杜启鹏教授分期论治小儿上气道咳嗽综合征致慢性湿性咳嗽经验

Professor DU Qipeng’s experience in syndrome differentiation and treatment of children with upper airway cough syndrome causing chronic wet cough by stages

杜启鹏教授基于小儿稚阴稚阳、易虚易实的生理病理特点,认为小儿上气道咳嗽综合征致慢性湿性咳嗽病因病机为本虚标实、肺气失宣,病理因素常夹风、夹痰、夹瘀。提出分期论治:疾病早期,以标实为主,治以宣肺祛邪,佐以燥湿化痰;疾病中期,正虚邪恋,以肺气阴不足、脾失健运为主,治以补肺益阴、健脾助运,佐以理气化痰、活血通络;疾病后期,以本虚为主,治以扶正固本,补肺益肾纳气。分别选自拟温肺化饮汤、自拟补肺运脾汤和自拟培元纳气汤,随症加减,疗效满意。附案例1则,以资验证。

Professor DU Qipeng holds that the etiology and pathogenesis of children with upper airway cough syndrome(UACS)causing chronic wet cough lie in deficiency in origin and excess in superficiality as well as failure of pulmonary qi to disperse,the pathological factors thereof are often complicated by wind,phlegm and blood stasis based on the the physiological and pathological characteristics of children with premature yin and yang as well as proneness to deficiency or excess.He puts forward syndrome differentiation and treatment by stages:In the early stage of the disease dominating with excess in superficiality,the treatment is dispersing lung and expelling pathogenic factors,supplemented by drying dampness and resolving phlegm;In the middle stage of the disease of lingering of pathogenic factors due to deficiency of healthy qi,dominating with insufficiency of both pulmonary qi and yin as well as failure of spleen in transportation,the treatment is invigorating lung to nourish yin and streng-thening spleen to reinforce transportation,supplemented by regulating qi to resolve phlegm and promoting blood circulation to dredge collaterals;In the late stage of the disease dominating with deficiency in origin,the treatment is strengthening healthy qi to consolidate constitution and invigorating lung to nourish kidney and receive qi.The prescriptions of self-made Wenfei Huayin Tang(温肺化饮汤),self-made Bufei Yunpi Tang(补肺运脾汤)and self-made Peiyuan Naqi Tang(培元纳气汤)are selected respectively,modifying in accordance with syndromes,all of which has obtained satisfactory efficacy.One case is attached for verification.