20 ): 1728 - 1731 .
褚襄萍 . 药对麻黄-地龙抗哮喘药效物质基础与作用机制研究 [D]. 上海 : 上海交通大学 , 2008 .
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