唐方教授脏腑辨证治疗小儿急性咳嗽经验

Clinical experience by professor TANG Fang on treating acute cough in children with syndrome differentiation and treatment

小儿急性咳嗽作为儿科常见病,因小儿脏腑娇嫩、形气未充,具有发病急骤、传变迅速的病理特点,故易出现各种变证,建立完善的小儿急性咳嗽诊治体系就显得尤为重要。因咳嗽病程不同,病邪部位有异,辨证论治之法亦有不同,唐方教授通过多年临床实践归纳和总结出小儿咳嗽从“肺胃肝三脏”治疗理论。该理论以脏腑辨证为基础,具有紧抓主症、用药考究、灵活加减的特点。临床用药加减则依据肺主宣发肃降,故多予炙麻黄、桔梗开宣肺气,予桑白皮、葶苈子降气止咳,且小儿生理特点为“脾常不足”,故而过量进食之后,损伤脾胃,造成肺胃热盛同病,胃多气多血之腑,故予红景天、地龙、牡丹皮活血凉血清热。通过对临床医案的分析,进一步阐释从“肺胃肝三脏”治疗理论,从而为小儿咳嗽的临床诊治工作提供有益借鉴。

As a common pediatric disease,acute cough in children is very important because of its delicate viscera and incomplete,so it has the pathological characteristics of rapid onset and rapid change.Therefore,it is particularly important to establish a complete diagnosis and treatment system for acute cough in children.Because the course of cough is different,the pathogenic parts are different,and the methods of syndrome differentiation and treatment are also different.Professor TANG fang ummarized the theory of treatment of pediatric cough from“three organs of lung and stomach liver”through many years of clinical practice.The theory is based on differentiation of syndromes of viscera,and has the characteristics of grasping the main symptoms tightly,exquisite medication,and flexible addition and subtraction.Clinical medication is added or subtracted according to the principle of lung advocates propaganda and depression,therefore,it is given to roast ephedra and Platycodon grandiflorum to promote lung qi,mulberry bark and lepidium seed to reduce qi and relieve cough,and children’s physiological characteristics are“spleen is often insufficient”.Therefore,after excessive eating,the spleen and stomach are damaged,resulting in the same disease of lung and stomach,which is rich in qi and blood.Therefore,it is given to rhodiola root,earthworm and peony bark to promote blood circulation and cool serum fever.Through analysis of clinical medical case and clinical experience by Professor TANG was elaborated,to provide a useful reference for clinical diagnosis and treatment.