王新华教授治疗湿热咳嗽的临床辨治经验

Professor WANG Xinhua's Clinical Diagnosis and Treatment Experience of Dampness-heat Cough

[目的]总结王新华教授运用清热化湿法治疗湿热咳嗽的临床经验。[方法]通过跟师临证、聆听讲授、整理医案,分析王师对于湿热蕴肺型咳嗽的病因病机、辨证要点的认识,并与痰热郁肺型咳嗽相鉴别,释述王师临床中应用麻黄连翘赤小豆汤加减的组方意义,并以临床典型病例加以佐证。[结果]王师结合自身临证经验,认为湿热蕴肺型咳嗽病因多与外感湿热,饮食、情志失宜,失治误治有关,治疗需清热化湿并举,然而热易清,湿难去,故当以湿邪为重。湿性粘滞,需在寒凉药物中加用淡渗利湿之品,通调水道,使邪有出路,才可化缠绵湿邪,清亢盛之热。临床中运用麻黄连翘赤小豆汤加减,以清热化湿、宣肺止咳。治疗过程中需关注舌象变化,以此推定湿热的进退传变及湿、热的孰重孰轻,随证加减,临床疗效佳。所举案例,充分展示了上述辨证思路和治疗经验。[结论]王新华教授运用清热化湿法治疗湿热蕴肺型咳嗽,临床上行之有效,值得临床医者借鉴。

[Objective] To summarize Professor WANG Xinhua＇s clinical experience of clearing heat and resolving dampness method to treat the type of damp-heat lungs. [Methods] Through learning with Professor WANG, listening to lectures, medical records, analyse Professor WANG＇s understanding of the etiology and pathogenesis of cough in damp-heat Yun-lung type, summed up the dialectical points and phlegm-heat lung type cough phase identification. Explain the significance of the composition of Ephedra Forsythia Red Bean Decoction plus or minus in the clinical practice of Professor WANG and typical clinical cases were used as evidence. [Results] According to Professor WANG own experience in clinical trials, it is believed that the cause of dampness and heat accumulation of lung-type cough is related to exogenous heat and dampness, improper diet and emotion, and mistreatment. It is necessary to treat heat and dampness simultaneously. However, heat is easy to clean but wet is hard to go, so wet evil should be the most important.Wet is sticky, cold medicine need to be added in the light seepage dampness of the herbs, pass the waterway, so evil out of the way. The dampness and heat can be removed. The clinical application of Ephedra Forsythia Red Bean Decoction plus or minus in clearing heat and resolving dampness and relieving the cough. Tongue image changes should be paid attention in the treatment process, to presume hot and humid transfer of advance and retreating,the pros and cons, with the addition and subtraction, it had good clinical efficacy. The case presented in the paper fully demonstrated the above dialectical thinking and treatment experience. [Conclusion] Professor WANG Xinhua used the method of clearing away heat and dampness to cure dampness-heat cough, which is clinically effective and worth learning.