633 | 0 | 15 |
下载次数 | 被引频次 | 阅读次数 |
玄府乃气机升降出入、精血津液流通、脏腑得以濡养的总司,贵在畅通,忌于壅滞。咳嗽变异型哮喘属中医“风咳”范畴,玄府开阖升降失司贯穿其发病全程。聚焦于咳嗽变异型哮喘病程演变中玄府失司的动态变化,归纳为玄府失枢、玄府失通、玄府失养三阶段。治疗上以“风药开玄”为核心,始动期以启玄祛风,宣肺理气;进展期以畅玄散风,肃肺消滞;转归期以养玄御风,补肺固本分以施治,以期为咳嗽变异型哮喘临床诊治提供思路。
Abstract:Sweat pore serves as the central regulator for ascending, descending, exiting and entering of qi movement, the circulation of essence, blood, and body fluids, and the nourishment of zang-fu organs. Its proper function depends on maintaining smooth flow and avoiding stagnation. Cough variant asthma(CVA), in traditional Chinese medicine, falls under the "wind cough" category. The dysfunction of sweat pores' opening, closing, ascending, and descending is integral to the pathogenesis of CVA. This article focused on the dynamic changes in sweat pores' dysfunction throughout the progression of CVA, categorized into three stages,i. e. loss of pivot function, blockage of sweat pores, and lack of nourishment. The treatment approach centers on "wind medicinal opening sweat pores", so for the initial stage, the focus is on activating sweat pores and dispelling wind, diffusing the lungs and rectifying qi; for the progression stage, the strategy shifts to unblocking sweat pores and dispersing wind, clearing lung stagnation and resolving obstructions; for the resolution stage, the emphasis is on nourishing sweat pores and defending against wind, strengthening the lungs and consolidating the body's foundation. This approach provides a systematic approach to the clinical diagnosis and treatment of CVA.
[1]中华医学会呼吸病学分会哮喘学组.支气管哮喘防治指南(2020年版)[J].中华结核和呼吸杂志,2020,43(12):1023-1048.
[2]田雪,周新.咳嗽变异性哮喘诊治新进展[J].华西医学,2018, 33(1):99-103.
[3]黄雲菲.中医药治疗咳嗽变异性哮喘疗效性与安全性Meta分析及组方规律初探[D].天津:天津中医药大学,2024.
[4]罗社文.晁恩祥治疗咳嗽变异性哮喘经验[J].中医杂志,2002,43(1):74.
[5]兰丹丹,贾新华.从风痰瘀论治咳嗽变异性哮喘[J].云南中医中药杂志,2018, 39(2):5-8.
[6]陆鹏,任凤艳,潘迪,等.肺玄府络脉与气血屏障论[J].中医杂志,2016,57(16):1433-1435.
[7]黄文博,付西,黄娅,等.基于“玄府气液”学说探析肺结节的治疗[J].中医杂志,2022, 63(12):1189-1192.
[8]邢亚萍,韩姗姗,丁樱,等.基于“肾玄府开阖、络脉疏塞”理论探讨儿童过敏性紫癜性肾炎的病机治法[J].北京中医药大学学报,2023, 46(6):842-847.
[9]蔡松,张立山,司徒惠昀,等.基于玄府、腠理认识的从表达邪治疗间质性肺病经验探讨[J].北京中医药,2024, 43(2):186-189.
[10]叶俏波,江花,江玉,等.风药未必尽祛风,升散透泄用无穷:玄府学派名家论风药[J].成都中医药大学学报,2020, 43(3):4-7.
[11]张艺,崔红生,吕明圣,等.基于伏风理论辨治咳嗽变异性哮喘的思路[J].中医杂志,2023, 64(13):1391-1395,1404.
[12]于明霞,王妍妍,张艺,等.伏风理论在肺系疾病中临床运用[J].中国实验方剂学杂志,2024,30(16):92-99.
[13]汪受传,林丽丽,冯璐.“消风法”三期分证论治小儿哮喘[J].南京中医药大学学报,2022, 38(6):467-475.
[14]聂天义.《内经》水血相关论探讨[J].四川中医,1992(6):3-4.
[15]明溪,薛征,李利清,等.虞坚尔“三阶序治法”辨治小儿哮喘经验[J].中医杂志,2017, 58(6):467-469.
[16]孟翔,王真.王真治疗咳嗽变异型哮喘经验[J].浙江中西医结合杂志,2022, 32(7):593-594.
[17]汪受传.从风论治儿童过敏性疾病[J].中医杂志,2016, 57(20):1728-1731.
[18]李敏,赵霞.基于“玄府理论”辨治儿童过敏性鼻炎-哮喘综合征[J].江苏中医药,2022, 54(12):27-30.
[19]牛学恩,李振华.风药运用新识[J].时珍国医国药,2014, 25(11):2741-2743.
[20]樊建设,徐菁蔚,陈琳雯,等.咳嗽变异性哮喘中医用药的数据挖掘[J].中日友好医院学报,2022, 36(2):119-120.
[21]李垚锬,侯金易,赵乐滢,等.王耀献基于“玄府理论”运用风药治疗慢性肾脏病[J].中医学报,2025,40(3):576-579.
[22]魏云霞,沈洪.东垣以风药升阳的理论及应用探析[J].中国中医药图书情报杂志,2024, 48(3):200-204.
基本信息:
DOI:10.13288/j.11-2166/r.2025.08.008
中图分类号:R256.12
引用信息:
[1]周晓青,陈佳玲,周林水等.从“风药开玄”探析咳嗽变异型哮喘的辨治思路[J].中医杂志,2025,66(08):800-803.DOI:10.13288/j.11-2166/r.2025.08.008.
基金信息:
国家自然科学基金(82174302); 浙江省中医药科技计划项目(2022ZA063)