基于“玄府-气液-三焦”理论辨治小儿慢性咳嗽

Differential treatment for pediatric chronic cough based on the theory of "Xuanfu-Qiye-Sanjiao"

摘要

小儿慢性咳嗽是儿童及青少年时期常见病之一, 病程迁延, 现代医学治疗存在易复发等问题。中医药治疗该病显示出独特优势。本文以“玄府-气液-三焦”理论为切入点, 将刘完素“玄府气液”理论与传统三焦理论相结合, 探究其生理病理与小儿慢性咳嗽的联系。基于该理论, 其病理核心环节可归纳为玄府开阖失司、气液输布失司、三焦宣降失常三部分, 因此, 治疗应从“开玄府、调气液、畅三焦”着手, 打破上述病理循环, 从根本上解决小儿慢性咳嗽迁延不愈的问题。方用“三仁汤”, 该方契合“宣上、畅中、渗下”之法, 共奏开玄府、畅三焦以恢复气化之效。其多靶点、多层次的整体调节作用, 与小儿慢性咳嗽涉及的“气道高反应、慢性炎症、免疫紊乱”等现代病理机制相契合, 最终使得气液调达, 咳嗽自止。

Abstract

Chronic cough in children is one of the common diseases during childhood and adolescence with a prolonged course, and modern medical treatments often face problems of high recurrence rate. Traditional Chinese medicine shows unique advantages in the treatment of this disease. This article takes the "Xuanfu–Qiye–Sanjiao" theory as the entry point, and combines Liu Wansu's "Xuanfu Qiye" theory with the traditional Sanjiao theory to explore the association between its pathophysiology and pediatric chronic cough. Based on this theory, the core pathological mechanism can be summarized as the failure of Xuanfu in opening and closing, the disordered transportation of Qiye, and the abnormal functioning of the Sanjiao in dispersing and descending. Therefore, treatment should focus on "opening Xuanfu, regulating Qiye, and unblocking the Sanjiao" to break the pathological cycle mentioned above, fundamentally solving the problem of prolonged and refractory chronic cough in children. The prescription used is "Sanren decoction", which aligns with the principles of "dispersing the upper Jiao, regulating the middle Jiao, and draining the lower Jiao" to work together to open Xuanfu and unblock the Sanjiao to restore Qi transformation. Its overall multi-target and multi-level regulatory effects correspond to modern pathological mechanisms involved in pediatric chronic cough, such as "airway hyperreactivity, chronic inflammation, and immune disorder", which ultimately achieves the effect of proper circulation of Qiye, and the cough stops.

关键词

慢性咳嗽 / 玄府 / 三仁汤 / 儿童

Key words

Chronic cough / Xuanfu / Sanren decoction / Child

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基金资助

国家自然科学基金面上项目(82274580)