张骠教授治疗小儿反复呼吸道感染经验
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摘要
反复呼吸道感染是儿童时期常见的多发的呼吸道疾病。根据小儿生理病理特点,结合小儿罹病后的临床征象,张骠教授认为风痰留恋、肺脾气虚是本病关键病机。按病机及临床表现将本病分三期而治。感染期以邪实为重,治疗以祛邪为主,辨兼夹不同;迁延期邪恋正虚,治以消补兼施;恢复期以本虚为主,治疗上重平补肺脾,调燮阴阳。重视肺脾兼治在各期治疗中的地位。临床用药强调药性轻灵平和,达药至病处又防伤及脏腑之气的目的。文章总结了张骠教授治疗反复呼吸道感染的经验,分析其辨证思路及立法、用药特点,供读者借鉴。
Recurrent respiratory tract infections(RRTI) is a common and frequent respiratory disease in children.professor Zhang Biao deems that the key mechanisms of pediatric RRTI are wind-phlegm remain and lung-spleen deficiency,according to children's physiological and pathological characteristics and combining with clinical signs of RRTI.According to the pathogenesis and clinical manifestations,the disease was treated in three phases.In acute phase,professor Zhang focuses on pathogenic qi and gives priority to the treatment of eliminating the pathogenic and distinguishing different symptoms.In deferment phase,deficient vital qi leading to lingering of pathogen that occupies an important position and directs the treatment of dispersing and supplementing simultaneously.Convalescence is given priority to with the virtual and the treatment of which concentrates on tonifying both lung and spleen and regulatingyin and Yang.During all the stages,professor Zhang takes equal attention on lung and spleen.The use of clinical medicine emphasizes that the drug property should be mild and gentle,the purpose of which is to cure disease and protect the qi of organ,which has achieved remarkable clinical effect.The article summarizes professor Zhang's experience in treating pediatric RRTI,and analyzes his characteristics in syndrome differentiation,treatment and application of drugs,which can provide reference for the readers.
Recurrent respiratory tract infections(RRTI) is a common and frequent respiratory disease in children.professor Zhang Biao deems that the key mechanisms of pediatric RRTI are wind-phlegm remain and lung-spleen deficiency,according to children's physiological and pathological characteristics and combining with clinical signs of RRTI.According to the pathogenesis and clinical manifestations,the disease was treated in three phases.In acute phase,professor Zhang focuses on pathogenic qi and gives priority to the treatment of eliminating the pathogenic and distinguishing different symptoms.In deferment phase,deficient vital qi leading to lingering of pathogen that occupies an important position and directs the treatment of dispersing and supplementing simultaneously.Convalescence is given priority to with the virtual and the treatment of which concentrates on tonifying both lung and spleen and regulatingyin and Yang.During all the stages,professor Zhang takes equal attention on lung and spleen.The use of clinical medicine emphasizes that the drug property should be mild and gentle,the purpose of which is to cure disease and protect the qi of organ,which has achieved remarkable clinical effect.The article summarizes professor Zhang's experience in treating pediatric RRTI,and analyzes his characteristics in syndrome differentiation,treatment and application of drugs,which can provide reference for the readers.
引文
[1] 汪受传,虞坚尔.中医儿科学[M].北京:中国中医药出版社,2012:97-101.
[2] 王雪峰,郑健.中西医结合儿科学[M].北京:中国中医药出版社,2016:86-89.
[3] 董斐.从胃肠积热论治小儿反复呼吸道感染[A].中华中医药学会、北京中医药大学.第三次全国温病学论坛暨温病学辨治思路临床拓展应用高级研修班论文集[C].中华中医药学会、北京中医药大学,2016:6.
[4] 高国鹏,高树彬.基于“食积常有”理论对小儿反复呼吸道感染病前状态的再认识[J].中医儿科杂志,2016,12(6):27-29.
[5] 张骠,隆红艳.略论运脾学说的建立与发展及其对儿科临床的指导意义[J].江苏中医药,2008,35(11):28-31.
[6] 王江.银葛清解汤治疗小儿外感发热(肺卫风热证)的临床疗效观察及作用机制探讨[D].南京:南京中医药大学,2016.
[7] 南丽娟.宣化止嗽汤治疗小儿感染后咳嗽的临床研究[D].南京:南京中医药大学,2013.
[8] 王培珍.灵芝的药理作用与临床应用进展[J].上海医药,2012,33(9):28-30.
[9] 金芝贵,金剑,肖忠革,等.贞子的药理作用及其临床应用进展[J].药学服务与研究,2011,11(3):189-192.
[10] 陈文霞,闫永彬,马融.马融教授运用膏方防治小儿反复呼吸道感染的经验[J].中国社区医师,2016,32(1):80-81.
[11] 张志巧,夏以琳.夏以琳运用膏方调治小儿复感经验[J].吉林中医药,2012,32(4):335-337.
[12] 马传贞,杜萍,高丹.健儿扶正膏方治疗小儿反复呼吸道感染100例临床研究[J].世界中西医结合杂志,2015,10(1):94-96.
[13] 曹志宏.膏方治疗小儿反复呼吸道感染30例观察[J].实用中医药杂志,2013,29(9):720.
[2] 王雪峰,郑健.中西医结合儿科学[M].北京:中国中医药出版社,2016:86-89.
[3] 董斐.从胃肠积热论治小儿反复呼吸道感染[A].中华中医药学会、北京中医药大学.第三次全国温病学论坛暨温病学辨治思路临床拓展应用高级研修班论文集[C].中华中医药学会、北京中医药大学,2016:6.
[4] 高国鹏,高树彬.基于“食积常有”理论对小儿反复呼吸道感染病前状态的再认识[J].中医儿科杂志,2016,12(6):27-29.
[5] 张骠,隆红艳.略论运脾学说的建立与发展及其对儿科临床的指导意义[J].江苏中医药,2008,35(11):28-31.
[6] 王江.银葛清解汤治疗小儿外感发热(肺卫风热证)的临床疗效观察及作用机制探讨[D].南京:南京中医药大学,2016.
[7] 南丽娟.宣化止嗽汤治疗小儿感染后咳嗽的临床研究[D].南京:南京中医药大学,2013.
[8] 王培珍.灵芝的药理作用与临床应用进展[J].上海医药,2012,33(9):28-30.
[9] 金芝贵,金剑,肖忠革,等.贞子的药理作用及其临床应用进展[J].药学服务与研究,2011,11(3):189-192.
[10] 陈文霞,闫永彬,马融.马融教授运用膏方防治小儿反复呼吸道感染的经验[J].中国社区医师,2016,32(1):80-81.
[11] 张志巧,夏以琳.夏以琳运用膏方调治小儿复感经验[J].吉林中医药,2012,32(4):335-337.
[12] 马传贞,杜萍,高丹.健儿扶正膏方治疗小儿反复呼吸道感染100例临床研究[J].世界中西医结合杂志,2015,10(1):94-96.
[13] 曹志宏.膏方治疗小儿反复呼吸道感染30例观察[J].实用中医药杂志,2013,29(9):720.