陈文霞教授治疗儿童咳嗽变异性哮喘临证经验

Professor Chen Wenxia’s clinical Experience in the Treatment of Children’s Cough Variant Asthma

儿童咳嗽变异性哮喘是学龄前儿童的多发疾病,近几年发病率呈逐渐升高的趋势,目前西医治疗咳嗽变异性哮喘以吸入糖皮质激素为主要治疗方法,见效虽快但停药后复发率较高,长期服用激素副作用较大且影响患儿生长发育,家长依从性差。陈文霞教授总结多年临床经验,善于把中医的辨证论与西医的治疗方法结合起来,认为咳嗽变异性哮喘的病理因素为风、痰、瘀,其病机当属正虚邪实,中医治疗应以疏风化痰,活血祛瘀为主兼顾润肺、舒肝、健脾、益肾,达到扶正祛邪之目的;咳嗽较甚患儿采用口服西药及雾化吸入支气管扩张剂与糖皮质激素辅助治疗;合并鼻炎患儿则辅以鼻腔冲洗,在能较好控制咳嗽、喘息症状的基础上逐渐减少乃至停用激素类药物,增强患儿体质。

Cough variant asthma in children is a common disease in preschool children.The incidence of cough variant asthma has been increasing in recent years.At present,inhalation of glucocorticoid is the main treatment method for cough variant asthma in Western medicine.Although the effect is quick,the recurrence rate is high after discontinuation of treatment.Parental compliance is poor.Professor Chen Wenxia summed up many years of clinical experience and was good at combining the dialectics of traditional Chinese medicine with the treatment of Western medicine.He believed that the pathological factors of cough variant asthma were wind,phlegm and blood stasis.The pathogenesis of cough variant asthma should be deficiency and pathogenic excess.The treatment of traditional Chinese medicine should be based on dispersing wind and resolving phlegm,promoting blood circulation and removing blood stasis,giving consideration to moistening lung,soothing liver,strengthening spleen and benefiting kidn To strengthen the purpose of eliminating evil.Some children with severe cough were treated with oral western medicine,aerosol inhalation bronchodilator and glucocorticoid,while those with rhinitis were treated with nasal irrigation.On the basis of better control of cough and wheezing symptoms,hormone drugs were gradually reduced or even discontinued to enhance the constitution of the children.