从圆运动六经辨证体系探讨咳嗽变异性哮喘治疗思路

Exploration on Therapeutic Approach for Cough Variant Asthma from the Perspective of the Syndrome Differentiation System of Six-Meridian of Circular Motion

摘要:

从中医经典理论出发，以几何圆为理论模型，结合《伤寒杂病论》三阴三阳六经辨证以及脏腑辨证学说，融阴阳五行、六气、脏腑经络、气血津液、气机升降为一体，天、地、人三才合一的辨证体系，称之为圆运动六经辨证体系。该体系通过调节气机升降，恢复一气周流，促进疾病向愈。咳嗽变异性哮喘以刺激性干咳，咽痒为主，同时伴有气道痉挛，夜间平躺时气冲作咳等临床表现，符合“风”“寒”“伏饮”等邪气致病的病理特点。基于圆运动六经辨证体系，通过“明病因、定病位、辨病性、断病势”等辨证方法，提出咳嗽变异性哮喘主要病位在太阳及太阴、少阴，涉及少阳和阳明，临证从开太阳、运太阴、温少阴入手，灵活使用经方加减治疗，临床可取得佳效。

Abstract:

Abstract：The syndrome differentiation system of six-meridian of circular motion is a concept under the guidance of classical traditional Chinese medicine （TCM） theories. Using the geometric circle as a theoretical model，it integrates the three-yin and three-yang six-meridian differentiation from Shang Han Za Bing Lun （Treatise on Cold Damage and Miscellaneous Diseases） with the zang-fu syndrome differentiation，incorporating yin-yang and the five elements，the six qi，zang-fu，meridians，qi，blood，body fluids，and the ascending and descending of qi movement. This forms a holistic differentiation system of three realms that unites heaven， earth， and humanity. This system promotes the recovery from diseases by regulating the ascending and descending of qi movement and restoring the circular flow of qi. Cough variant asthma （CVA） is mainly characterized by an irritant dry cough and throat itching， accompanied by airway spasm and coughing triggered by qi rushing upward when the patient lies flat at night. These clinical manifestations align with the pathological features of pathogenic factors such as "wind，" "cold，" and "hidden fluid." Based on the syndrome differentiation system of six-meridian of circular motion，and through the diagnostic methods of "identifying the cause， determining the affected site， differentiating the nature of the disease， and judging the progression of disease，" it is proposed that the affected site of CVA primarily focuses on the Taiyang，Taiyin，and Shaoyin meridians，with the Shaoyang and Yangming meridians also being involved. In clinical practice，by treating from the perspective of opening the Taiyang， regulating the Taiyin， and warming the Shaoyin， and flexibly using modified classical formulas，satisfactory therapeutic outcomes can be achieved.