基于“勿令窍闭”论芳香药在腺样体肥大中的应用

Application of aromatic herbs in adenoid hypertrophy based on "preventing orifices obstruction"

摘要

腺样体肥大是指鼻咽部的腺样体因反复炎症刺激而发生病理性增生肥大, 并引起一系列临床症状的儿科及耳鼻咽喉科的一种常见疾病。本文基于“勿令窍闭”理论的来源及中医内涵, 认为窍闭是百病之由, 是变生百病的病理基础, 阐述了腺样体肥大的病因病机, 说明其发病的核心在于肺窍闭塞不通, 气血津液运行受阻, 加之小儿肺脾肾三脏本不足, 易化生痰、瘀等多种病理产物而发病, 从而出现鼻塞流涕、张口呼吸、寐时打鼾、耳闷耳胀等症状, 故采取及时有效的干预对患儿生活与睡眠质量、颌面发育, 甚至身心健康十分必要。在临证治疗中, 遵循“勿令窍闭”理论, 急性期腺样体肥大多因感外邪而发, 处方中配伍辛夷、苍耳子、白芷等辛温芳香药, 助解表药散表邪的同时, 其芳香之气又能宣通肺窍, 缓解鼻塞流涕等症状；缓解期芳香化湿药如藿香、苍术、石菖蒲等的配伍运用, 在于健脾助运, 宣化中焦湿浊, 加强消痰化瘀, 散结通窍, 疏通气机之效, 进而恢复局部气血津液运行, 使脏腑功能正常发挥。

Abstract

Adenoid hypertrophy (AH) is a common disease in pediatrics and otorhinolaryngology, which refers to the pathological hyperplasia and hypertrophy of adenoids in the nasopharynx due to repeated inflammatory stimulation, and causes a series of clinical symptoms. Based on the origin of the theory of "preventing orifices obstruction" and its connotation in traditional Chinese medicine, this paper holds that the closure of the orifices is the cause of all diseases and the pathological basis of all diseases. It expounds the etiology and pathogenesis of AH, indicating that the core of its pathogenesis lies in the obstruction of the lung orifices and the obstruction in the flow of qi, blood and body fluid. In addition, the deficiency in the three organs of the lung, spleen and kidney in children is likely to produce phlegm, blood stasis and other pathological products, resulting in symptoms such as nasal congestion and runny nose, mouth breathing, snoring during sleep, ear tightness and ear swelling. Therefore, it is necessary to make timely and effective intervention to improve the quality of life and sleep, the maxillofacial development and even physical and mental health of children. In clinical treatment, the theory of "preventing orifices obstruction" is followed; AH in the acute phase is mostly caused by external pathogens, and Xinyi, Cangerzi, Baizhi and other pungent and warm aromatic herbs are added to the prescription to help the exterior-releasing herbs to disperse the exterior pathogens. At the same time, its aromatic smell can dredge the lung orifices and relieve symptoms such as nasal congestion and runny nose. The application of aromatic dampness-resolving herbs such as Huoxiang, Cangzhu and Shichangpu in the remission period is to strengthen the spleen and help transportation, disperse dampness and turbidity in the middle energizer, strengthen the effect of eliminating phlegm and removing blood stasis, disperse stagnation and dredge orifices, and dredge qi movement, so as to restore the flow of local qi and blood and body fluid and enable Zang-fu organs to work normally.

关键词

腺样体肥大 / 勿令窍闭 / 病因病机 / 病理产物 / 芳香药 / 儿童

Key words

Adenoid hypertrophy / Preventing orifices obstruction / Etiology and pathogenesis / Pathological products / Aromatic herbs / Child

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基金资助

赵鋆中医药传承创新工作室(2025CXGZS-04)