[1]江容飞,付亚玲,王 敏.老年咳嗽变异性哮喘患者中医证候特点及干预研究概况[J].陕西中医,2021,(2):269-272.[doi:DOI:10.3969/j.issn.1000-7369.2020.02.033]
　JIANG Rongfei,FU Yaling,WANG Min.Research summary on characteristics of TCM syndromes and intervention in elderly patients with cough variant asthma[J].,2021,(2):269-272.[doi:DOI:10.3969/j.issn.1000-7369.2020.02.033]
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老年咳嗽变异性哮喘患者中医证候特点及干预研究概况
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《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2021年2期
页码:
269-272
栏目:
综述
出版日期:
2021-02-05

文章信息/Info

Title:
Research summary on characteristics of TCM syndromes and intervention in elderly patients with cough variant asthma
作者:
江容飞; 付亚玲; 王 敏
(成都上锦南府医院中西医结合科,四川 成都 610000)
Author(s):
JIANG Rongfei; FU Yaling; WANG Min
(Department of Integrated Chinese and Western Medicine,Chengdu Shangjin Nanfu Hospital,Chengdu 610000,China)
关键词:
咳嗽变异性哮喘;  中医证候;  老年;  预后评估;  治法治则
Keywords:
Cough variant asthma;  TCM syndromes;  Elderly;  Prognosis evaluation;  Prevention and treatment
分类号:
R 256.12
DOI:
DOI:10.3969/j.issn.1000-7369.2020.02.033
文献标志码:
A
摘要:
目的:探究老年咳嗽变异性哮喘(CVA)患者中医证候特点及干预概况,为临床制定辨证治疗方案提供可靠依据。方法:通过查阅文献并整合相关资料的方式进行总结分析,根据发病情况、症状特点、证候类型等归纳出临床老年CVA患者较为常见的中医证候特点,制定出统一的中医临床证候分布特点规律,并在证候分析的基础上,结合以往临床CVA患者的中医药用药情况进行系统观察及研究,总结现临床针对老年CVA患者的干预概况。结果:老年CVA患者临床表现以阵发性、刺激性干咳为主,并伴有咽痛、鼻塞、打喷嚏、出汗、咳痰、口渴等症状,根据症状、舌象、脉象等分析其病因病机可能与先天禀赋不足、后天复感风邪,抑制肺气上逆,肺管不利,引起气道挛急有关,日久则邪郁于肺,瘀阻肺络、津液耗伤,概括为风邪犯肺证、风寒袭肺证、风热犯肺证、痰热壅肺证、肺热阴虚证、肺阴亏虚证等证候。中医药治疗途径分为药物内服及外治两种,其中内治法主要以祛邪宣肺、补益肺肾、祛邪扶正为主,而外治又可分为穴位敷贴,穴位注射、针刺等,疗效显著。结论:CVA以本虚标实为主要病机,中医治疗疗效确切,具有作用温和、辨证论治、安全性高等优势,优势明显。
Abstract:
Objective:To explore the characteristics of TCM syndromes and intervention in elderly patients with cough variant asthma(CVA),and to provide a reliable basis for clinical development of regimen of TCM syndrome differentiation and treatment.Methods:Summary and analysis were performed by reviewing literature and integrating relevant data,and the common characteristics of TCM syndromes in clinically elderly CVA patients were summarized based on the incidence,symptoms characteristics and syndrome types,and a unified distribution pattern of TCM clinical syndromes was formulated.Based on the analysis of syndromes,systematic observation and research were carried out by combining the use of traditional Chinese medicine in previous clinically CVA patients,and the current clinical intervention for elderly CVA patients was summarized.Results:The clinical manifestations of elderly CVA patients were mainly paroxysmal dry cough and irritating dry cough,accompanied by sore throat,nasal congestion,sneezing,sweating,expectoration and thirst.According to the symptoms,tongue picture and pulse conditions,the etiology and pathogenesis might be related to the lack of congenital endowment,acquired relapse of wind pathogens,suppression of lung qi upward reversal,unfavorable lung ducts and airway spasm causing.As time went by,pathogenic factors stagnated in the lungs,blood stasis blocked in lung collaterals and body fluid was consumed,which could be summarized as wind-pathogen invasion of the lungs,wind-cold attack of the lungs,wind-heat invasion of the lungs,phlegm-heat obstruction of the lungs,heat-yin deficiency of the lungs and lung-yin deficiency.Therapeutic approaches of traditional Chinese medicine were divided into two types:oral medicine and external treatment.The internal treatment methods were mainly to dispel pathogens and promote the lung,replenish the lungs and kidneys,and dispel pathogens and strengthen the body,and the external treatment methods included acupoint application,acupoint injection and acupuncture,with remarkable efficacy.Conclusion:The main pathogenesis of CVA is deficient root and excessive superficial.Traditional Chinese medicine therapy has a definite efficacy and has the advantages of mild effect,dialectical treatment and high safety,and its advantages are obvious.

参考文献/References:

[1] 门 翔,尚喜雨,党 强.咳嗽变异性哮喘和典型支气管哮喘患者DCs、mDC、pDC比例和数量的变化及意义[J].广东医学,2017,38(3):448-450.
[2] 侯安存,沙 莉.咳嗽变异性哮喘诊断标准的差异及解析[J].临床和实验医学杂志,2016,15(2):106-109.
[3] 吴 奎,王 彦,陈 章,等.糖皮质激素吸入对咳嗽变异性哮喘患者呼出气NO水平的影响[J].重庆医学,2015,44(8):1041-1043.
[4] 王月娇,马 健.从伏邪理论探讨咳嗽变异性哮喘的辨治[J].中华中医药杂志,2017,32(12):5402-5403.
[5] 吴丽华,蒋红丽,闵 捷,等.中药治疗咳嗽变异性哮喘的系统评价[J].中国循证医学杂志,2015,15(9):1084-1089.
[6] 刘继华.中医分期论治咳嗽变异性哮喘的验案一则[J].天津中医药,2017,34(10):686-687.
[7] 吴昀蓉.中西医结合治疗咳嗽变异性哮喘52例疗效观察[J].西部中医药,2017,30(3):102-104.
[8] 陈树煜,方泽葵,方 思,等.典型哮喘与咳嗽变异性哮喘的小气道功能差异分析[J].南方医科大学学报,2017,37(3):330-336.
[9] 胡伟林,赵珊珊,涂明利,等.疏风化痰方对咳嗽变异性哮喘临床疗效及气道炎性因子的影响[J].中医药信息,2016,33(5):81-84.
[10] 谢 梅.止咳丸联合孟鲁司特钠治疗咳嗽变异性哮喘的临床研究[J].现代药物与临床,2019,34(9):2654-2659.
[11] 胡晓英,武维屏.调肝理肺法治疗咳嗽变异性哮喘探究[J].北京中医药,2016,35(7):674-676.
[12] 陈 旋,张 炜.蝉芩颗粒治疗风邪犯肺型咳嗽变异性哮喘临床观察[J].上海中医药杂志,2017,51(1):60-63.
[13] 钟云青.宣肺止嗽合剂辅助治疗咳嗽变异性哮喘的风邪犯肺证患者[J].中成药,2017,39(5):912-915.
[14] 王红霞,郭 烁,郭雨晴,等.百杏润肺止咳方对肺阴亏虚型咳嗽变异性哮喘患者炎症因子及肺功能的影响[J].中国中医基础医学杂志,2019,25(10):1377-1379.
[15] 邵玉锋,侯瑞蕊,杨云峰,等.三九咳喘贴联合膏方治疗咳嗽变异性哮喘疗效观察[J].四川中医,2020,38(1):95-97.
[16] 李 琛,陈丽萍,冯 平,等.祛风补肾方对成人咳嗽变异性哮喘患者临床症状和免疫功能的影响[J].现代中西医结合杂志,2020,29(8):882-884.
[17] 范艺龄,马 冲,曹 庆,等.从“寒留三焦”论治咳嗽变异性哮喘的思路[J].中医杂志,2020,61(2):114-118.
[18] 管新竹,张 伟.咳嗽变异性哮喘与痰饮相关性探讨[J].山东中医杂志,2016,35(9):770-771.
[19] 中华医学会呼吸病学分会哮喘学组.咳嗽的诊断与治疗指南(2009版)[J].中华结核和呼吸杂志,2009,19(22):1-7.
[20] 中华中医药学会内科分会肺系病专业委员会.咳嗽中医诊疗专家共识意见(2011版)[J].中医杂志,2011,52(10):896-899.
[21] 易桂生,杨 帆.咳嗽变异性哮喘中医证候分布规律研究[J].辽宁中医药大学学报,2013,15(4):25-26.
[22] 罗社文,李友林,晁恩祥.咳嗽变异性哮喘的中医证候学研究[J].现代中医临床,2007,14(3):11-14.
[23] 温敏勇,肖 曼.咳嗽变异型哮喘中医证型规律与诱导痰细胞学分析相关性研究[J].辽宁中医杂志,2013,40(8):1530-1533.
[24] 钟云青,许光兰,王秀峰.宣肃止咳汤辅助治疗咳嗽变异性哮喘风邪犯肺证的临床观察[J].中医药信息,2018,35(6):50-53.
[25] 徐萍利,李自力.制风止咳汤治疗咳嗽变异性哮喘的疗效分析[J].中国中医急症,2016,25(11):2145-2147.
[26] 张文江,樊长征,张燕萍,等.润肺止咳法治疗咳嗽变异性哮喘(肺热阴虚证)临床研究[J].中国中医急症,2011,20(12):1900-1901,1944.
[27] 于国强,石绍顺,付东升.止嗽散化裁辨治风寒犯肺证咳嗽变异性哮喘的临床研究[J].世界中医药,2016,11(1):70-73.
[28] 马蕴蕾,宿英豪,苏奎国,等.宣肺化痰通络方治疗咳嗽变异性哮喘-痰热郁肺证的临床观察[J].世界中医药,2015,10(1):481-482.
[29] 章 玲,张专名,武煦峰.千金麦门冬汤加减对肺阴虚证老年咳嗽变异性哮喘患者气道功能,炎症状态的影响[J].现代中西医结合杂志,2020,29(2):143-147.
[30] 刘 梦,张 迪,陈云凤.祛风敛肺汤治疗咳嗽变异性哮喘(风盛挛急证)临床研究[J].四川中医,2019,37(12):84-87.
[31] 杨新艳,廖理粤,李 靖,等.吸烟者咳嗽变异性哮喘漏诊50例分析[J].国际呼吸杂志,2018,38(21):1616-1618.
[32] 王成斌,王桂云,张 青,等.清肺十八味丸联合盐酸氯丙那林治疗老年咳嗽变异性哮喘并发阻塞性肺气肿临床研究[J].陕西中医,2018,39(11):1536-1539.
[33] 邱 容,肖昌武,富 强.布地奈德福莫特罗联合苏黄止咳胶囊对咳嗽变异性哮喘的疗效观察[J].临床肺科杂志,2017,22(2):304-306.
[34] 马嘉蓉,张春霞,韩 玉,等.布地奈德福莫特罗粉吸入剂联合中医药辨证治疗老年咳嗽变异性哮喘[J].重庆医学,2017,46(21):2962-2965.
[35] 朱晓婷,张 磊,张 妍,等.运用肺胃相关理论指导针刺治疗咳嗽变异性哮喘的临床研究[J].针灸临床杂志,2016,32(12):20-22.
[36] 张丽霞,李雪青,石志敏.针药结合治疗咳嗽变异性哮喘的临床研究[J].针灸临床杂志,2017,33(1):15-17.
[37] 王淑英,丁 静,杨环玮.白冰方穴位贴敷治疗咳嗽变异性哮喘临床观察[J].四川中医,2014,32(1):103-104.
[38] 邵玉锋,侯瑞蕊,杨云峰,等.三九咳喘贴联合膏方治疗咳嗽变异性哮喘疗效观察[J].四川中医,2020,38(1):95-97.
[39] 曹 娴,黄湘琴,周奇兴.常规用药联合穴位注射治疗咳嗽变异性哮喘疗效观察[J].人民军医,2018,61(3):253-254.
[40] 刘 莉,张红梅,王伟霞,等.呼出气一氧化氮在老年咳嗽变异性哮喘鉴别诊断中的应用[J].检验医学与临床,2018,15(15):2325-2328.
[41] 杨 原,王华启,孙志宏,等.沙美特罗替卡松粉吸入剂联合百令胶囊治疗老年咳嗽变异性哮喘疗效及对血清炎症因子水平的影响[J].现代中西医结合杂志,2020,29(8):853-856.
[42] 白晓瑞,刘春娥,拓轩惠.咳喘宁胶囊联合布地奈德对老年咳嗽变异性哮喘病人炎症指标及疗效的影响[J].实用老年医学,2020,34(1):66-69.

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备注/Memo

备注/Memo:
基金项目:四川省科技基金资助项目(2019YFS0259)
更新日期/Last Update: 2021-01-28