陈团营基于“风咳”理论治疗小儿上气道咳嗽综合征(风痰恋肺证)经验

CHEN Tuanying’s experience in treating pediatric upper airway cough syndrome(the wind-phlegm retention of lung syndrome)based on the theory of wind cough

文章主要总结陈团营副主任医师运用中医“风咳”理论治疗小儿上气道咳嗽综合征(风痰恋肺证)的临床经验。上气道咳嗽综合征是以咳嗽为主要或唯一临床表现的一组临床综合征,伴鼻塞、流涕、咽痒、咽干有异物感、脓性分泌物等症状,常由各种鼻炎、腺样体肥大及慢性咽炎等一系列上气道疾病引起,是引起小儿慢性咳嗽的第二大原因,需要引起临床关注。临床上,上气道咳嗽综合征常合并其他疾病共同引起慢性咳嗽,所以其诊断及治疗较为困难。西医治疗上气道咳嗽综合征常采用口服抗组胺药物或白三烯受体拮抗剂、鼻用糖皮质激素对症处理以及手术等治疗,但上述疗法均具有一定的局限性,未能根除病因,疗效不尽如人意。陈师具有多年中医临床经验,认为小儿上气道咳嗽综合征(风痰恋肺证)的病因为风邪侵犯人体,导致肺脾功能失调,痰邪内生,或素体肺脾不足,痰湿内生,复感风邪所致。病位以肺为主,涉及脾及鼻咽二窍,病机关键为风痰恋肺,肺失宣肃。方用祛风消痰方以祛风宣肺,消痰止咳,对于虚证者,兼以补虚;对于实证者,则增强祛邪之力,临床获得显著疗效。

This article mainly summarizes Deputy Chief Physician CHEN Tuanying’s experience in treating pediatric upper airway cough syndrome(the wind-phlegm retention of lung syndrome)based on the theory of wind cough of TCM.Upper airway cough syndrome is a group of clinical syndromes with cough as the main or only clinical manifestation,accompanied by nasal congestion,T runny nose,throat itch,dry throat and foreign body sensation,purulent discharge and other symptoms.It is often caused by a series of upper airway diseases such as rhinitis,adenoid hypertrophy and chronic pharyngitis.It is the second major cause of chronic cough in children and needs clinical attention.Clinically,upper airway cough syndrome often causes chronic cough together with other diseases,so it is difficult to diagnose and treat.Western medicine often uses oral antihistamines or leukotriene receptor antagonists,nasal glucocorticoid symptomatic treatment and surgery to treat upper airway cough syndrome,but the above therapies have certain limitations,can not eradicate the cause,and the efficacy is not satisfactory.Dr.CHEN has many years of clinical experience in traditional Chinese medicine,and believes that the disease of pediatric upper airway cough syndrome(the wind-phlegm retention in lung syndrome)is caused by wind-evil invading the human body,resulting in endogenous phlegm after dysfunction of lung and spleen,or wind evil invasion after endogenous phlegm-dampness due to lung and spleen insufficiency.The main location of the disease is the lung,involving the spleen and nasopharynx,the key pathogenesis is that wind-phlegm is blocked in the lung,which resulting the abnormal function of the lung.The Qufeng Xiaotan decoction(祛风消痰方)is used to dispel wind and disperse the lung,and eliminate phlegm and relieve cough.For patients with deficiency syndrome,nourishing method is also applied.For patients with excess syndrome,the power of dispelling pathogenic bacteria is enhanced.The clinical effect is remarkable.