基于“五脏之伤, 穷必及肾”理论探讨慢性咳嗽致儿童身材矮小

An exploration into chronic cough-induced short stature in children based on the theory of "Prolonged damage to the five Zang-organs eventually affects the kidney"

摘要

慢性咳嗽和身材矮小均对儿童及其家属造成严重的心理负担, 然而少有学者将二者联系起来, 本文基于张仲景《景岳全书》中“五脏之伤, 穷必及肾”理论, 结合现代实验研究, 系统探讨慢性咳嗽致使儿童矮小的内在联系。中医核心病机为慢性咳嗽患儿久咳伤肺, 肺病及脾, 穷必及肾, 髓亏骨弱, 故而矮小。现代医学认为儿童受慢性咳嗽影响, 或处于慢性炎症状态, 营养摄入、睡眠及运动不足等多方面因素影响终致身高线性增长受损。故而在疾病后期根据辨证采用“培土生金” “金水相生”等治法调理儿童体质, 弥补儿童久病未愈的机体损伤, 助力儿童的生长发育, 避免未至成年理想终身高。本文系统总结慢性咳嗽致使儿童矮小的中医病机、病理机制、中医治法理念, 以期为防治儿童慢性咳嗽致使生长发育受损提供理论依据与临床参考。

Abstract

Chronic cough and short stature both impose significant psychological burdens on the children and their family members. However, few scholars have explored the connection between the two. This paper systematically investigates the intrinsic link between chronic cough and short stature in children, based on Zhang Zhongjing's theory from Jingyue Quanshu that "Prolonged damage to the five Zang-organs eventually affects the kidney" and combined with modern experimental research. The core pathogenesis in traditional Chinese medicine is that prolonged coughing in children with chronic cough injures the lungs, which in turn affects the spleen and eventually impacts the kidneys, leading to bone marrow depletion and weakened bones and resulting in short stature. Modern medicine believes that the children are affected by chronic cough or chronic inflammation, inadequate nutrition, insufficient sleep and lack of exercise, which ultimately impairs linear growth of height. Therefore, in the later stages of the disease, treatment principles such as "reinforcing the earth to generate metal" and "mutual promotion between metal and water" are applied based on syndrome differentiation to regulate the children's constitution, compensate for physical damage caused by prolonged illness, support growth and development, and prevent failure to reach the ideal adult height. This article systematically summarizes the TCM pathogenesis, pathological mechanisms, and therapeutic principles of TCM of chronic cough that lead to short stature in children, aiming to provide theoretical foundations and clinical references for preventing and treating growth impairment due to chronic cough in children.

关键词

慢性咳嗽 / 矮小症 / 穷必及肾 / 慢性炎症状态 / 儿童

Key words

Chronic cough / Short stature / Prolonged damage eventually affects the kidney / Chronic inflammatory state / Child

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基金资助

黑龙江省中医药科研项目(ZYW2025-011)