干咳辨治刍议

Discussion About Differentiation and Treatment of Dry Cough

干咳可分为8型进行论治,风邪闭肺者,治以疏风宣肺,风寒为主者,辛温宣肺,方选三拗汤加减;风热为主者,治以辛凉宣肺,方选桑菊饮为主;风邪伏肺者,治以疏风解痉,选用苏黄止咳方。燥邪犯肺者,应轻宣温润,治以甘润为主。凉燥者,治以辛甘温润,多选杏苏散为主方;温燥者,治以辛凉清热润肺,方选桑杏汤加减。火热闭肺者,宜宣肺泻热,邪热闭肺早期,宜使用辛凉或辛寒泻热之品,采用银翘散或白虎汤合麻杏甘石汤;外感肺病后期,应宣肺泻热,佐以养阴,方选清络饮、竹叶石膏汤类。肺阴不足者,治以养阴润燥,常选用沙参麦冬汤治疗。肝气郁滞者,宜平肝降逆,可选用四逆散合半夏厚朴汤或旋覆代赭汤治疗。湿热闭肺者,宜清化宣肺,可选用清化湿热、宣畅气机的方法,以恢复肺的宣肃功能。水饮停滞者,当温阳化饮,可采用真武汤、苓桂术甘汤、肾气丸之类。燥湿犯肺者,治以甘寒味薄之品,方选麦门冬汤、竹叶石膏汤等。

Dry cough can be divided into 8 types for treatment.For syndrome of wind pathogen closing lung,the treatment should focus on dispelling wind and ventilating lung.For those patients with wind and cold as the main syndrome,Modified Rough and Ready Three Decoction can be used for ventilating lung with pungent and warm properties.For those with wind and heat as the main syndrome,Mulberry Leaf and Chrysanthemum Beverage can be used for ventilating lung with pungent and cold properties.For latent wind pathogen in lung,Folium Perillae and Prapared Herba Ephedrae Cough-Stopping Decoction can be used for dispelling wind and relieving spasm.For syndrome of dryness pathogen invading lung,the treatment should focus on slight ventilating and warming and moistening with sweet and moistening properties.For those with cold dryness,Apricot Kernel and Perilla Powder is mainly used,while for those with warm dryness,Modified Mulberry Leaf and Apricot Kernel Decoction can be used.For syndrome of fire-heat closing lung,the treatment should focus on ventilating lung and purging fire.For those in the early stage,the medicinals with pungent and cool or cold properties and functions of purging fire are always used,so Lonicera and Forsythia Powder,or White Tiger Decoction combined with Ephedra and Apricot Kernel and Gypsum and Licorice Decoction can be adopted.For For exogenous lung disease in the later stage,it is necessary to ventilate lung and purge heat,supplemented by nourishing yin,so Channel-Clearing Beverage,Lophatherum and Gypsum Decoction can be adopted.For syndrome of lung qi yin deficiency,Radix Adenophorae seu Glehniae and Ophiopogon Decoction can be used for nourishing yin and moistening dryness.For syndrome of liver qi stagnation,Frigid Extremities Powder combined with Pinellia and Officinal Magnolia Bark Decoction,or Inula and Hematite Decoction can be used for pacifying liver and descending counterflow of qi.For syndrome of dampness-heat closing lung,the method of clear away dampness-heat and dredge qi movement to restore the proper function of lung.For syndrome of fluid stagnation,True Warrior Decoction,Poria and Cinnamon Twig and Atractylodes Macrocephala and Licorice Decoction,Kidney Qi Pill can be used for warming yang and resolving fluid retention.For syndrome of dryness-dampness invading lung,the medicinals with sweet-cold and thin flavor should be chosen,so Ophiopogon Decoction,Lophatherum and Gypsum Decoction,etc.are often used.