闫慧敏基于气机升降理论治疗儿童重症肺炎支原体肺炎经验

YAN Hui-min's experience in treating severe mycoplasma pneumoniae pneumonia in children based on the theory of ascending and descending of Qi

肺炎支原体肺炎(MPP)是儿童常见的感染性肺疾病,重症支原体肺炎(SMPP)发生时可危及患儿生命。闫慧敏教授认为气机升降失常是SMPP发生的根本病机,掌握气机变化规律,尽早开展治疗,能够预防其发生,并进行有效治疗。闫教授从肺失宣发肃降、三焦气化不利、痰热阻遏气机、脾胃升降功能失常等多个角度进行辨证施治,使气机升降有序。肺失宣肃,自拟麻杏肃降汤宣肺降气。气化不利,水湿停滞,方选三仁汤开上焦肺气。邪热壅盛,痰阻气道,治以清热宣肺、通腑泻下,予千金苇茎汤合大承气汤化裁。脾胃升降失常,方用半夏泻心汤化裁调理脾胃,升清降浊。

Mycoplasma pneumoniae pneumonia is a common infectious lung disease in children,and severe cases of mycoplasma pneumoniae pneumonia can endanger the lives of children.Professor YAN Hui-min believes that the abnormal rise and fall of qi is the fundamental pathogenesis of severe mycoplasma pneumoniae pneumonia.Understanding the changes in qi movement and giving treatment as soon as possible can prevent the occurrence of severe mycoplasma pneumoniae pneumonia and provide effective treatment.Professor YAN made syndrome differentiation and treatment from multiple perspectives,such as failure of lung qi to disperse and descend,unfavorable gasification of Three Jiao,phlegm heat blocking and suppressing qi movement,and dysfunction of spleen and stomach in ascending and descending,to ensure orderly ascending and descending of qi.The lung loses its ability to promote diuresis,and the self-designed Maxing Xuanjiang Tang can promote dispersing and descending of lung qi.If the gasification is unfavorable and the water dampness stagnates,choose Sanren Tang to activate lung qi in the Upper Jiao.Due to the accumulation of pathogenic heat and obstruction of phlegm in the airways,the treatment is to clear heat,disperse lung qi,and promote bowel movement,then Qianjin Weijing Tang and Dachengqi Tang are used to treat this condition.If the spleen and stomach are abnormal in ascending and descending,the prescription is modified Banxia Xiexin Tang to regulate the spleen and stomach and increase the clear and reduce turbidity.