王继安辨治小儿肺系疾病经验

Wang Ji′an′s experience in treating infantile pulmonary diseases

王继安老师强调小儿肺系疾病宣肃有别,以利肺气升降;清温勿过,辨治及时准确;补泻适时,务求邪去正安;剂轻程短,切记脏腑娇嫩;脏腑关联,治肺不拘一脏,五脏中多从脾胃及肝论治;肺气不宣者根据寒热,风热犯肺者当清宣肺气,风寒犯肺者当温宣肺气;肺失肃降者有降气肃肺、解痉肃肺、通腑肃肺、泻肺平喘四法;王继安老师认为麻疹肺炎的治疗以宣透清解为要,临床上麻疹以卫气同病、气营同病多见,深入血分者较少,其精髓在于针对病因透邪外出,进而调达气机,以求营分热邪有外泄之路;从肝论治百日咳,其经验名方“旋磁白部汤”对百日咳、类百日咳综合征痉咳期疗效明显。

Professor Wang Ji’an emphasizes that there is difference between dispersing and clearing in pulmonary diseases,which helps lung-qi to go upward or downward.Clearing and warming must not be excessive in order that the differentiated treatment can be carried out in time.The reinforcing and reducing should be given properly to eliminate the evil and secure health.The drugs should be mild in nature and the course should be short because the organs are delicate.The organs are inter-related,so the treatment for pulmonary diseases should not be limited to lung,and spleen,stomach and liver should be considered.For patients whose lung-qi can’t be dispersed,the treatment should be based on coldness or heat:for patients with wind-heat invading the lung,the lung-qi should be cleared,while for those with wind-coldness invading the lung,the lung-qi should be warmed to disperse.For the patients whose lung-qi can’t be cleared,there are 4 ways to clear the lung:descending lung-qi,relieving spasm,clearing organs,and reducing lung to relieve asthma.Prof.Wang Ji’an believes that the treatment for measle pneumonia should focus on dispersing,clearing and relieving.Clinically,measles usually is a disease involving both weifen and qifen,and involving qifen and yingfen,but it rarely involves xuefen,so the treatment focuses on the causes:to remove the evil and regulate qi in order for the heat-evil of yingfen to be eliminated.The treatment for pertussis can be based on liver,and the well-known prescription——Xuanci Baibu decoction——has significant effect on spasm and cough of pertussis and pertussis-like syndrome.