从中医角度看气道黏液高分泌
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摘要
气道黏液高分泌是呼吸系统疾病的重要特征。中医认为气道黏液属于"津"的范畴,而气道黏液高分泌属于"痰"的范畴。气道黏液高分泌的病机关键为"肺-脾-肠"轴功能失调,而核心为脾运不足。治疗当标本兼顾,以运脾为核心,通调"肺-脾-肠"轴为关键。后附以典型案例予以说明。
Airway mucus hypersecretion is an important feature of respiratory diseases. In Chinese medicine airway mucus belongs to the category of "Jin", and hypersecretion of mucus in the airway belongs to the category of "Tan". The key to the pathogenesis of hypersecretion of mucus in the airway is the dysfunction of the lung-spleen-gut axis, and the lack of spleen method as the core. The treatment should focus on both the causes and symptoms, with the spleen method as the core, and the lung-spleen-gut axis as the key. A typical case is used as an example.
Airway mucus hypersecretion is an important feature of respiratory diseases. In Chinese medicine airway mucus belongs to the category of "Jin", and hypersecretion of mucus in the airway belongs to the category of "Tan". The key to the pathogenesis of hypersecretion of mucus in the airway is the dysfunction of the lung-spleen-gut axis, and the lack of spleen method as the core. The treatment should focus on both the causes and symptoms, with the spleen method as the core, and the lung-spleen-gut axis as the key. A typical case is used as an example.
引文
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[32] 陈霭平.旋复花在治疗咽源性咳嗽中的应用[J].广东药学,1998,8(2):12-28.
[33] 黄杰熙.《本草三家合注》平释[M].太原:山西科学技术出版社,1995:314-315.
[2] 江载芳,申昆玲,沈颖.诸福棠实用儿科学[M].8版.北京:人民卫生出版社,2015:1232-1233.
[3] 蔡柏蔷,李龙芸.协和呼吸病学[M].2版.北京:中国协和医科大学出版社,2011:6-7.
[4] 阎承先.气管食管学[M].上海:上海科学技术出版社,2001:14-16.
[5] 江载芳.实用小儿呼吸病学[M].北京:人民卫生出版社,2010:10-12,23-29.
[6] Voynow JA,Rubin BK.Mucins,mucus,and sputum[J].Chest,2009,135(2):505-512.
[7] Fahy JV,Dickey BF.Airway mucus function and dysfunction[J].N Engl J Med,2010,363(23):2233-2247.
[8] Bonser LR,Erle DJ.Airway Mucus and Asthma:The Role of MUC5AC and MUC5B[J].J Clin Med,2017,6(12):e112.
[9] Evans CM,Kim K,Tuvim MJ,et al.Mucus hypersecretion in asthma:causes and effects[J].Curr Opin Pulm Med,2009,15(1):4-11.
[10] Hauber HP,Zabel P.Emerging mucus regulating drugs in inflammatory and allergic lung disease[J].Inflamm Allergy Drug Targets,2008,7(1):30-34.
[11] 王雪峰,金晓颖,吴振起,等.儿童哮喘中医病机学说与现代发病机制关系初探[J].中国中西医结合儿科学,2010,2(2):105-107.
[12] Evans CM,Koo JS.Airway mucus:the good,the bad,the sticky[J].Pharmacol Ther,2009,121(3):332-348.
[13] Kang JW,Lee YH,Kang MJ,et al.Synergistic mucus secretion by histamine and IL-4 through TMEM16A in airway epithelium[J].Am J Physiol Lung Cell Mol Physiol,2017,313(3):L466-476.
[14] 张海邻,吕芳芳.儿童气道黏液高分泌疾病[J].中国实用儿科杂志,2018,33(3):184-188.
[15] 慢性气道炎症性疾病气道黏液高分泌管理中国专家共识编写组.慢性气道炎症性疾病气道黏液高分泌管理中国专家共识[J].中华结核和呼吸杂志,2015,38(10):723-729.
[16] Shen Y,Huang S,Kang J,et al.Management of airway mucus hypersecretion in chronic airway inflammatory disease:Chineseexpert consensus (English edition)[J].Int J Chron Obstruct Pulmon Dis,2018,13:399-407.
[17] Rubin BK.Aerosol Medications for Treatment of Mucus Clearance Disorders[J].Respir Care,2015,60(6):825-829.
[18] 王新华.中医基础理论[M].北京:人民卫生出版社,2001:366-369.
[19] 吴焕林,吕渭辉,潘桂娟,等.中医痰证诊断标准[J].中国中西医结合杂志,2016,36(7):776-780.
[20] 张年顺.痰病钩玄——对3部中医权威辞书有关“痰”词条的研究[J].山东中医药大学学报,2004,28(2):86-89.
[21] 李经纬,余瀛鳌,蔡景峰,等.中医大辞典[M].北京:人民卫生出版社,1995:1173.
[22] 李德新.李德新中医基础理论讲稿[M].北京:人民卫生出版社,2008:237-240.
[23] 杨慧,孙世晓.浅谈中医对“痰”的认识[J].黑龙江中医药,2014,43(3):11-12.
[24] 章真如.风火痰瘀论[M].北京:人民卫生出版社,2012:81-82.
[25] 潘桂娟.论中医“痰病”的临床特征[J].中华中医药杂志,2009,24(9):1183-1185.
[26] 周晓燕,李守朝.痰病证治刍议[J].现代中医药,2006,26(1):38-39.
[27] 张重寿.痰饮学说的起源发展及临床应用[J].陕西中医,2008,29(2):199-200.
[28] 潘桂娟.论中医“痰病”的预防与治疗[J].中华中医药杂志,2009,24(10):1322-1324.
[29] 唐步祺.咳嗽之辨证论治[M].西安:陕西科学技术出版社.1982:174-180.
[30] 王力宁,姚勇志,程志勇,等.小儿特禀质咳嗽中医证治规律及疗效评价研究[J].中国中西医结合儿科学,2014,6(2):105-108.
[31] 高旅,史正刚.基于“肺-脾-肠”轴理论的小儿咳喘诊治思路[J].中华中医药杂志,2018,33(8):3438-3439.
[32] 陈霭平.旋复花在治疗咽源性咳嗽中的应用[J].广东药学,1998,8(2):12-28.
[33] 黄杰熙.《本草三家合注》平释[M].太原:山西科学技术出版社,1995:314-315.