刘琼治疗亚急性咳嗽经验
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摘要
刘琼教授认为亚急性咳嗽在初期多以风寒、风热、凉燥、温燥为主,以风燥之邪伤肺,肺气失于宣将,发为咳嗽;咳嗽迁延不愈,表邪已去,病久伤及脏腑,或化燥伤阴,或灼津为痰,痰湿、痰热内蕴,三焦失司,既而发为"顽咳""久咳"。辨证方面,刘教授认为当首先辨干咳、湿咳,再分表里虚实及所属脏腑,治疗应以治肺脏为主,还应兼顾肝、心、脾、肾等他脏,从整体论治,重视祛痰、泻火、祛风。湿咳偏于风寒,可用止嗽散加减;偏于风热者,可用桑菊饮加减。湿咳为痰热证,方用清金化痰汤;为痰湿证,方用二陈汤。干咳偏于温燥,方用桑杏汤加减;偏于凉燥,方用杏苏散;干咳无表证多用沙参麦冬汤、百合固金汤及小柴胡汤合二陈汤。
Professor Liu Qiong believes that subacute cough is mainly caused by wind cold,wind heat,cool dryness and warm dryness. With wind and dryness,the lung will be damaged and the lung qi will fail to disperse and lead to cough. Protracted course of cough will damage Zang-Fu organs,either by transforming dryness and hurting yin,or burning fluid into phlegm. When phlegm dampness and phlegm heat accumulate and cause three energizers failing to work properly, " chronic cough" and " long cough" will occur. In the aspect of syndrome differentiation,Professor Liu thinks that dry and wet cough should be distinguished,then interior,exterior,deficiency and excess and the related organs are clarified. The treatment should focus on lungs,and should also take into account the liver,heart,spleen,kidney and other organs to remove phlegm,fire and wind based on syndrome differentiation. For wet cough with wind cold,Modified Cough-Stopping Powder should be used. For wet cough with wind heat,Modified Mulberry Leaf and Chrysanthemum Beverage should be used. For wet cough with phlegm heat,Lung-Clearing and Phlegm-Transforming Decoction should be used. For wet phlegm syndrome,Two Matured Substances Decoction should be used. For dry cough with warm dryness,Modified Mulberry Leaf and Apricot Kernel Decoction should be used. For dry cough with cool dryness,Apricot Kernel and Perilla Powder should be used. For dry cough without superficial syndrome,Radix Glehniae and Ophiopogon Decoction,Lily Bulb Metal-Securing Decoction,Minor Bupleurum Decoction combined with Two Matured Substances Decoction are often used.
Professor Liu Qiong believes that subacute cough is mainly caused by wind cold,wind heat,cool dryness and warm dryness. With wind and dryness,the lung will be damaged and the lung qi will fail to disperse and lead to cough. Protracted course of cough will damage Zang-Fu organs,either by transforming dryness and hurting yin,or burning fluid into phlegm. When phlegm dampness and phlegm heat accumulate and cause three energizers failing to work properly, " chronic cough" and " long cough" will occur. In the aspect of syndrome differentiation,Professor Liu thinks that dry and wet cough should be distinguished,then interior,exterior,deficiency and excess and the related organs are clarified. The treatment should focus on lungs,and should also take into account the liver,heart,spleen,kidney and other organs to remove phlegm,fire and wind based on syndrome differentiation. For wet cough with wind cold,Modified Cough-Stopping Powder should be used. For wet cough with wind heat,Modified Mulberry Leaf and Chrysanthemum Beverage should be used. For wet cough with phlegm heat,Lung-Clearing and Phlegm-Transforming Decoction should be used. For wet phlegm syndrome,Two Matured Substances Decoction should be used. For dry cough with warm dryness,Modified Mulberry Leaf and Apricot Kernel Decoction should be used. For dry cough with cool dryness,Apricot Kernel and Perilla Powder should be used. For dry cough without superficial syndrome,Radix Glehniae and Ophiopogon Decoction,Lily Bulb Metal-Securing Decoction,Minor Bupleurum Decoction combined with Two Matured Substances Decoction are often used.
引文
[1]赖克方,陈如冲,刘春丽,等.不明原因慢性咳嗽的病因分布及诊断程序的建立[J].中华结核和呼吸杂志,2006,29(2):96-99.
[2]周继朴,王莒生.王莒生教授治疗亚急性咳嗽经验[J].世界中西医结合杂志,2012,7(12):1022-1024.
[3]朱诗乒,董雷,蔡宛如.蔡宛如从“肝肺升降”辨治亚急性咳嗽经验[J].浙江中医杂志,2013,48(5):316.
[4]张景岳.景岳全书[M].北京:人民卫生出版社,1991:828.
[5]王赤兵.中医舌诊学[M].成都:四川科学技术出版社,1985:13-14.
[6]陈家旭.中医诊断学[M].北京:人民卫生出版社,2012:38-39,43-44.
[7]吴勉华,王新月.中医内科学[M].北京:中国中医药出版社,2012:78-79.
[8]李文成.基于文献评价与数据挖掘的亚急性咳嗽证候特征研究[D].北京:北京中医药大学,2013.
[9]李凛.亚急性、慢性咳嗽病因与中医证型相关性研究[D].北京:北京中医药大学,2012.
[10]中华医学会呼吸病学分会哮喘学组.咳嗽的诊断和治疗指南2015[J].中华结核和呼吸杂志,2016,39(5):336-337.
[11]吴银根.慢性咳嗽的中医治疗思路和经验[J].江苏中医药,2008,40(7):7-8.
[12]刘琼.感染后咳嗽从燥论治思路探讨[J].四川中医,2010,28(9):32-33.
[13]孙志佳.久咳从肝论治[J].陕西中医,2005,26(10):1067-1068.
[14]王胜.胡国俊辨治感染后咳嗽经验介绍[J].辽宁中医药大学学报,2011,13(1):112-114.
[2]周继朴,王莒生.王莒生教授治疗亚急性咳嗽经验[J].世界中西医结合杂志,2012,7(12):1022-1024.
[3]朱诗乒,董雷,蔡宛如.蔡宛如从“肝肺升降”辨治亚急性咳嗽经验[J].浙江中医杂志,2013,48(5):316.
[4]张景岳.景岳全书[M].北京:人民卫生出版社,1991:828.
[5]王赤兵.中医舌诊学[M].成都:四川科学技术出版社,1985:13-14.
[6]陈家旭.中医诊断学[M].北京:人民卫生出版社,2012:38-39,43-44.
[7]吴勉华,王新月.中医内科学[M].北京:中国中医药出版社,2012:78-79.
[8]李文成.基于文献评价与数据挖掘的亚急性咳嗽证候特征研究[D].北京:北京中医药大学,2013.
[9]李凛.亚急性、慢性咳嗽病因与中医证型相关性研究[D].北京:北京中医药大学,2012.
[10]中华医学会呼吸病学分会哮喘学组.咳嗽的诊断和治疗指南2015[J].中华结核和呼吸杂志,2016,39(5):336-337.
[11]吴银根.慢性咳嗽的中医治疗思路和经验[J].江苏中医药,2008,40(7):7-8.
[12]刘琼.感染后咳嗽从燥论治思路探讨[J].四川中医,2010,28(9):32-33.
[13]孙志佳.久咳从肝论治[J].陕西中医,2005,26(10):1067-1068.
[14]王胜.胡国俊辨治感染后咳嗽经验介绍[J].辽宁中医药大学学报,2011,13(1):112-114.