基于“风盛湿氲、湿随风动”探讨变应性咳嗽的病机及治疗

Exploration of the Pathogenesis and Treatment of Allergic Cough Based on the Concept of "Exuberant Wind and Pervasive Dampness，Dampness Moves with Wind"

摘要:

变应性咳嗽（AC） 属于呼吸道变态反应性疾病，该疾病发病机制复杂、一般药物治疗效果较差。 AC发病急骤、迁延难愈等临床特征，与中医学风邪、湿邪致病特点相似；肺脾气虚、湿浊内伏、风引湿动、 上乘阳位是AC的关键病机。伏湿内藏、遇风引动，诱而发之；阳邪开泄通道，阴邪乘虚固着，风动湿流，湿 阻风散，二者相互为因。在治疗上，当风湿并治，祛风、平逆、搜剔以清导风盛之象；补肺健脾以绝生湿之 源；宣上、畅中、渗下以分消内藏伏湿。临证需审风、湿之偏胜，察病势之缓急，把握“动与静”“升与降” “通与补”的动态平衡，以达“风静湿去咳自宁”之效。

Abstract:

Abstract： Allergic cough （AC） is a respiratory allergic disease with a complex pathogenesis and generally poor response to conventional drug therapy. The clinical characteristics of AC，such as sudden onset and prolonged refractory course，are similar to the pathogenic features of wind and dampness in traditional Chinese medicine （TCM）. The key pathogenesis of AC involves lung-spleen qi deficiency， internal accumulation of dampness-turbidity， wind stirring dampness， and upward disturbance of yang positions. Latent dampness is stirred by wind， triggering the onset of symptoms；yang pathogens open and drain pathways，allowing yin pathogens to take advantage and become entrenched. Wind movement drives dampness flow， while dampness obstruction disperses wind， creating a mutually causative relationship. In treatment， wind and dampness should be addressed simultaneously： dispelling wind， suppressing adverse qi，and searching out pathogens to clear exuberant wind manifestations；tonifying the lung and strengthening the spleen to eliminate the source of dampness production； diffusing the upper body， unblocking the middle， and percolating the lower body to disperse and eliminate latent dampness. Clinical practice requires assessing the predominance of wind or dampness，differentiating the urgency of the disease progression，and maintaining a dynamic balance between "movement and stillness， " "ascent and descent， " and "unblocking and tonifying" to achieve the effect of "calming wind and removing dampness，thereby naturally relieving cough."