“宣摄合和”法治疗变应性鼻炎的用药经验

Medication experience in treating allergic rhinitis with"dispersing,astringing,and harmonizing"therapy

变应性鼻炎是一种临床常见的变态反应性疾病,发病时对患者生活以及各方面均会造成明显的负面影响。随着近年来社会、环境、工作等变化,变应性鼻炎的发病率显著升高,严重影响患者的生活。通过探讨《神农本草经》中“宣摄合和”的组方法则,结合临床实践解决临床实际问题。以医家经典为骨,临床实践经验为翼,总结变应性鼻炎的根本病机在于肺气疏郁无权,导致肺之开窍对寰宇之气的反应或敏或缓,发为本病。变应性鼻炎治以宣摄肺气,合和阴阳。以首批全国老中医药专家学术经验继承工作指导老师祝谌予治疗过敏性疾病的常用方剂过敏煎为参考,方中五药防风、银柴胡、乌梅、五味子、甘草,临证加减。结合医家经典用药组方法则,化裁名方,借力经典,总结变应性鼻炎典型病案,并作详析。

Allergic rhinitis is a common allergic disease in clinic,which has a significant negative impact on all aspects of patients'life.Due to the changes in society,environment,work,and others,the incidence of allergic rhinitis has increased significantly in recent years,seriously affecting the daily life of patients.By discussing the formula principles of"dispersing,astringing and harmonizing"in Shen Nong Ben Cao Jing(Shen Nong's Classic of the Materia Medica),this paper strives to solve clinical practical problems in combination with clinical practice.Taking the Chinese medicine classics as the bone(base)and clinical experience as the wing(soul),it is concluded that the fundamental pathogenesis of allergic rhinitis is that the deficiency of lung qi leads to unconsolidation of defense-exterior,resulting in a hypersensitive or hyposensitive reaction of the nose(the lung opens into the nose)to the qi from the natural world,thus giving rise to the disease.Therefore,allergic rhinitis can be treated by dispersing and astringing lung qi and harmonizing yin and yang.In this paper,Guomin Decoction,commonly used by ZHU Chenyu(one of the first batch of national senior Chinese medicine experts academic experience inheritance instructors)in treating allergic diseases,was taken as the reference,and then the five herbs in the formula,namely Fangfeng(Saposhnikoviae Radix),Yinchaihu(Stellariae Radix),Wumei(Mume Fructus),Wuweizi(Schisandrae Chinensis Fructus),and Gancao(Glycyrrhizae Radix et Rhizoma)were modified based on differentiation of patterns.Finally,combined with the classical formula principles of TCM doctors and leveraging the advantages of TCM classics,some famous formulas have been modified,and the typical medical records of allergic rhinitis has been summarized and analyzed at length.