王应麟学术思想与临床经验总结及小儿上腭望诊在咳嗽辨治中应用的研究
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摘要
本论文包括指导老师王应麟学术渊源、各家学说等,指导老师学术思想和临床经验的整理与研究,以及指导老师学术经验的临床研究三部分。
第一部分详尽介绍了指导老师王应麟学术渊源、各家学说等相关内容。
20世纪50年代以前,中医不单设儿科,只有大方脉、小方脉之分,小方脉就指小儿科。一般是精通大方脉的大夫,方有把握治好小儿病。因此,才有所谓“宁治十男子,不治一妇人,宁治十妇人,不治一小儿”之说。中华民国时期北平地区中医儿科是发展较快的专科,专门从事中医儿科的医家各具特色,大都具有高超的医术,在当时造成了一定的影响,代表性医家有六位：王子仲、王鹏飞、周慕新、张世杰、杨艺农、祁振华。
王子仲,名文通,字子仲,北京市人,祖籍陕西。王子仲的父亲王润吉公精通歧黄,道光年间自陕西来京业医。20世纪30年代前后,王子仲医名大噪,求医者门庭若市,小儿家长经常馈送匾额,“石虎胡同小儿王”的美名传遍京城。王子仲治疗小儿各种疾病特别注重调理脾胃,用药多以茯苓为主,故药肆常以“茯苓大夫”戏称。王鹏飞,名王勋,字鹏飞,出生于中医世家,毕业于北平民国大学,尔后随父习医,1933年个人独立行医。王鹏飞的祖父润吉公和父亲王子仲均为京都著名儿科医生,被群众尊称为“小儿王”,其声名三代不衰。王鹏飞继承了父亲“望头顶”的的诊断方法,并有所发挥,提出“望上腭”的诊断方法。王鹏飞对儿科用药独有奇径,除继承家传外,又敢于创新。他用药虽然不尽同于父辈,但用意相同或殊途同归。首创出“攻病而不泄,护脾胃勿用滋补”,“稍呆则滞,稍重则伤”的原则,务求得当,恰到好处。在临床上特别重视后天之本“脾胃”,并重视小儿体质的强弱,用药主张量少、力专,擅用小儿易于接受的药物,尤其在治疗小儿消化不良、营养障碍性贫血、肺炎、嗜异症等病,疗效尤为显著。四代儿科世家“小儿王”王应麟等就属于世医派。王老师接受了正规的中医院校教育,同时又全面继承了儿科家学,并不断丰富、提高,形成了自己的独特诊疗经验,在当今的临床实践中仍具有重要的指导意义。
在各家学说部分重点总结了部分儿科名家的学术思想及临床经验,同时还以大量翔实的资料阐述了现代医学及传统中医药学对小儿咳嗽的认识与理解。
第二部分详尽介绍了指导老师学术思想和临床经验的整理与研究。
首都医科大学附属北京中医医院王应麟主任医师从事中医儿科临床近五十年。医术祖传四代,遣方用药,独具风格,是北京地区闻名的儿科医师,人们亲切地称他为“京城小儿王”,擅治儿科疑难杂证,常能于危急时刻起沉疴。从王老师曾祖父起就从事中医儿科。曾祖父王润吉早年除在北京临诊外,每年还用大部分时间,深入到云、贵、川等地区,在为当地老百姓解除疾病痛苦之余,还向当地的草泽医虚心学习验方、秘方。民间医药之丰富多采,使用药物之简便,疗效之神速,使祖父大开眼界,并深为惊叹。因此,在以后诊断用药方面,也慢慢地转向简、便、廉、验,并开始自己制备成药,急病者可以立服,药价便宜,效果迅速,影响日见扩大,开始被誉为“小儿王”。王老师祖父王子仲承继家学,奋发图强,勤学苦研,尽得祖父之心传,医名渐噪,求诊者亦络绎不绝。王老师生长在中医世家,大学期间系统地学习了中医经典著作如《黄帝内经》、《伤寒论》、《金匮要略》、《难经》以及《神农本草经》等,并时常向当时的北京名医前辈如祁振华、周慕新等请教,受其指点,亦获益不浅。扎实的基础理论学习对于王老师以后应付繁忙的临床工作起了很大的作用。
在临床中王老师重视望诊,尤重舌诊、望头顶污垢以及上腭望诊法；在临诊中结合小儿稚阴稚阳的特点,始终重视小儿脾胃的调理,达到标本兼治、治病祛根的目的；在治病的同时,特别重视儿科的保养与护理。在儿科常见病、多发病如小儿咳嗽、小儿发热、小儿湿疹、小儿厌食、小儿鼻渊、小儿腹泻、儿童腹痛、小儿习惯性便秘、小儿疝气等提出了自己独到了见解,临床疗效满意；在儿科急证、疑难杂证如惊风、小儿夜啼、小儿鼻出血、疳积、紫癜、肾炎、小儿抽动—秽语综合症等方面积累了丰富的经验,全国各地就医者络绎不绝,大多获愈或得到不同程度的减轻,为病人增强了同疾病抗争的信心和力量。
第三部分介绍了指导老师学术经验的临床研究。
本部分为病例观察与对照研究,观察王老师治疗小儿咳嗽病例资料107例,将患者随机分为治疗组(54例)和对照组(53例),每例患者的疗程为2周,除四诊资料外,重点观察上腭情况,通过观察治疗前后上腭情况的变化,探索小儿咳嗽的病因病机特点及其与中医辨证分型的关系。研究表明：1、前3位病因依次为上呼吸道感染后咳嗽56例(51.9%),气管炎36例(33.7%),支气管炎5例(4.4%)。慢性咳嗽在各年龄段的病因分布有一定特征性,在婴儿组支气管炎所占比例最高,达39.99%(2/5例),其次为鼻后滴流综合征,占20.00%(1/5例)。55.36%(31/56例)的上呼吸道感染发生在1～3岁幼儿组,上呼吸道感染是该年龄段慢性咳嗽的主要原因。2、治疗前后咳嗽情况比较：治疗前107例患儿中均有咳嗽,其中,剧烈咳嗽49例,占45.80%；较剧烈咳嗽21例,占19.63%；一般咳嗽21例,占19.63%；偶咳16例,占14.94%。经治疗后咳嗽症状明显改善,107例中不咳嗽者87例,占81.31%；偶咳11例,占10.28%；一般咳嗽9例,占8.41%。经统计学处理,t=11.49,P<0.01,差异有显著性；3、治疗前后症状积分比较：治疗后各主要症状积分均明显降低(P<0.01或P<0.05),说明分阶段型辨证能较好地缓解患儿咳嗽、有痰等症状；4、疗效比较：共痊愈47例(43.93%),显效21例(19.63%),有效32例(29.91%),无效7例(6.53%),总有效率为93.47%；5、小儿咳嗽辨证分型：一、风寒袭表、痰浊阻肺；二、风燥入里、痰阻气机；三、风热上扰、痰阻清窍；四、肺气失宣、痰热内扰；五、气阴两虚、余痰未尽；6、王老师治疗小儿咳嗽学术经验：摒不同、寻共性——未病先防；参四诊、重望诊——辨证用药；调脾胃、畅枢机——祛痰为先；抓重点、寻共性——把握传变；重继承、勇探索——推陈出新。
1.1中文摘要
本部分为病例观察与对照研究,观察王老师治疗小儿咳嗽病例资料107例,随机分为治疗组(54例)和对照组(53例),每例患者的疗程为2周,除四诊资料外,重点观察上腭情况,通过观察治疗前后上腭情况的变化,探索小儿咳嗽的病因病机特点及其与中医辨证分型的关系。研究表明：1、前3位病因依次为上呼吸道感染后咳嗽56例(51.9%),气管炎36例(33.7%),支气管炎5例(4.4%)。慢性咳嗽在各年龄段的病因分布有一定特征性,在婴儿组气管炎所占比例最高,达39.99%(2/5例),其次为鼻后滴流综合征,占20.00%(1/5例)。55.36%(31/56例)的上呼吸道感染发生在1～3岁幼儿组,上呼吸道感染是该年龄段慢性咳嗽的主要原因。2、治疗前后咳嗽情况比较：治疗前107例患儿中均有咳嗽,其中,剧烈咳嗽49例,占45.8 0%；较剧烈咳嗽21例,占19.63%；一般咳嗽21例,占19.63%；偶咳16例,占14.94%。经治疗后咳嗽症状明显改善,107例中不咳嗽者87例,占81.31%；偶咳11例,占10.28%；一般咳嗽9例,占8.41%。经统计学处理,t=11.49,P<0.01,差异有显著性；3、治疗前后症状积分比较：治疗后各主要症状积分均明显降低(P<0.01或P<0.05),说明分阶段型辨证能较好地缓解患儿咳嗽、有痰等症状；4、疗效比较：共痊愈47例(43.93%),显效21例(19.63%),有效32例(29.91%),无效7例(6.53%),总有效率为93.47%；5、小儿咳嗽辨证分型：一、风寒袭表、痰浊阻肺；二、风燥入里、痰阻气机；三、风热上扰、痰阻清窍；四、肺气失宣、痰热内扰；五、气阴两虚、余痰未尽；6、王老师治疗小儿咳嗽学术经验：摒不同、寻共性—未病先防；参四诊、重望诊——辨证用药；调脾胃、畅枢机——祛痰为先；抓重点、寻共性——把握传变；重继承、勇探索——推陈出新。
1.2 Abstract
This part is about the case observing and control study, it includes 107 cases, course of treatment for two weeks,except the four diagnostic methods data means,emphasis on observing palate. To find the relation between origin of a disease and the differentiation of symptoms and signs for classification of syndrome by surveying the change of palate between pretherapy and post-treatment. The study indicated that:1. the causes of cough by turn is the upper respiratory infection(56cases,51.9%), trache it is(36cases,33.7%),bronchus infect ion(5 cases,4.4%).There are some mark on the disposition of the cause of a disease in chronic cough at the different age. Pulmonary infection is the highest ratio in the infant group (39.99%),then is the post nasal drip syndrome (20%).55.36% take place at the young children on the upper airway infection which is the main cause of the chronic cough.2. The compare between pretherapy and post-treatment on cough:all the 107 cases caugh,49 cases(45.8%) caugh severely; 21 cases (19.63%) caugh better than the severy;21 cases (19.63%) cough generally; 16 cases (14.94%) cough by chance. The cough is amendment obviously after the treatment,87 cases not to cough in 107 (81.31%);11 cases cough by chance (10.28%); 9 cases cough generally (10.28%). The discrepancy is significance by statistics treatment, t=11.49, P <0.01; 3. The comparison of symptom integration between the pretherapy and the post-treatment:the cardinal symptom be to lower after treatment(P <0.01或P<0.05), it concludes that can relieve the cough and the phlegm by differentiation of symptoms and signs;4.The comparison of therapeutic:47 cases are cured (43.93%),21 cases are excellenced (19.63%), 32 cases are utility(29.91%),7 cases are invalid(6.53%), the total effective rate is 93.47%; 5. The differentiation of symptoms and signs for classification of syndrome on the infantile cough:the exterior attacked by wind and cold,turbid phlegm obstructing in the lung;wind dryness to enter,stagnation of phlegm activities of qi;wind-heat preceding, stagnation the upper orifices;lung-Qi failure toupper, phlegm and heat to trouble; deficiency of both vital energy and yin, remant phlegm is not to exhaust; 6. Teacher's academic experience about the treatment of infantile cough:to get rid of the disparity, find the commonness-to prepare for not to sick; to counsel four diagnostic methods, emphases the inspection-differentiation of symptoms and signs; to adjust the appetite, smooth the cardinalate-eliminating phlegm first; to grasp the focal point, find the commonness-to grasp the change; reconstruct ion to inherit, courageous to search for-to lay out the old and creat the new.
第一部分详尽介绍了指导老师王应麟学术渊源、各家学说等相关内容。
20世纪50年代以前,中医不单设儿科,只有大方脉、小方脉之分,小方脉就指小儿科。一般是精通大方脉的大夫,方有把握治好小儿病。因此,才有所谓“宁治十男子,不治一妇人,宁治十妇人,不治一小儿”之说。中华民国时期北平地区中医儿科是发展较快的专科,专门从事中医儿科的医家各具特色,大都具有高超的医术,在当时造成了一定的影响,代表性医家有六位：王子仲、王鹏飞、周慕新、张世杰、杨艺农、祁振华。
王子仲,名文通,字子仲,北京市人,祖籍陕西。王子仲的父亲王润吉公精通歧黄,道光年间自陕西来京业医。20世纪30年代前后,王子仲医名大噪,求医者门庭若市,小儿家长经常馈送匾额,“石虎胡同小儿王”的美名传遍京城。王子仲治疗小儿各种疾病特别注重调理脾胃,用药多以茯苓为主,故药肆常以“茯苓大夫”戏称。王鹏飞,名王勋,字鹏飞,出生于中医世家,毕业于北平民国大学,尔后随父习医,1933年个人独立行医。王鹏飞的祖父润吉公和父亲王子仲均为京都著名儿科医生,被群众尊称为“小儿王”,其声名三代不衰。王鹏飞继承了父亲“望头顶”的的诊断方法,并有所发挥,提出“望上腭”的诊断方法。王鹏飞对儿科用药独有奇径,除继承家传外,又敢于创新。他用药虽然不尽同于父辈,但用意相同或殊途同归。首创出“攻病而不泄,护脾胃勿用滋补”,“稍呆则滞,稍重则伤”的原则,务求得当,恰到好处。在临床上特别重视后天之本“脾胃”,并重视小儿体质的强弱,用药主张量少、力专,擅用小儿易于接受的药物,尤其在治疗小儿消化不良、营养障碍性贫血、肺炎、嗜异症等病,疗效尤为显著。四代儿科世家“小儿王”王应麟等就属于世医派。王老师接受了正规的中医院校教育,同时又全面继承了儿科家学,并不断丰富、提高,形成了自己的独特诊疗经验,在当今的临床实践中仍具有重要的指导意义。
在各家学说部分重点总结了部分儿科名家的学术思想及临床经验,同时还以大量翔实的资料阐述了现代医学及传统中医药学对小儿咳嗽的认识与理解。
第二部分详尽介绍了指导老师学术思想和临床经验的整理与研究。
首都医科大学附属北京中医医院王应麟主任医师从事中医儿科临床近五十年。医术祖传四代,遣方用药,独具风格,是北京地区闻名的儿科医师,人们亲切地称他为“京城小儿王”,擅治儿科疑难杂证,常能于危急时刻起沉疴。从王老师曾祖父起就从事中医儿科。曾祖父王润吉早年除在北京临诊外,每年还用大部分时间,深入到云、贵、川等地区,在为当地老百姓解除疾病痛苦之余,还向当地的草泽医虚心学习验方、秘方。民间医药之丰富多采,使用药物之简便,疗效之神速,使祖父大开眼界,并深为惊叹。因此,在以后诊断用药方面,也慢慢地转向简、便、廉、验,并开始自己制备成药,急病者可以立服,药价便宜,效果迅速,影响日见扩大,开始被誉为“小儿王”。王老师祖父王子仲承继家学,奋发图强,勤学苦研,尽得祖父之心传,医名渐噪,求诊者亦络绎不绝。王老师生长在中医世家,大学期间系统地学习了中医经典著作如《黄帝内经》、《伤寒论》、《金匮要略》、《难经》以及《神农本草经》等,并时常向当时的北京名医前辈如祁振华、周慕新等请教,受其指点,亦获益不浅。扎实的基础理论学习对于王老师以后应付繁忙的临床工作起了很大的作用。
在临床中王老师重视望诊,尤重舌诊、望头顶污垢以及上腭望诊法；在临诊中结合小儿稚阴稚阳的特点,始终重视小儿脾胃的调理,达到标本兼治、治病祛根的目的；在治病的同时,特别重视儿科的保养与护理。在儿科常见病、多发病如小儿咳嗽、小儿发热、小儿湿疹、小儿厌食、小儿鼻渊、小儿腹泻、儿童腹痛、小儿习惯性便秘、小儿疝气等提出了自己独到了见解,临床疗效满意；在儿科急证、疑难杂证如惊风、小儿夜啼、小儿鼻出血、疳积、紫癜、肾炎、小儿抽动—秽语综合症等方面积累了丰富的经验,全国各地就医者络绎不绝,大多获愈或得到不同程度的减轻,为病人增强了同疾病抗争的信心和力量。
第三部分介绍了指导老师学术经验的临床研究。
本部分为病例观察与对照研究,观察王老师治疗小儿咳嗽病例资料107例,将患者随机分为治疗组(54例)和对照组(53例),每例患者的疗程为2周,除四诊资料外,重点观察上腭情况,通过观察治疗前后上腭情况的变化,探索小儿咳嗽的病因病机特点及其与中医辨证分型的关系。研究表明：1、前3位病因依次为上呼吸道感染后咳嗽56例(51.9%),气管炎36例(33.7%),支气管炎5例(4.4%)。慢性咳嗽在各年龄段的病因分布有一定特征性,在婴儿组支气管炎所占比例最高,达39.99%(2/5例),其次为鼻后滴流综合征,占20.00%(1/5例)。55.36%(31/56例)的上呼吸道感染发生在1～3岁幼儿组,上呼吸道感染是该年龄段慢性咳嗽的主要原因。2、治疗前后咳嗽情况比较：治疗前107例患儿中均有咳嗽,其中,剧烈咳嗽49例,占45.80%；较剧烈咳嗽21例,占19.63%；一般咳嗽21例,占19.63%；偶咳16例,占14.94%。经治疗后咳嗽症状明显改善,107例中不咳嗽者87例,占81.31%；偶咳11例,占10.28%；一般咳嗽9例,占8.41%。经统计学处理,t=11.49,P<0.01,差异有显著性；3、治疗前后症状积分比较：治疗后各主要症状积分均明显降低(P<0.01或P<0.05),说明分阶段型辨证能较好地缓解患儿咳嗽、有痰等症状；4、疗效比较：共痊愈47例(43.93%),显效21例(19.63%),有效32例(29.91%),无效7例(6.53%),总有效率为93.47%；5、小儿咳嗽辨证分型：一、风寒袭表、痰浊阻肺；二、风燥入里、痰阻气机；三、风热上扰、痰阻清窍；四、肺气失宣、痰热内扰；五、气阴两虚、余痰未尽；6、王老师治疗小儿咳嗽学术经验：摒不同、寻共性——未病先防；参四诊、重望诊——辨证用药；调脾胃、畅枢机——祛痰为先；抓重点、寻共性——把握传变；重继承、勇探索——推陈出新。
1.1中文摘要
本部分为病例观察与对照研究,观察王老师治疗小儿咳嗽病例资料107例,随机分为治疗组(54例)和对照组(53例),每例患者的疗程为2周,除四诊资料外,重点观察上腭情况,通过观察治疗前后上腭情况的变化,探索小儿咳嗽的病因病机特点及其与中医辨证分型的关系。研究表明：1、前3位病因依次为上呼吸道感染后咳嗽56例(51.9%),气管炎36例(33.7%),支气管炎5例(4.4%)。慢性咳嗽在各年龄段的病因分布有一定特征性,在婴儿组气管炎所占比例最高,达39.99%(2/5例),其次为鼻后滴流综合征,占20.00%(1/5例)。55.36%(31/56例)的上呼吸道感染发生在1～3岁幼儿组,上呼吸道感染是该年龄段慢性咳嗽的主要原因。2、治疗前后咳嗽情况比较：治疗前107例患儿中均有咳嗽,其中,剧烈咳嗽49例,占45.8 0%；较剧烈咳嗽21例,占19.63%；一般咳嗽21例,占19.63%；偶咳16例,占14.94%。经治疗后咳嗽症状明显改善,107例中不咳嗽者87例,占81.31%；偶咳11例,占10.28%；一般咳嗽9例,占8.41%。经统计学处理,t=11.49,P<0.01,差异有显著性；3、治疗前后症状积分比较：治疗后各主要症状积分均明显降低(P<0.01或P<0.05),说明分阶段型辨证能较好地缓解患儿咳嗽、有痰等症状；4、疗效比较：共痊愈47例(43.93%),显效21例(19.63%),有效32例(29.91%),无效7例(6.53%),总有效率为93.47%；5、小儿咳嗽辨证分型：一、风寒袭表、痰浊阻肺；二、风燥入里、痰阻气机；三、风热上扰、痰阻清窍；四、肺气失宣、痰热内扰；五、气阴两虚、余痰未尽；6、王老师治疗小儿咳嗽学术经验：摒不同、寻共性—未病先防；参四诊、重望诊——辨证用药；调脾胃、畅枢机——祛痰为先；抓重点、寻共性——把握传变；重继承、勇探索——推陈出新。
1.2 Abstract
This part is about the case observing and control study, it includes 107 cases, course of treatment for two weeks,except the four diagnostic methods data means,emphasis on observing palate. To find the relation between origin of a disease and the differentiation of symptoms and signs for classification of syndrome by surveying the change of palate between pretherapy and post-treatment. The study indicated that:1. the causes of cough by turn is the upper respiratory infection(56cases,51.9%), trache it is(36cases,33.7%),bronchus infect ion(5 cases,4.4%).There are some mark on the disposition of the cause of a disease in chronic cough at the different age. Pulmonary infection is the highest ratio in the infant group (39.99%),then is the post nasal drip syndrome (20%).55.36% take place at the young children on the upper airway infection which is the main cause of the chronic cough.2. The compare between pretherapy and post-treatment on cough:all the 107 cases caugh,49 cases(45.8%) caugh severely; 21 cases (19.63%) caugh better than the severy;21 cases (19.63%) cough generally; 16 cases (14.94%) cough by chance. The cough is amendment obviously after the treatment,87 cases not to cough in 107 (81.31%);11 cases cough by chance (10.28%); 9 cases cough generally (10.28%). The discrepancy is significance by statistics treatment, t=11.49, P <0.01; 3. The comparison of symptom integration between the pretherapy and the post-treatment:the cardinal symptom be to lower after treatment(P <0.01或P<0.05), it concludes that can relieve the cough and the phlegm by differentiation of symptoms and signs;4.The comparison of therapeutic:47 cases are cured (43.93%),21 cases are excellenced (19.63%), 32 cases are utility(29.91%),7 cases are invalid(6.53%), the total effective rate is 93.47%; 5. The differentiation of symptoms and signs for classification of syndrome on the infantile cough:the exterior attacked by wind and cold,turbid phlegm obstructing in the lung;wind dryness to enter,stagnation of phlegm activities of qi;wind-heat preceding, stagnation the upper orifices;lung-Qi failure toupper, phlegm and heat to trouble; deficiency of both vital energy and yin, remant phlegm is not to exhaust; 6. Teacher's academic experience about the treatment of infantile cough:to get rid of the disparity, find the commonness-to prepare for not to sick; to counsel four diagnostic methods, emphases the inspection-differentiation of symptoms and signs; to adjust the appetite, smooth the cardinalate-eliminating phlegm first; to grasp the focal point, find the commonness-to grasp the change; reconstruct ion to inherit, courageous to search for-to lay out the old and creat the new.
引文
1.Cullinan P. Persistent cough and sputum:prevalence andclinical characteristics in south east England [J]. RespirMed,1992,86(2):143-149.
2.Curley FJ, Irwin RS, Pratter MR, et al. Cough and the common cold [J]. Am Rev Respir Dis,1988,138(2):305-311.
3. McGravey LPA. Cough·6:Which investigation are most useful in the diagnose of chronic cough? [J]. Thorax,2004,59(4):342-346.
4.MoriceAH, FontanaGA, SovijarviAR, etal. The diagnosis andmanage-ment of chronic cough [J]. EurRespirJ,2004,24(3):481-492.
5. ChangAB, GlombWB. Guidelines for evaluating chronic cough in pedia-trics:ACCP evidence-based clinical practice guidalines[J]. Chest,2006,129 (suppll):260-283.
6.ChangAB, Landau LI, vanAsperen PP,etal. Cough in children:Def ini-tions and cl inical evaluation[J]. Med JAust,2006,184 (8): 398-403.
7. ChangAB, GlombWB. Guidelines for evaluating chronic cough in pedia-trics:ACCP evidence-based clinical practice guidalines[J]. Chest,2006,129 (suppll):260-283.
8.中华医学会儿科学分会呼吸学组,《中华儿科杂志》编辑委员会.儿童慢性咳嗽诊断与治疗指南[J].中华儿科杂志,2008,46(2)：104-107.
9. Bremont F. Definition and nosological aspects of chronic cough in children [J]. Arch Pediatr,2001,8(3):597-599.
10. Bremont F, Micheau P, Le Roux P, et al. Etiology of chronic cough in children:analysis of 100 cases [J]. Arch Pediatr,2001,8(3):645-649.
11.马洪明,朱礼星,赖克方,等.嗜酸性粒细胞性支气管炎的气道炎症和临床特点[J].中华结核和呼吸杂志.2003,26(6)：362-365.
12. Irwin RS, Madison JM. Diagnosis and treatment of chronic cough due to gastro! esophageal reflux disease and post-nasal drip syndrome [J]. Pulm Pharmacol Ther,2002,5 (3):261-266.
13.中华医学会儿科学分会呼吸学组,中华医学会《中华儿科杂志》编辑委员会.儿童支气管哮喘防治常规(试行)[J].中华儿科杂志,2004,42(2)：100-106.
14.Tatli MM, An I, Araoglanogin M. Paranasal sinus compu-ted tomographic findings of children with chronic cough [J]. Int Pediatr Otorhinolaryngol,2001,60(3):213-217.
15. Juchet A, Bemont F, Dutan G, et al. Chronic cough and gastroesophageal reflux in children [J]. Arch Pediatr,2001,8(suppl 3): 629-634.
16. Katz PO. Gastroesophageal reflux disease!state of the art[J]. Rev Gastroenterol Disord,2001,1(3):128-138.
17.陆权.非典型微生物感染与慢性咳嗽[J].中国实用儿科杂志,2004,19(2)：1708.
18.何奎华.小儿慢性咳嗽与肺炎支原体、肺炎衣原体的关系[J].中国当代儿科学杂志,2002,4(6)：529.
19. Gibson PG, Fujimura M, Niimi A. Eos inophilie bronchi-t is:clinical manifestation and implicat eons for treatment [J]. Thorax,2002,57(2) 178-182.
20.楚辉,张杰,林隆.慢性咳嗽的临床诊断与治疗[J].首都医科大学学报,2006,27(2)：52-55.
21. French CT, Fletcher KE, Irwin RS. Gender differences in health! related quality of life in patients complaining of chronic cough. Chest, 2004,125(2):482-488.
22.王素青.儿童咳嗽变异性哮喘50例误诊分析[J].中国临床医学,2005,12(5)：896-897.
23.谢娟娟,钱俊,王文建,等.脉冲震荡技术诊断儿童咳嗽变异性哮喘的临床研究[J].中国临床医学,2005,12(5)：891-892.
24.中华医学会呼吸病学分会哮喘组.咳嗽的诊断与治疗指南(草案)[J].中华结核和呼吸杂志,2005,28(11)：738-744.
25.Kopriva F, Sobolova L, Szotkowska J, et al. Treatment of chronic cough in children with montelukast, a leukotriene receptor antagonist [J]. J Asthma,2004,41(7):715-720.
26.中华医学会儿科学会分会呼吸学组.儿童支气管哮喘防治常规(试行)[J].中华儿科杂志,2004,42(2)：100-106.
27.郑春盛,林青,林莉婷,等.小儿哮喘与白三烯关系的研究[J].福建医药杂志,2003,25(3)：167-168.
28. Bisgaard H, Nielsen KG. Bronchoprotection with a leukotriene receptor antagonist in asthmatic preschool children[J]. Am J Respir Crit Care Med.2000,162(1):187-190.
29. Matsumoto H, Niimi A, Takemura M, et al. Prognosis of cough variant asthma:a retrospective analysis [J]. J Asth-ma,2006,43(2):131-135.
30. Todokoro M, Mochizuki H, Tokuyama K, et al. Child-hood cough variant asthma and its relationship to classic asthma [J]. Ann Allergy Clin Immunol,2003,90(6):652-659.
31.张海邻,李昌崇.小儿咳嗽咳嗽诊断中几个值得关注的问题.实用儿科临床杂志,2008,23(16)：1228-1230.
32.刘志娟,陈静.辨病位与辨证相结合治疗小儿咳嗽.中国自然医学杂志,2010,12(3)：221-222.
33.闫永彬,从“伏风暗瘀”论治小儿咳嗽变异型哮喘探析.中华中医药杂志(原中国医药学报),2009,24(5)：606-608.
34.李吉燕,欧阳利民,赵云龙.从三焦辨治小儿咳嗽.河南中医,2010,30(3)：259-260.
35.孙淑芬,观痰听音法辨治小儿咳嗽刍议.辽宁中医杂志,2007,34(6)：745.
36.崔霞,王素梅,吴力群等.刘弼臣治疗小儿咳嗽八法.中医杂志,2008,49(4)：303-304.
37.白凌军.汪受传论治咳嗽变异型哮喘经验.中医杂志,2008,49(8)：695.
38.符虹.金绍文治疗小儿外感咳嗽经验.中医药学报,2005,33(3)：71.
39.苗冲.史正刚教授治疗小儿咳嗽经验拾萃.中医儿科杂志,2007,3(2)：3-4.
40.中华医学会呼吸疾病学会.支气管哮喘的定义诊断,严重程度分级及疗效判断标准(修正案).中华结核和呼吸杂志,1993,16(增刊)：5.
41.国家中医药管理局.中医病证诊断疗效标准.南京：南京大学出版社,1994.61-62.
42. Irwin RS, Madison JM. Analomical diugnoslie prolocol in evalualing chronic cough with specific reference to gas-troesophageal reflux disease [J]. Am J Med,2000,108 (Suppl 4a): 126s-130s.
43. Palombini BC, Villanova CA,Araujo E, et al. A pathogenic triad in chronic cough:asthma, postnasal drip syndrome, and gastroesophageal reflux disease [J]. Chest,1999,116(2):279-284.
44.赖克方,陈如冲,钟南山,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
45.Holinger LD. Chronic cough in infants and children [J]. Laryngoscope,1986,96 (3):316-322.
46.康厚乾,郑曼蕾,许志恒.咳嗽变异性哮喘28例[J],实用儿科临床杂志,2003,18(9)：714-715.
47. Richard S,Madison M. The persistently troublesome cough [J] AmJ ResCrit Care Med,2002,165:1496-1474.
48.儿童支气答哮喘防治常规(试行)[J]. 中华儿科杂志,2004,42(2)：100-106。
49. Patrick H, Patrick F. Chronic cough [J]. Med Clin North Am,1995, 79(2):361-372.
2.Curley FJ, Irwin RS, Pratter MR, et al. Cough and the common cold [J]. Am Rev Respir Dis,1988,138(2):305-311.
3. McGravey LPA. Cough·6:Which investigation are most useful in the diagnose of chronic cough? [J]. Thorax,2004,59(4):342-346.
4.MoriceAH, FontanaGA, SovijarviAR, etal. The diagnosis andmanage-ment of chronic cough [J]. EurRespirJ,2004,24(3):481-492.
5. ChangAB, GlombWB. Guidelines for evaluating chronic cough in pedia-trics:ACCP evidence-based clinical practice guidalines[J]. Chest,2006,129 (suppll):260-283.
6.ChangAB, Landau LI, vanAsperen PP,etal. Cough in children:Def ini-tions and cl inical evaluation[J]. Med JAust,2006,184 (8): 398-403.
7. ChangAB, GlombWB. Guidelines for evaluating chronic cough in pedia-trics:ACCP evidence-based clinical practice guidalines[J]. Chest,2006,129 (suppll):260-283.
8.中华医学会儿科学分会呼吸学组,《中华儿科杂志》编辑委员会.儿童慢性咳嗽诊断与治疗指南[J].中华儿科杂志,2008,46(2)：104-107.
9. Bremont F. Definition and nosological aspects of chronic cough in children [J]. Arch Pediatr,2001,8(3):597-599.
10. Bremont F, Micheau P, Le Roux P, et al. Etiology of chronic cough in children:analysis of 100 cases [J]. Arch Pediatr,2001,8(3):645-649.
11.马洪明,朱礼星,赖克方,等.嗜酸性粒细胞性支气管炎的气道炎症和临床特点[J].中华结核和呼吸杂志.2003,26(6)：362-365.
12. Irwin RS, Madison JM. Diagnosis and treatment of chronic cough due to gastro! esophageal reflux disease and post-nasal drip syndrome [J]. Pulm Pharmacol Ther,2002,5 (3):261-266.
13.中华医学会儿科学分会呼吸学组,中华医学会《中华儿科杂志》编辑委员会.儿童支气管哮喘防治常规(试行)[J].中华儿科杂志,2004,42(2)：100-106.
14.Tatli MM, An I, Araoglanogin M. Paranasal sinus compu-ted tomographic findings of children with chronic cough [J]. Int Pediatr Otorhinolaryngol,2001,60(3):213-217.
15. Juchet A, Bemont F, Dutan G, et al. Chronic cough and gastroesophageal reflux in children [J]. Arch Pediatr,2001,8(suppl 3): 629-634.
16. Katz PO. Gastroesophageal reflux disease!state of the art[J]. Rev Gastroenterol Disord,2001,1(3):128-138.
17.陆权.非典型微生物感染与慢性咳嗽[J].中国实用儿科杂志,2004,19(2)：1708.
18.何奎华.小儿慢性咳嗽与肺炎支原体、肺炎衣原体的关系[J].中国当代儿科学杂志,2002,4(6)：529.
19. Gibson PG, Fujimura M, Niimi A. Eos inophilie bronchi-t is:clinical manifestation and implicat eons for treatment [J]. Thorax,2002,57(2) 178-182.
20.楚辉,张杰,林隆.慢性咳嗽的临床诊断与治疗[J].首都医科大学学报,2006,27(2)：52-55.
21. French CT, Fletcher KE, Irwin RS. Gender differences in health! related quality of life in patients complaining of chronic cough. Chest, 2004,125(2):482-488.
22.王素青.儿童咳嗽变异性哮喘50例误诊分析[J].中国临床医学,2005,12(5)：896-897.
23.谢娟娟,钱俊,王文建,等.脉冲震荡技术诊断儿童咳嗽变异性哮喘的临床研究[J].中国临床医学,2005,12(5)：891-892.
24.中华医学会呼吸病学分会哮喘组.咳嗽的诊断与治疗指南(草案)[J].中华结核和呼吸杂志,2005,28(11)：738-744.
25.Kopriva F, Sobolova L, Szotkowska J, et al. Treatment of chronic cough in children with montelukast, a leukotriene receptor antagonist [J]. J Asthma,2004,41(7):715-720.
26.中华医学会儿科学会分会呼吸学组.儿童支气管哮喘防治常规(试行)[J].中华儿科杂志,2004,42(2)：100-106.
27.郑春盛,林青,林莉婷,等.小儿哮喘与白三烯关系的研究[J].福建医药杂志,2003,25(3)：167-168.
28. Bisgaard H, Nielsen KG. Bronchoprotection with a leukotriene receptor antagonist in asthmatic preschool children[J]. Am J Respir Crit Care Med.2000,162(1):187-190.
29. Matsumoto H, Niimi A, Takemura M, et al. Prognosis of cough variant asthma:a retrospective analysis [J]. J Asth-ma,2006,43(2):131-135.
30. Todokoro M, Mochizuki H, Tokuyama K, et al. Child-hood cough variant asthma and its relationship to classic asthma [J]. Ann Allergy Clin Immunol,2003,90(6):652-659.
31.张海邻,李昌崇.小儿咳嗽咳嗽诊断中几个值得关注的问题.实用儿科临床杂志,2008,23(16)：1228-1230.
32.刘志娟,陈静.辨病位与辨证相结合治疗小儿咳嗽.中国自然医学杂志,2010,12(3)：221-222.
33.闫永彬,从“伏风暗瘀”论治小儿咳嗽变异型哮喘探析.中华中医药杂志(原中国医药学报),2009,24(5)：606-608.
34.李吉燕,欧阳利民,赵云龙.从三焦辨治小儿咳嗽.河南中医,2010,30(3)：259-260.
35.孙淑芬,观痰听音法辨治小儿咳嗽刍议.辽宁中医杂志,2007,34(6)：745.
36.崔霞,王素梅,吴力群等.刘弼臣治疗小儿咳嗽八法.中医杂志,2008,49(4)：303-304.
37.白凌军.汪受传论治咳嗽变异型哮喘经验.中医杂志,2008,49(8)：695.
38.符虹.金绍文治疗小儿外感咳嗽经验.中医药学报,2005,33(3)：71.
39.苗冲.史正刚教授治疗小儿咳嗽经验拾萃.中医儿科杂志,2007,3(2)：3-4.
40.中华医学会呼吸疾病学会.支气管哮喘的定义诊断,严重程度分级及疗效判断标准(修正案).中华结核和呼吸杂志,1993,16(增刊)：5.
41.国家中医药管理局.中医病证诊断疗效标准.南京：南京大学出版社,1994.61-62.
42. Irwin RS, Madison JM. Analomical diugnoslie prolocol in evalualing chronic cough with specific reference to gas-troesophageal reflux disease [J]. Am J Med,2000,108 (Suppl 4a): 126s-130s.
43. Palombini BC, Villanova CA,Araujo E, et al. A pathogenic triad in chronic cough:asthma, postnasal drip syndrome, and gastroesophageal reflux disease [J]. Chest,1999,116(2):279-284.
44.赖克方,陈如冲,钟南山,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
45.Holinger LD. Chronic cough in infants and children [J]. Laryngoscope,1986,96 (3):316-322.
46.康厚乾,郑曼蕾,许志恒.咳嗽变异性哮喘28例[J],实用儿科临床杂志,2003,18(9)：714-715.
47. Richard S,Madison M. The persistently troublesome cough [J] AmJ ResCrit Care Med,2002,165:1496-1474.
48.儿童支气答哮喘防治常规(试行)[J]. 中华儿科杂志,2004,42(2)：100-106。
49. Patrick H, Patrick F. Chronic cough [J]. Med Clin North Am,1995, 79(2):361-372.