摘要
概述常克教授运用宣痹化浊法治疗小儿肺炎支原体肺炎湿热证之经验。本病核心病机在于湿热郁遏清阳,氤氲酿痰,痹阻肺络。初因肺气闭郁,失于宣降,湿饮内停;继则湿郁化热,上蒸于肺;湿热胶结,酿生痰浊,壅塞肺络,此乃病变关键。终致湿热痰浊胶着难解,临床见身热持续、咳嗽痰重、鼻塞气促、胸闷痰壅,部分患儿兼见恶心欲吐、纳差、苔黄白或黄腻等中焦湿热之象。针对此,疗法以宣痹化浊为主导,内服自拟“宣茎汤”。由上焦宣痹汤宣通气机、化湿清热合千金苇茎汤清肺化痰、逐瘀排浊,加杏仁增强宣降止咳,滑石强化清利湿热化裁而成。全方旨在宣通肺气痹阻,清化湿热痰浊。外敷经验方“敷胸散”,助宣通肺络、温化痰浊、散结行气。此治法紧扣湿热痰浊痹阻肺络之核心,通过内部疏通肺络气机之缠遏,化解胶浊之根;外部宣透皮膜腠理,松动痰瘀之形,立体化地针对“痹”与“浊”展开攻势。临床实践证实其能有效缓解症状,体现中医治疗本病的特色与常克教授的学术思想。
This paper summarizes Professor Chang Ke's experience in treating damp-heat syndrome of mycoplasma pneumoniae pneumonia in children with the method of Xuanbi Huazhuo.The core pathogenesis of this disease is that damp-heat stagnates and suppresses clear yang,condenses to form phlegm,and obstructs the lung collaterals.At the beginning,it is due to the stagnation of lung qi and failure in diffusion and descent,leading to the internal retention of dampness and fluid;then,the stagnated dampness turns into heat,which goes upward to the lungs;damp and heat binds together,generating phlegm and turbidity and blocking the lung collaterals,which is the key to the pathological changes.Eventually,damp,heat,phlegm and turbidity interacts with each other.Clinically,there are symptoms such as persistent fever,severe cough with much phlegm,nasal congestion,shortness of breath,chest tightness and phlegm congestion.Some children also have symptoms of damp-heat in the middle jiao,such as nausea and vomiting,poor appetite,yellowish-white or yellow-greasy tongue coating.In view of this,Xuanbi Huazhuo is the main treatment method.The self-made"Xuanjing decoction"is taken orally.It is composed of Shangjiao Xuanbi decoction(decoction for relieving obstruction in the upper Jiao)which can promote the flow of qi,resolve dampness and clear heat,combined with Qianjin Weijing decoction which can clear the lung,resolve phlegm,remove blood stasis and expel turbidity.Almond is added to enhance the functions of dispersing,descending and relieving cough,and talc is added to strengthen the clearing and draining of damp-heat.The whole prescription aims to dredge the obstruction of lung qi and clear away damp-heat,phlegm and turbidity.The empirical formula"Fuxiong powder"for external application helps to dredge the lung collaterals,warm and resolve phlegm and turbidity,disperse stagnation and promote qi flow.This treatment method focuses on the core of damp-heat,phlegm and turbidity obstructing the lung collaterals.It addresses the root cause of the stubborn turbidity by internally dredging the stagnation of qi in the lung collaterals;externally,it diffuses and penetrates through the skin,membranes and interstitial spaces,loosening the phlegm and blood stasis,thus launching a three-dimensional attack on"bi(obstruction)"and"zhuo(turbidity)".Clinical practice has confirmed that it can effectively relieve symptoms,which embodies the characteristics of traditional Chinese medicine in the treatment of this disease and the academic thoughts of Professor Chang Ke.
作者
李佳宇
孙媛
冯馨
常克
LI Jiayu;SUN Yuan;FENG Xin;CHANG Ke(Chengdu University of Traditional Chinese Medicine,Chengdu 610075,China;Hospital of Chengdu University of Traditional Chinese Medicine,Chengdu 610032,China)
出处
《中国中西医结合儿科学》
2025年第5期442-446,共5页
Chinese Pediatrics of Integrated Traditional and Western Medicine
基金
国家中医药管理局2022年全国名老中医药专家传承工作室建设项目(国中医药人教函〔2022〕75号)
四川省中医药管理局科技项目(2023MS287)。
关键词
肺炎支原体肺炎
湿热证
宣痹化浊
名医经验
儿童
Mycoplasma pneumoniae pneumonia
Damp-heat syndrome
Dredging obstruction and resolving turbidity(Xuanbi Huazhuo)
Famous doctor's experience
Child
