论“呼多吸少”与慢性气道疾病的相关性及中医辨治

On Correlation between “More Exhalation and Less Inhalation” and Chronic Airway Diseases & Differentiation and Treatment in Chinese Medicine

"呼多吸少"是临床常见现象,最常见于以慢性阻塞性肺疾病为代表的慢性气道疾病。以文献与理论论述为基础,结合临床解读"呼多吸少",认为"呼多吸少"从现代医学角度可以解释为由于气道炎症及远端气道破坏、重塑,气道及肺泡弹性回缩力减退造成的呼气时相延长;在中医方面,"呼多吸少"则与肺失宣肃、肺脾气虚、肺肾亏虚密切相关,不能单纯理解为"肾不纳气",治疗方面提出"辛开苦降、补脾益肺、补肺纳肾"为相应病证的治疗原则。

'More exhalation and less inhalation' is a common clinical phenomenon which is common in the chronic airway diseases represented by chronic obstructive pulmonary disease. This paper from the literature theory and clinical aspects of the understanding of 'more exhalation and less inhalation' believed that 'more exhalation and less inhalation' in modern medicine can be explained by air duct inflammation and distal airway damage,remodeling,prolonged expiratory phase caused by decreased airway and alveolar elastic recoil. In traditional Chinese medicine,'more exhalation and less inhalation' is considered to be related to lung qi failing in ascending and purification,spleen and lung qi deficiency and deficiency of lung and kidney,which can not be simply understood as 'kidney failing in qi reception'. In terms of treatment,pungent dispersing and bitter descending,invigorating spleen and replenishing lung,tonifying lung and improving kidney qi reception are the therapeutic principles for the related syndromes.