辛开苦降法治疗儿童重症肺炎支原体肺炎的临证体会

Clinical experience of acridness relieving superficies and bitterness expelling internal heat as adjuvant treatment of severe MPP in children

辛开苦降法源于《黄帝内经》,经后世医家不断发挥,被广泛应用于临床,但主要用于治疗脾胃系疾病,后经现代儿科医家刘弼臣教授和徐荣谦教授的创新,始被很好地应用在小儿肺系疾病的临床治疗。笔者认为儿童肺炎支原体肺炎(MPP)的病机特点为肺热程度重,肺气闭郁程度亦重,因此治疗上应以辛味药开肺闭,苦味药清肺热,即辛开苦降,宣肺开闭,清热化痰;若单纯使用清肺泻热之品,并不能奏效,只有在气机得以宣畅的基础上,再投以清肺泻热之品,才能收获满意疗效。附案例1则,以资验证。

"Acridness relieving superficies and bitterness expelling internal heat"originated from the Huangdi Nejing and has been widely used in clinical practice by later medical practitioners with their development of the idea,mainly for treating diseases related to the spleen and stomach.However,it has also been innovatively applied to pediatric respiratory diseases by professor LIU Bichen and professor XU Rongqian.The author believes that the pathogenesis of mycoplasma pneumonia in children is characterized by severe lung heat and lung qi stagnation,so the treatment should focus on relieving stagnation with pungent herbs,clearing lung heat with bitter herbs,and promoting lung circulation,clearing heat,and resolving phlegm.If only herbs that clear the lung and relieve heat are used,satisfactory results may not be achieved.Only on the basis of smoothing the lung qi,and then using medicines to clear the lung and remove heat,can we reap satisfactory results.One case is presented to verify this approach.