北京中医药大学学报2025，Vol.48Issue(6)：767-773,7.DOI:10.3969/j.issn.1006-2157.2025.06.005
"通身气不宣"视角下探讨儿童咳嗽变异性哮喘的病机与治法
Discussion on the pathogenesis and treatment of cough variant asthma in children from the perspective of"systemic qi stagnation"
摘要
Abstract
Cough variant asthma is a distinct subtype of asthma characterized by chronic irritant dry cough as the sole or predominant clinical manifestation.It is one of the primary causes of chronic cough in children.In traditional Chinese medicine,it belongs to the category of"spasmodic cough","wind-induced cough","chronic cough",and"asthmatic cough".At present,Western medicine treatment approaches mainly focus on symptomatic treatment,but fail to fully deal with its complex systemic mechanisms,and have limitations such as poor control of clinical symptoms and rebound exacerbation upon treatment cessation.Based on the theory of"systemic qi stagnation",this paper proposes that the core pathogenesis of cough variant asthma in children is qi stagnation,intermingling of phlegm and blood stasis,and obstruction of collaterals.Disease progression is fundamentally driven by exogenous pathogen activation of endogenous predispositions,particularly dysregulation of sanjiao qi movement,which serves as the primary disease-inducing factor.During the acute phase,the treatment principle focuses on dispelling wind and ventilating lung to restore physiological qi.As the disease progresses to the progressive phase,the focus shifts toward smoothing liver and purging lung to resolve qi counterflow.In the chronic phase,therapeutic strategy prioritizes dissipating phlegm and eliminating blood stasis to smooth collaterals.Finally,during the remission phase,treatment emphasizes strengthening spleen and kidney to consolidate the foundation and cultivate the vitality.This integrative approach synergizes the external elimination of latent pathogens,internal harmonization of qi movement,and dredging collaterals by dispelling blood stasis.It also incorporates the theory of"gentle dispersion to expel pathogens and moistening dryness to harmonize collaterals",aiming to provide a theoretical basis and effective prescriptions for the integrated traditional Chinese and Western medicine treatment of cough variant asthma in children.关键词
咳嗽变异性哮喘/痉咳/儿童/通身气不宣/清润Key words
cough variant asthma/spasmodic cough/children/systemic qi stagnation/clear-moistening分类
中医学引用本文复制引用
巩雪,刘智慧,刘芳,白晓红.."通身气不宣"视角下探讨儿童咳嗽变异性哮喘的病机与治法[J].北京中医药大学学报,2025,48(6):767-773,7.基金项目
国家中医药管理局2022年中医药古籍文献和特色技术传承专项项目(No.0686-2211CA080200Z) （No.0686-2211CA080200Z）
国家中医药管理局高水平中医药重点学科建设项目(No.zyyzdxk-2023036) （No.zyyzdxk-2023036）
辽宁省名中医传承工作室项目(辽中医药综合字[2024]19号)Special Project for Inheritance of Ancient Chinese Medicine Documents and Characteristic Technologies of National Administration of Traditional Chinese Medicine in 2022(No.0686-2211CA080200Z) （辽中医药综合字[2024]19号）
