贾斌教授运用肺脾同治法治疗小儿咳嗽经验

Professor JIA Bin’s experience in treating children with cough by simultaneous treatment of lung and spleen

贾斌教授认为小儿咳嗽可分为外感和内伤,二者常兼夹为病,但总以外感者居多。因小儿肺、脾常不足,故临床常以肺脾同病见证者居多,主要表现为咳嗽、咳痰,伴纳呆、腹胀、便秘、泄泻等症,临床可分为4期,且多采用肺脾同治之法。初期风寒或风热初犯,病势尚浅,治宜解表透邪、和胃导滞,风寒者予止嗽散合保和丸加减,风热者则予桑菊饮加消食导滞药;中期正邪相争,痰热交织,气机上逆,治宜清肺化痰、顺气和中,方予清金化痰汤合旋覆代赭汤加减;后期风寒或风热已去,痰浊或痰热内恋,治宜止咳化痰、健脾化湿,方予二陈汤合参苓白术散加减;缓解期,邪去正未复,治宜补益肺脾、顾护正气,方予六君子汤合玉屏风散加减。附案例2则,以资验证。

Professor JIA Bin holds that children with cough can be divided into external contraction and internal injury,both of which are often accompanying and complicated as diseases,but the former one is in majority.Because children’s lung and spleen are frequently in insufficiency,it is common to see patients with lung and spleen diseases clinically.The main manifestations are cough,expectoration,concomitant with anorexia,abdominal distension,constipation and diarrhea,etc.The clinical stage consists of four stages,and most of them are treated with simultaneous treatment of lung and spleen.In the early stage of wind-cold or wind-heat initial attack,the tendency of disease is at the superficiality,it is advisable to treat with relieving superficial pathogenic factors to let out pathogenic factors and regulating stomach to relieve stagnation,and those with wind-cold syndrome are given modified Zhisou San(止嗽散)combined Baohe Wan(保和丸),while those with wind-heat syndrome are given Sangju Yin(桑菊饮)plus promoting digestion to resolve food retention medicinals.In the middle stage,struggle between healthy qi and pathogenic factors causes mixture of phlegm and heat,leading to adverse flow of qi,it is advisable to treat with clearing lung to resolve phlegm and smoothing qi to harmonize middle energizer,and give prescription modified Qingjin Huatan Tang(清金化痰汤)combined Xuanfu Daizhe Tang(旋覆代赭汤).At the later stage,wind-cold or wind-heat has been expelled,the result of which is internal lingering of phlegm turbidity or phlegm heat,it is advisable to treat with relieving cough to resolve phlegm and invigorating spleen to resolve dampness,and give prescription modified Erchen Tang(二陈汤)combined Shenling Baizhu San(参苓白术散).In the remission stage,removal of pathogenic factors accompanying with unrecovered healthy qi,it is advisable to treat with nourishing lung and stomach and protecting healthy qi,and give prescription modified Liujunzi Tang(六君子汤)combined Yupingfeng San(玉屏风散).Two cases are attached for verification.