李燕宁运用大柴胡汤治疗儿童过敏性咳嗽的方证研究

Formula and Syndrome Study on Li Yan-ning′s Application of Major Bupleurum Decoction in the Treatment of Allergic Cough in Children

目的:总结李燕宁教授运用大柴胡汤治疗儿童过敏性咳嗽的方证规律。方法:选择2018年7月1日至2020年12月30日李教授运用大柴胡汤治疗的儿童过敏性咳嗽病案103则,规范数据,建立EXCEL数据库,用黄金分割法对方证进行优选,大于0.618者定义为主要方证。结果:舌质红出现频率为68.9%,舌苔黄腻与黄燥频率之和为85.44%,弦脉、弦滑脉、弦数脉频率之和占72.82%,黄痰、胸胁苦满、小便黄频率分别为63.10%、65.05%、62.14%。大柴胡汤原方中,柴胡、黄芩两味药完全保留;枳实(枳壳)、半夏(清半夏、姜半夏、竹沥半夏)、芍药(白芍、赤芍)用了不同的品种,但亦保留,其中以枳实、清半夏、白芍为主;大黄以酒大黄为主;生姜、大枣的使用率较高。药物加味有瓜蒌、浙贝母、川贝母、蝉蜕等。结论:李教授运用大柴胡汤治疗儿童过敏性咳嗽指征为黄痰、胸胁苦满、小便黄,舌质红,舌苔黄腻、黄燥,脉象为弦、弦滑或弦数,符合《伤寒论》原文宗旨,但具体症状上有所扩展。

Objective:To summarize the formula and syndrome law of Professor Li Yan-ning′s application of Major Bupleurum Decoction in the treatment of allergic cough in children.Methods:A total of 103 cases of allergic cough in children treated by Professor Li with Major Bupleurum Decoction from July 1,2018 to December 30,2020 were selected,the data were standardized,the Excel database was established,and the formula and syndrome were optimized by the golden section method.And any syndrome greater than 0.618 was defined as the main syndrome.Results:The frequency of red tongue was 68.9%;the sum of yellow greasy tongue coating and yellow dryness accounted for 85.44%;the sum of string pulse,string slippery pulse and string rapid pulse accounted for 72.82%;and the frequencies of yellow phlegm,chest and flank pain,and fullness,and yellow urine accounted for 63.10%,65.05%and 62.14%respectively.In the original Major Bupleurum Decoction,Chaihu(Radix Bupleuri)and Huangqin(Radix Scutellariae)were completely retained.Different varieties of Zhishi(Fructus Aurantii Immaturus)or Zhiqiao(Fructus Aurantii),Banxia(Rhizoma Pinelliae),including Qingbanxia(Rhizoma Pinelliae Praeparata cum Alumen),Jiangbanxia(Rhizoma Pinelliae Praeparatum)and Zhulibanxia(Succus Bambusae Rhizoma Pinelliae),Shaoyao(Radix Paeoniae Alba seu Rubra),including Baishao(Radix Paeoniae Alba)and Chishao(Radix Paeoniae Rubra)were used,but they were also retained.Wine-Prepared Daihuang(Radix et Rhizoma Rhei)was mainly used.The utilization rate of Shengjiang(Rhizoma Zingiveris Recens)and Dazao(Fructus Jujubae)was high.The supplemented drugs included Gualou(Fructus Trichosanthis),Zhebeimu(Bulbus Fritillariae Thunbergii),Chuanbeimu(Bulbus Fritillariae Cirrhosae),Chantui(Periostracum Cicadae),etc.Conclusion:Professor Li uses Major Bupleurum Decoction to treat children′s allergic cough.The indications are yellow phlegm,full chest and flank pain,yellow urine,red tongue,yellow greasy and dry tongue coating,and the pulse is string-like,string-like slippery or string-like rapid,which is in line with the original purpose of Treatise on Cold Damage Diseases,but the specific symptoms are expanded.