老年咳嗽变异性哮喘患者中医证候特点及干预研究概况

Research summary on characteristics of TCM syndromes and intervention in elderly patients with cough variant asthma

目的:探究老年咳嗽变异性哮喘(CVA)患者中医证候特点及干预概况,为临床制定辨证治疗方案提供可靠依据。方法:通过查阅文献并整合相关资料的方式进行总结分析,根据发病情况、症状特点、证候类型等归纳出临床老年CVA患者较为常见的中医证候特点,制定出统一的中医临床证候分布特点规律,并在证候分析的基础上,结合以往临床CVA患者的中医药用药情况进行系统观察及研究,总结现临床针对老年CVA患者的干预概况。结果:老年CVA患者临床表现以阵发性、刺激性干咳为主,并伴有咽痛、鼻塞、打喷嚏、出汗、咳痰、口渴等症状,根据症状、舌象、脉象等分析其病因病机可能与先天禀赋不足、后天复感风邪,抑制肺气上逆,肺管不利,引起气道挛急有关,日久则邪郁于肺,瘀阻肺络、津液耗伤,概括为风邪犯肺证、风寒袭肺证、风热犯肺证、痰热壅肺证、肺热阴虚证、肺阴亏虚证等证候。中医药治疗途径分为药物内服及外治两种,其中内治法主要以祛邪宣肺、补益肺肾、祛邪扶正为主,而外治又可分为穴位敷贴,穴位注射、针刺等,疗效显著。结论:CVA以本虚标实为主要病机,中医治疗疗效确切,具有作用温和、辨证论治、安全性高等优势,优势明显。

Objective:To explore the characteristics of TCM syndromes and intervention in elderly patients with cough variant asthma(CVA),and to provide a reliable basis for clinical development of regimen of TCM syndrome differentiation and treatment.Methods:Summary and analysis were performed by reviewing literature and integrating relevant data,and the common characteristics of TCM syndromes in clinically elderly CVA patients were summarized based on the incidence,symptoms characteristics and syndrome types,and a unified distribution pattern of TCM clinical syndromes was formulated.Based on the analysis of syndromes,systematic observation and research were carried out by combining the use of traditional Chinese medicine in previous clinically CVA patients,and the current clinical intervention for elderly CVA patients was summarized.Results:The clinical manifestations of elderly CVA patients were mainly paroxysmal dry cough and irritating dry cough,accompanied by sore throat,nasal congestion,sneezing,sweating,expectoration and thirst.According to the symptoms,tongue picture and pulse conditions,the etiology and pathogenesis might be related to the lack of congenital endowment,acquired relapse of wind pathogens,suppression of lung qi upward reversal,unfavorable lung ducts and airway spasm causing.As time went by,pathogenic factors stagnated in the lungs,blood stasis blocked in lung collaterals and body fluid was consumed,which could be summarized as wind-pathogen invasion of the lungs,wind-cold attack of the lungs,wind-heat invasion of the lungs,phlegm-heat obstruction of the lungs,heat-yin deficiency of the lungs and lung-yin deficiency.Therapeutic approaches of traditional Chinese medicine were divided into two types:oral medicine and external treatment.The internal treatment methods were mainly to dispel pathogens and promote the lung,replenish the lungs and kidneys,and dispel pathogens and strengthen the body,and the external treatment methods included acupoint application,acupoint injection and acupuncture,with remarkable efficacy.Conclusion:The main pathogenesis of CVA is deficient root and excessive superficial.Traditional Chinese medicine therapy has a definite efficacy and has the advantages of mild effect,dialectical treatment and high safety,and its advantages are obvious.