郑小伟教授治疗顽固性咳嗽经验浅析

Professor ZHENG Xiaowei's Experience in Treatment of Intractable Cough

[目的]总结郑小伟教授治疗顽固性咳嗽的临床经验。[方法]通过门诊抄方、整理医案及查阅相关文献,探讨顽固性咳嗽的病因病机,并运用病案列举兼评析的方法总结郑师治疗顽固性咳嗽的诊治思路及用药经验。[结果]郑师辨治顽固性咳嗽多从肺、脾、肾出发,辨证以风邪滞肺、脾虚湿困、肺肾气虚为主,治以清肺祛风、健脾化痰、补肾固本。郑师治疗顽固性咳嗽,注重审证辨因,标本同治,附举案例中风邪滞肺、宣发不彻者,治以清肺止咳、祛风止痒;脾虚湿困、痰气郁结者,治以健脾祛痰、理气止咳;肺肾气虚者,治以补肾纳气、敛肺止咳,均获良效。[结论]郑师对顽固性咳嗽辨证思路清晰,咽痒而咳从肺论治,痰多而咳从脾论治,虚喘而咳从肾论治,临床疗效显著,值得借鉴学习。

[Objective]To summarize Professor ZHENG Xiaowei’s experience in treatment of intractable cough.[Methods]Through copying prescriptions,organizing medical cases,consulting the literature,and exploring the etiology and pathogenesis,the method of enumeration was used and medical records were evaluated to summarize Professor ZHENG Xiaowei’s clinical thoughts and experience.[Results]Professor ZHENG Xiaowei deems that the treatment of intractable cough mostly starts from the lungs,spleen and kidney,and syndrome differentiation is mainly due to wind evil,spleen deficiency and dampness,lung and kidney Qi deficiency,and treatment of intractable cough emphasizes on the treatment of lung and wind,spleen and phlegm,and kidney-reinforcing.In the treatment of intractable cough,Professor ZHENG pays attention to the identification of the cause of differentiation,specimens with the same treatment,attached cases,specifically proves the above experience.The case with wind evil stagnating the lung was treated with removing heat from the lung to relieve cough,dispelling wind and relieving itching;the case with dampness due to spleen deficiency and stagnation of phlegm Qi was treated with invigorating the spleen,eliminating phlegm,regulating Qi and relieving cough;and the case with deficiency of lung and kidney Qi was treated with invigorating kidney,promoting Qi and astringing the lung to stop cough.All cases achieved good results.[Conclusion]Professor ZHENG Xiaowei has a clear understanding of intractable cough,cough and pharyngeal itching treated from the lungs,cough and phlegm treated from the spleen,cough and virtual asthma treated from the kidney,and his herbs have guiding significance in the clinic.It is worthwhile to be learned and used for reference.