基于“聚于胃,关于肺”论治小儿咳嗽变异性哮喘

Treatment of cough variant asthma in children based on the theory of“gathered in the stomach,blocked in the lung”

咳嗽变异性哮喘是儿科慢性咳嗽中最常见的疾病之一,“聚于胃,关于肺”是对咳嗽病机的概括,反映了《黄帝内经》在治疗咳嗽病时对肺胃的高度重视。肺胃两脏解剖位置相近,脉络相互贯通,在生理病理方面也相互影响,为临床从肺胃论治咳嗽变异性哮喘提供了充实的理论依据。根据此理论,临床上对于风热犯肺证以桑菊饮为主疏风清热,宣肺止咳;胃阳虚弱,脾虚气滞证者以异功散和或苓桂术甘汤为主温脾和胃,理气止咳;脾虚痰伏,肺热气逆证以加味六安煎为主健中化痰,清肺降气;肺胃阴伤证以麦门冬汤为主养阴生津。以求治咳不离肺,也不拘泥于肺。

Cough variant asthma is one of the most common diseases in pediatric,and“gathered in the stomach,blocked in the lung”is a summary of the cough pathogenesis,reflecting The Yellow Emperor’s Canon of Internal Medicine value it.The stomach near the lungs,the veins are interconnected,and they also affected each other in physiology and pathology which provides a theoretical basis for the clinical.Thus,clinically,Sangju Yin is used to the lung evidence of wind and fever syndrome;Yigong San and Linggui Zhugan Tang are used to the weak yang of stomach and spleen deficiency and qi stagnation;Jiawei Liu’an Jian is used to the spleen deficiency and phlegm accumulation syndrome;Maimendong Tang is used to the lungs and stomach yin injury syndrome,in order to achieve the treatment of cough does not leave the lungs,nor is it confined to the lungs.