王烈“肺鼻同治”分期论治儿童过敏性鼻炎-哮喘综合征经验

WANG Lie's Experience in Treating Combined Allergic Rhinitis and Asthma Syndrome in Children by Stages with the Principle of“Treating Lung and Nose Simultaneously”

总结王烈教授从“肺鼻同治”分期论治儿童过敏性鼻炎-哮喘综合征的临证经验。提出将过敏性鼻炎-哮喘综合征以“鼻性哮喘”论治,临证分为发作期、缓解期、稳定期三期,发作期以风寒犯肺、内热蕴脾为关键病机,治以散寒清热、通鼻止哮,常用鼻哮汤加减;缓解期以正虚邪恋、痰饮留伏为关键病机,治以理肺化痰、补肾健脾,常用哮痰汤加减;稳定期以正虚不固、伏痰蕴肺为关键病机,治以益气抑痰、固本防哮,常用固哮方加减。临证验方随症加减,取得良好疗效。

This paper summarized the clinical experience of Professor WANG Lie in treating combined allergic rhinitis and asthma syndrome(CARAS)in children by stages from the perspective of“treating lung and nose simulta⁃neously”.It is proposed to treat CARAS as“nasal asthma”from attack period,remission period and stable period.In attack period,the key pathogenesis is wind-cold stirring the lungs and internal heat accumulating in the spleen,for which the treatment is to dispel cold and clear heat,unblock the nose and relieve asthma,and modified Bixiao Decoc⁃tion(鼻哮汤)is usually used.In the remission period,the key pathogenesis is healthy qi deficiency and pathology not leaving,phlegm-rheum lingering,and the treatment is to regulate the lung and resolve phlegm,tonify the kidney and fortify the spleen,usually using modified Xiaotan Decoction(哮痰汤).In the stable period,the key pathogenesis is healthy qi deficiency and insecurity,latent phlegm accumulation in the lung,for which it is suggested to boost qi and suppress phlegm,consolidate the root and prevent asthma with modified Guxiao Formula(固哮方).In clinical prac⁃tice,the approved formulas are used in their modifications according to the symptoms,and good curative effect has been achieved.