基于宗气理论探讨口鼻呼吸方式对儿童阻塞性睡眠呼吸暂停的影响

Exploring the impact of oral and nasal breathing patterns on pediatric obstructive sleep apnea based on the theory of pectoral Qi

摘要

宗气作为人体后天之气核心, 由肺吸入之清气和脾胃运化之水谷精微相合而成, 其“走息道以司呼吸、贯心脉以行气血”的功能与呼吸方式密切相关。文章立足中医宗气理论, 结合西医研究成果, 系统阐释鼻呼吸与口呼吸对宗气生成及功能影响的差异机制。鼻呼吸能够保障“清气”的纯净与适宜, 为宗气化生与布散奠定生理基础；口呼吸则易使浊冷之气直侵肺脏, 耗伤肺脾之气, 壅滞咽喉气机, 最终导致宗气失调, 成为儿童阻塞性睡眠呼吸暂停发生与进展的关键病机环节。基于此, 构建“鼻-气-神”三位一体的儿童阻塞性睡眠呼吸暂停综合防治体系, 以恢复鼻呼吸为首要治则, 并配合补益肺脾、宣畅气机之法。

Abstract

Pectoral Qi (Zongqi), as the core of acquired Qi in the human body, is formed by the combination of clean Qi inhaled by the lungs and the essential Qi of water and grain transformed and transported by the spleen and stomach. Its functions of "governing respiration through the respiratory tract and promoting blood circulation by penetrating the heart vessels" are closely related to breathing patterns. Based on the traditional Chinese medicine theory of pectoral Qi and integrated with modern medical research findings, the paper systematically elucidates the differential mechanisms by which nasal and oral breathing affects the generation and function of pectoral Qi. Nasal breathing ensures the purity and suitability of "clean Qi", laying the physiological foundation for the transformation, generation, and distribution of pectoral Qi. In contrast, oral breathing tends to allow turbid and cold Qi to directly invade the lung, consuming the Qi of the lung and spleen, and stagnating the Qi movement in the throat, which ultimately leads to disharmony of pectoral Qi, becoming a key pathogenic link in the occurrence and progression of pediatric obstructive sleep apnea (OSA). Based on it, a comprehensive prevention and treatment system of pediatric OSA embodying the trinity of "nose-Qi-spirit" is established, with restoring nasal breathing as the primary treatment principle and combined with methods to tonify the lung and spleen and free Qi movement.

关键词

阻塞性睡眠呼吸暂停 / 宗气 / 鼻呼吸 / 口呼吸 / 儿童

Key words

Obstructive sleep apnea / Pectoral Qi (Zongqi) / Nasal breathing / Oral breathing / Child

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基金资助

深圳市“医疗三名工程”项目(SZZYSM202311005)

邱宝珊广东省名中医传承工作室(粤中医办函〔2023〕108号)