仲景辨治百日咳思想探析

Analysis on Differentiation and Treatment of Pertussis by Zhang Zhongjing

通过对百日咳的文献研究以及张仲景在《伤寒论》《金匮要略》中对其的病因病机、症状、方药的研究发现百日咳属中医学“顿咳”范畴,多因疫邪而得,病多在三阳经。根据《中医病证诊断疗效标准·中医儿科病证诊断疗效标准》中顿咳一证的描述及患者恶寒、发热、汗出等情况将顿咳分为太阳证、阳明证、太阳阳明合证、少阳证四证,并在其四证上又分伤寒证、中风证、腑实证等而用麻黄汤、桂枝加厚朴杏仁汤、调胃承气汤等方临证对治,初步分析张仲景治疗顿咳的辨治经验,以期为临床诊疗提供参考。

The research on pertussis is insufficient,and with the recent prevalence of pertussis,the number of patients is also rising,resulting in 13 deaths.Through the study of literature on pertussis and Zhang Zhongjing′s research on its etiology,pathogenesis,symptoms,and prescriptions in Treatise on Cold Damage and Synopsis of the Golden Chamber,it is found that pertussis falls within the category of sudden cough in traditional Chinese medicine(TCM).Sudden cough is often caused by epidemic pathogens,and the disease primarily affects the three yang meridians.According to the description of sudden cough in Diagnostic Criteria and Efficacy Standards for TCM Diseases and Syndromes:Diagnostic Criteria and Efficacy Standards for TCM Pediatric Diseases and Syndromes,based on the patient′s chills,fever,sweating,etc.,sudden cough is further divided into four syndromes:Taiyang,Yangming,combined Taiyang-Yangming,and Shaoyang.Within these four syndromes,there are sub-classifications such as cold-damage syndrome,wind-stroke syndrome,and visceral-fulness syndrome.Prescriptions like Mahuang Decoction,Guizhi plus Houpu Xingren Decoction,and Tiaowei Chengqi Decoction are used to treat these conditions.This preliminary analysis of Zhang Zhongjing′s experience in diagnosing and treating sudden cough aims to provide a reference for clinical diagnosis and treatment.