从肝郁生风论治咳嗽变异性哮喘

Treatment of Cough Variant Asthma from Stagnation of Liver Qi Producing Endogenous Wind

咳嗽变异性哮喘(CVA)是一种以咳嗽为主要或惟一表现,但存在可逆性气道高反应的特殊类型哮喘,多出现在夜间或清晨,遇冷空气后加重,无明显喘息、气促等症状或体征,部分会发展为典型哮喘。在临床诊治上存在漏诊及用药不规范,严重影响患者生活质量,并加重其经济负担。CVA未有中医对应病名,将其归入“咳嗽”范畴,又因其在症状及诊断上的特殊性,提出“风咳”病名,不从哮喘论治,而以疏风治疗贯穿始终。基于内风理论,结合名老中医经验,论述中医药治疗CVA的机制,旨在传承并发扬名医经验与中医药诊疗CVA优势,提供临床新思路。

Cough variant asthma(CVA) is a special type of asthma with cough as the main or only manifestation but reversible airway hyper response.It usually occurs at night or early morning,aggravated after cold air,with no obvious wheezing,shortness of breath and other symptoms or signs,some of which will develop into typical asthma.In clinical diagnosis and treatment,there are missed diagnosis and irregular drug treatment,which seriously affects the quality of life of patients and increases the economic burden.Therefore,many patients seek TCM treatment.CVA does not have the corresponding name of TCM,so it is classified in the category of “cough”,and because of its particularity in symptoms and diagnosis,proposed “wind cough”,not from asthma,but with wind treatment throughout.Based on the theory of internalization,combined with the experience of famous doctor of TCM,the mechanism of TCM in the treatment of CVA was discussed,aiming to inherit and develop the experience of famous doctors and the advantages of TCM diagnosis and treatment of CVA,and provide new clinical ideas.