《小儿药证直诀》喘证辨治探析

Analysis on the differentiation and treatment of panting syndrome in Xiao Er Yao Zheng Zhi Jue

儿科鼻祖钱乙所著的《小儿药证直诀》系统的阐述了小儿喘证,提出“肺主喘”,病位在肺,与脾脏有密切的关系,主要病机为肺失宣降。喘证分虚实,以盛即下之、久即补之为治则。喘证分为风寒喘急、肺热喘咳、痰热哮喘、气虚复感和阴虚喘咳型,以麻黄汤、泻白散、葶苈丸、人参生犀散和阿胶散治疗。《小儿药证直诀》中小儿喘证的论治对临床有宝贵的指导意义。

The renowned pediatrician Qian Yi,often hailed as the founder of TCM pediatrics,provides a comprehensive and systematic analysis of pediatric panting syndrome in his seminal work Xiao Er Yao Zheng Zhi Jue(Key to Diagnosis and Treatment of Children's Diseases).Qian asserts that the lung plays a central role in panting syndrome,stating that “the lung governs panting”.According to him,panting's primary locus is the lung,but it is intricately linked to the spleen,and the fundamental pathogenesis involves the lung's failure to properly conduct its descending and clearing functions.Panting is categorized into deficiency and excess types,with the therapeutic approach of reducing the excess and tonifying the deficiency.The text details specific asthma syndromes:wind-cold panting,lung-heat panting,phlegm-heat panting,qi-deficiency panting,and yin-deficiency panting.Corresponding treatments include the use of Mahuang Decoction(Ephedra Decoction) for the wind-cold type,Xiebai Powder(White-Draining Powder) for lung-heat,Tingli Pill(Lepidium/Descurainiae Pill) for phlegm-heat,Renshen Shengxi Powder(Gingsen and Rhinoceros Powder) for qi-deficiency,and Ejiao Powder(Donkey-Hide Gelatin Powder) for yin-deficiency.The insights provided in the book offer valuable guidance for contemporary clinical practice in pediatric panting.