孙建光从肝论治顽固性咳嗽经验辑要

Summary of Sun Jianguang’s experience in treating intractable cough from liver

顽固性咳嗽为临床上常见的疑难病症,抗炎止咳等常规治疗多效果不佳,且病程日久的咳嗽往往使患者深受其扰。但究其病机,总属外感后期,脏腑功能失和,肺气失于宣降所致,病位多在肺,但与心肝脾肾等脏腑密切相关,故其治疗亦不可单从肺论治,当需改善五脏异常的生克关系,恢复脏腑正常的生理功能,诸脏调和,则咳嗽自止。孙建光教授依据顽固性咳嗽的病因病机及发病特点,认为本病可从肝论治,着重于从调肝理肺、息风解痉、火郁发之、滋补肝肺角度治之,方选增液汤、四逆散、升降散等经典方剂进行临证化裁,药精方简且疗效显著。

Intractable cough is a common and difficult disease in clinical practice.The effect of conventional treatment,such as anti-infl ammatory and cough relieving,is often not good,and the cough with a prolonged course often makes patients deeply disturbed by it.However,its pathogenesis is always due to the improper function of zang-fu viscera and the failure of lung qi to ventilate and descend in the late stage of exogenous diseases.The disease is mostly located in the lung,but it is closely related to the heart,liver,spleen and kidney.Therefore,the treatment of intractable cough can not be based solely on the lung.When it is necessary to improve the abnormal relationship of generation and restriction between the fi ve viscera,restore the normal physiological function of the viscera and coordinate the viscera so that the cough will consequently stop by itself.Based on the etiology,pathogenesis and characteristics of intractable cough,Professor Sun Jianguang maintains that the disease can be treated from the perspective of the liver,focusing on regulating the liver and lung,dispelling wind and relieving spasms,eliminating the fi re stagnation,and nourishing the liver and lung.Classical prescriptions such as Zengye Decoction,Sini Powders,Shengjiang Powders,etc.,are selected and properly modifi ed for clinical treatment,and the refi ned prescriptions and medications are simple yet eff ective.