张之文治疗咳喘的经验

The Experience of Treating Cough with Dyspnea by Prof.Zhang Zhiwen

总结张之文教授治疗咳喘的经验,辨证应注意"两定",通过察咽喉、闻咳声、问胸部、查痰质等,首定病变部位,有咽喉(含西医鼻、咽、喉)和肺(含西医的气管及支气管)以及咽喉与肺同病之不同;其次确定病变的寒热性质。治疗以宣肺为先,灵活运用解表利咽、宣肺利咽、宣肺清金、化痰宣肺、清肝泻肺、泻肺滋润、运脾化痰、温阳化饮、补肾滋阴九法。同时,应病证结合,不同病证治疗各有特色。文中列举典型病案加以分析。

This paper summarizes the experience of Prof. Zhang Zhiwen on the treatment of cough with dyspnea. There is a principle of two confirmations for doctors to follow when differentiating symptoms and signs. Firstly, doctors should confirm the place of patho- logic changes by examining the throat, hearing the coughing sound, inquiring about chest and checking the sputum quality. Pathological manifestations are not the same in diseases of throat （including nose, pharynx and larynx in western medicine）, lung （including trachea and bronehia in western medicine）, and dual diseases of throat and lung. Secondly, doctors should confirm the temperature characteristics of the disease. On treatment principles, promoting the dispersing function of lungs should come first. Meanwhile, the other treatment principles could be considered, depending on various situations as well, such as resolving the exterior and disinhibiting the throat, dispersing function of lung and disinhibiting the throat, dispersing function of lung and clearing metal, transforming phlegm and dispersing function of lung, clearing the liver and discharging the lung, discharging, enriching and moistening the lung, activating spleen to trans-form phlegm, warming Yang to transform the fluid retention and tonifying Kidney and nourishing Yin. In addition, the combination of disease and Zheng should also be emphasized because the treatments are various. In this paper, there are some typical ease reports to analyze as examples.