“肺鼻同治”与“肝肺同调”结合治疗小儿咳嗽变异性哮喘理论探讨

Discussion on Combination of Lung-Nose Simultaneous Treatment and Liver-Lung Simultaneous Regulation for Treatment of Cough Variant Asthma in Children

分析小儿咳嗽变异性哮喘(CVA)的中西医发病机制,探讨"肺鼻同治"与"肝肺同调"结合治疗小儿咳嗽变异性哮喘.现代医学中,鼻与肺均为呼吸道的组成部分,二者为统一的气道,上下气道疾病相互影响;大部分CVA患儿合并有过敏性鼻炎,鼻部症状会加重CVA患儿的气道咳嗽敏感性.中医理论认为,"肺开窍于鼻",肺与鼻在经络、生理、病理与临床疾病表现方面密切相关.CVA发作时其气道高反应性及气道痉挛表现,符合"风咳"症状."诸风掉眩皆属于肝",其风为金不制木之肝风内动所致.故治疗CVA可"肺鼻同治"与"肝肺同调"相结合,并结合辨证加减,取效较佳.

The therapy of combining lung-nose simultaneous treatment with liver-lung simultaneous regulation for cough variant asthma(CVA)in children was explored on the basis of analysis of pathogenesis of CVA in the field of traditional Chinese medicine(TCM)and modern western medicine.In the field of modern western medicine,the lung and nose are parts of the respiratory tract,and consist of a unified airway,and upper and lower airway diseases interact with each other;most of CVA children suffer from allergic rhinitis,which increase the airway sensitivity of CVA children to cough.In the field of TCM,it is believed that the nose is the orifice of the lung,and the lung and nose have close relationship in the aspects of meridian,physiology,pathology and clinical manifestations.The clinical manifestations of airway hyper-reactivity and airway spasm during the onset of CVA accord with the characteristics of wind cough in TCM.According to the theory of all kinds of diseases with dizziness and vertigo being exclusively related to the liver,the wind cough is the result of the disturbance of liver-wind.Therefore,syndrome-based treatment following the therapeutic principle of combining lung-nose simultaneous treatment with liver-lung simultaneous regulation can achieve satisfactory therapeutic effect for CVA.