中医杂志

慢性咳嗽是肺结节手术后常见的并发症之一，其病因病机复杂，辨证施治需综合考虑术前、术中、术后三个时期的不同特点。术前正气亏虚、邪留肺间；术中金戈所伤、气血受损；术后正虚加重，以肺脾气阴两虚为本，易夹风、痰、滞、瘀诸邪。治疗宜三期合参、重在术后，补虚为先，尤以益气养阴、补肺健脾为主；并针对不同的兼夹证候分别采用祛风、化痰、行滞、通瘀之法，慎用攻伐之品以防耗气伤血。

Chronic cough is one of the common complications after pulmonary nodule surgery. Its etiology and pathogenesis are complex, and syndrome differentiation and treatment in traditional Chinese medicine(TCM) require comprehensive consideration of the distinct characteristics across the preoperative, intraoperative, and postoperative phases. Prior to surgery, there may be healthy qi depletion with lingering pathogens in the lungs; during surgery, metal instruments may injure the body, leading to qi and blood damage; after surgery, the depletion of healthy qi worsens, with dual deficiency of lung and spleen qi and yin as the root condition, often complicated by pathogens such as wind, phlegm, stagnation, and stasis. Treatment should follow the principle of comprehensively considering all three phases with a focus on the postoperative phase. Replenishing deficiency is the primary, particularly by tonifying qi and nourishing yin, as well as supplementing the lung and fortifying the spleen. For different accompanying syndromes, therapeutic methods such as dispelling wind, resolving phlegm, relieving stagnation, and unblocking stasis should be applied accordingly, while aggressive purgative herbs should be used with caution to avoid depletion of qi and blood injury.