儿童咳嗽变异性哮喘中医内治法研究进展OA
Research Progress of TCM Internal Treatments for Cough Variant Asthma in Children
咳嗽变异性哮喘(cough variant asthma,CVA)根本病机是肺脾肾不足,风邪是其发病及衍变的主要因素.目前该病内治法有:从"风、痰、瘀"等致病因素论治、从脏腑论治、从"气的运行"论治、从"调畅三焦"论治、从"玄府-络脉"论治等.但目前的研究尚有以下不足:(1)该病目前尚无统一中医病名和辨治体系,各家多依据临床经验施治,以专方治疗多见,中医诊断、证候判定及遣方用药等缺乏规范性;(2)该临床研究多为小样本量研究,存在个体化差异,缺乏双盲及多中心的大样本临床研究,且中药复方成分复杂,目前对其适应症、禁忌症及不良反应研究相对欠缺;(3)中医内治儿童咳嗽变异性哮喘疗效明显,但其作用机制不明,但目前关于其作用机制的研究较少.以后可规范CVA诊断、辨证、疗效判定标准,形成疾病诊疗指南;开展大样本、多中心、多盲的临床研究,引入循证医学研究手段,加强中药复方临床应用的安全性研究;开展关于中药复方配伍规律、药效物质基础、药效机制等方面的实验研究,深入挖掘中医药治疗CVA的分子机制及作用靶点.
The fundamental pathogenesis of cough variant asthma(CVA)is insufficiency of lung,spleen,and kidney,while wind patho-gen is the main factor in its onset and progression.Currently,the internal treatment methods for this disease include:treating from the pathogenic factors of"wind,phlegm,and blood stasis,"from the perspective of the internal organs,from the perspective of the circula-tion of qi,from the perspective of regulating the triple energizer,or from the perspective of sweat pores-collateral vessels.However,there are still some limitations in current research:(1)There is no unified Chinese medicine disease names and treatment system for this dis-ease,and various doctors mainly rely on clinical experiences to treat it.Special formulas are commonly used,and there is a lack of standardization in Chinese medicine diagnosis,syndrome differentiation,and formula selection and use;(2)Most of the clinical studies involve small sample size,with individual differences,lacking double-blind and multi-center large sample clinical studies.In addition,the complex components of Chinese medicinal compound formulas make it difficult to study their indications,contraindications,and ad-verse reactions;(3)The efficacy of TCM in treating CVA in children is obvious,but its mechanism of action is not clear.However,there are currently fewer studies on its mechanism of action.In the future,it is necessary to standardize the diagnosis,differentiation,and effi-cacy evaluation criteria for CVA,and form a disease treatment guideline,to conduct large-sample,multi-center,multi-blind clinical stud-ies,and introduce evidence-based medicine research methods to strengthen the safety research of Chinese medicinal compound formulas'clinical applications,to conduct experimental studies on the laws of Chinese medicinal compound formulas'compatibility,pharmacologi-cal substances,and mechanisms of action to deeply explore the molecular mechanisms and target sites of TCM treatments for CVA.
王心语;常克
成都中医药大学,四川成都 610075成都中医药大学附属医院,四川成都 610032
中医学
儿童咳嗽变异性哮喘内治法风邪
cough variant asthma(CVA)in childreninternal treatmentwind pathogen
《河南中医》 2024 (006)
962-967 / 6
国家中医药管理局2022年全国名老中医药专家传承工作室建设项目{国中医药人教发[2022]75号}
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