基于既病防变理念从瘀热论治小儿肺炎恢复期

Discussion on treating pediatric pneumonia convalescence from stagnant heat based on the concept of preventing disease from exacerbating

部分重症肺炎或慢性迁延性肺炎患儿经过规范治疗后,仍遗留咳嗽、咳痰等症状,或疾病迁延不愈,临床防治棘手。对于难治性迁延性肺系疾病的防治,中医具有一定优势,尤其强调肺炎恢复期辨治,有助于减少肺部损伤,改善肺功能。小儿肺炎发作期由于热、痰、毒邪相互胶结,易形成瘀热病理产物,瘀热也是小儿肺炎恢复期的关键病理因素,易导致症状迁延,疾病反复。小儿肺常不足,肺炎后,尤为易伤不易愈。小儿肺炎特别是重症肺炎恢复期,存在正气损伤,瘀热留伏问题。故基于中医既病防变理念,防治小儿肺炎应关注疾病全病程,防止疾病的发展与传变,从瘀热辨治小儿肺炎恢复期尤为必要,亦为临床减少重症肺炎后遗症提供思路。

Some children with severe pneumonia or chronic persistent pneumonia still have symptoms such as cough and expectoration after standardized treatment,or the disease persists.It is difficult to prevent and treat clinically.Traditional Chinese medicine has certain advantages in the prevention and treatment of refractory and persistent pulmonary diseases,emphasizing the syndrome differentiation of pneumonia convalescence,which helps alleviate lung injury and improve lung function.During the onset of pneumonia in children,due to the mutual cementation of heat,phlegm and toxic pathogens,it is easy to form pathological products of stagnant heat.Stagnant heat is also a critical pathological factor in pneumonia convalescence,resulting in persistent symptoms and disease recurrence.Children's lungs are often insufficient,especially after pneumonia.Some children with severe pneumonia have problems with healthy qi damage and stagnation of blood stasis and heat.Therefore,based on the concept of preventing disease from exacerbating,the prevention and treatment of pediatric pneumonia should pay attention to the whole course of the disease and prevent the development and spread of the disease.It is particularly necessary to treat pediatric pneumonia convalescence from stagnant heat,and provide ideas for reducing the sequelae of severe pneumonia in clinics.