付义教授从内外合邪论治顽咳经验举隅

Experience of Professor Fu Yi in Treating Persistent Cough from the Perspective of Internal and External Combined Pathogens

文章介绍了付义教授辨治顽固性咳嗽的临证经验,付义教授认为顽咳多为“内外合邪”,常系内伤基础上复受外邪,或表现为体质偏颇致邪气从化,或与内生邪气杂合,此种状态较之单纯外感或内伤咳嗽更加顽固难治;外邪主要是外感六淫及时疫戾气,以风、寒、火、燥居多;而内邪指由脏腑功能失调、气血违和所产生的内生邪气,其中以寒、痰、瘀为主。付义教授在临床诊治过程中非常强调四诊资料收集的完整和准确,认为如此方能识别内外状态;临证从“内外合邪”入手,安内攘外、内外兼治,每获良效。

This article introduced Professor Fu Yi’s clinical experience in the treatment of persistent cough.Professor Fu Yi believes that persistent cough is mostly“internal and external pathogens”,which is often caused by external pathogens on the basis of internal injury,or manifested as a partial constitution leading to the assimilation of pathogens,or mixed with internal pathogens,which is more stubborn and difficult to treat than simple external or internal injury cough.The tutor believes that the external pathogens mainly refers to the six exogenous pathogens and the current epidemic,which are mainly wind,cold,fire and dryness,while the internal pathogens refers to the internal pathogens generated by the dysfunction of viscera and the conflict between qi and blood,which is mainly cold,phlegm and blood stasis.In the process of clinical diagnosis and treatment,the tutor attached great importance to the integrity and accuracy of the collection of the four diagnoses,so as to distinguish the internal and external conditions.The clinical diagnosis starts with the“combination of internal and external pathogens”,and treats both internal and external,with good results every time.