从肺阳虚论治儿童哮喘

Treatment of Childhood Asthma Based on Deficiency of LungYang

哮喘是儿童时期最常见的呼吸系统疾病之一,具有反复发作的特点。防治哮喘反复发作的重要环节就是持续期和缓解期治疗。“未发以扶正气为主,既发以攻邪气为先”,因此非发作期应以调理肺脾肾三脏功能,消除伏痰夙根为则。其中,肺是哮喘的核心病位,而历代医家多从肺气虚、脾气虚、肾气虚、肾阳虚辨治持续期和缓解期,鲜少提及肺阳。然吾师宋桂华教授经过多年临床经验及理论研究,提出在哮喘发病中肺阳虚一证多见,且创制经验方“参芪青龙汤加减”,基于肺阳虚理论从持续期和缓解期论治儿童哮喘,持续期以散寒化饮为主,兼以温补肺阳,理气化痰;缓解期以温阳固本、温肺固表为主,兼以散寒化痰祛瘀,标本兼顾,扶正祛邪,分期据症加减,主次不同,各有侧重,取得了较好的临床疗效。

Asthma is one of the most common respiratory diseases in childhood,which is characterized by recurrent attacks.The key to preventing recurrent asthma attacks is duration and remission.“Strengthening vital Qi method is used in chronic case,elimminating pathogenic factor in acute condition as the first”,so the non-attack period should be to regulate the function of lung,spleen and kidney,eliminate the root of phlegm.Among them,lung is the core disease location of asthma,and the medical experts of previous dynasties mainly distinguish the treatment duration and remission period from lung Qi deficiency,spleenQi de⁃ficiency,kidney Qi deficiency and kidney Yang deficiency,and rarely mention lung Yang.However,after years of clinical experi⁃ence and theoretical research,Professor SONG Guihua,the tutor,has proposed that the deficiency of lung Yang is more common in the onset of asthma,and created an empirical formula“Modified Shenqi Qinglong Decoction(参芪青龙汤加减)”.Based on the deficiency of lung Yang theory from the duration and remission period of the treatment of childhood asthma,the duration treatment is mainly to dispelcold and resolve fluid retention,and also to warm and tonify lung Yang,rectify Qi and transform phlegm.The re⁃mission treatment is mainly to warm Yang and secure the root,warm lung and consolidate the exterior,and also to dispel cold and resolve phlegm and remove blood stasis.It has achieved good clinical effect by giving consideration to both the roots and the symp⁃toms,strengthening the vital Qi and eliminating the evils,and increasing or decreasing the symptoms according to different stages,with different priorities.