| 王金娥,刘晓红,张皓翔,等.基于“肝常有余”理论探讨化肝煎治疗儿童慢性咳嗽思路[J].浙江中医药大学学报,2024,48(4):429-433. |
| 基于“肝常有余”理论探讨化肝煎治疗儿童慢性咳嗽思路 |
| Exploring the Treatment of Chronic Cough in Children with Huagan Decoction Based on the Theory of “Liver is Often in Superabundance” |
| DOI：10.16466/j.issn1005-5509.2024.04.007 |
| 中文关键词: 肝常有余 肝郁化火 木火刑金 儿童 慢性咳嗽 化肝煎 中医理论 |
| 英文关键词: liver is often in superabundance liver depression transforms into fire wood fire punish gold children chronic cough Huagan Decoction traditional Chinese medicine theory |
| 基金项目:中国中医科学院广安门医院所级课题项目(HLCMHPP2023038) |
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| 中文摘要: |
| [目的] 基于“肝常有余”理论，探讨化肝煎治疗儿童慢性咳嗽思路。[方法] 通过查阅中医古籍和现代文献资料，并结合临床实践经验，从“肝常有余”理论与儿童的生理、病理联系着手，探讨儿童慢性咳嗽的病因病机、症状特点和论治规律，并阐释化肝煎的来源、方义及其在儿童慢性咳嗽中的应用，并附验案一则加以佐证。[结果] “肝常有余”理论分别阐述了儿童的生理和病理特点，生理上的“有余”体现了小儿良好生长发育的生理机能状态；病理上的“有余”指生理上的“有余”可在各种因素作用下转化为病理上的“亢盛”表现，是小儿疾病向“易实”转化的病理基础。由此探索小儿慢性咳嗽的病因通常与感受外邪、饮食不适、情志不遂等因素有关，核心病机多为肝郁化火，木火刑金，症状特点多表现为春季多发、情志异常、夜间发作、病程日久，治疗本病的关键在于调肝，同时联合治肺诸法，以达肝肺同治。化肝煎的主要功用是疏肝解郁、降逆散火，符合小儿慢性咳嗽的核心病机特点，临证可加减使用。文末所举小儿慢性咳嗽医案辨证为肝郁化火、木火刑金证，治以疏肝泻火、化痰止咳为主，方用化肝煎加减取得了较好的临床疗效。[结论] “肝常有余”理论可用于指导儿童慢性咳嗽的治疗，运用化肝煎治疗儿童慢性咳嗽有据可循，疗效显著，可为今后中医药早期干预与治疗儿童慢性咳嗽提供更为广阔的思路和方法，以提高临床疗效。 |
| 英文摘要: |
| [Objective] Based on the theory of “liver is often in superabundance”，to explore the treatment of chronic cough in children with Huagan Decoction. [Methods] By consulting ancient Chinese medicine books and modern literature， combined with clinical practice experience， starting from the connection between the theory of “liver is often in superabundance” and the physiological and pathological characteristics of children， this paper explores the etiology， pathogenesis， symptom characteristics and treatment rules of chronic cough in children， and explains the source， meaning and application of Huagan Decoction in children’s chronic cough. An experimental case is also provided as evidence. [Results] The theory of “liver is often in superabundance” elaborates on the physiological and pathological characteristics of children. Physiological “superabundance” contains the gradual filling of children’s positive energy， reflecting the physiological functional state of good growth and development in children. Pathological “superabundance” refers to the physiological “superabundance” that can be transformed into pathological “excess” under various factors， which is the pathological basis for the transformation of children’s diseases to “easy excess”. The exploration of the etiology of chronic cough in children is usually related to factors such as external pathogenic factors， dietary discomfort and emotional distress. The core pathogenesis is mostly liver depression transforming fire， wood fire punishing gold， and the symptoms are characterized by frequent spring， abnormal emotions， nocturnal attacks and a long course of disease. The key to the treatment of this disease is to regulate the liver， and combine various methods to treat the lung， so as to achieve the effect of liver and lung harmonization. The main function of Huagan Decoction is to soothe the liver and relieve depression， descend countercurrent Qi and dispel fire， which is in line with the core pathological characteristics of chronic cough in children， and it can be used with modifications according to clinical symptoms. The medical case listed at the end of the article was chronic cough in children，and the syndrome was liver depression turning fire and wood fire punishing gold. The main treatment was to relieve the liver fire and relieve phlegm and cough， and the use of modified Huagan Decoction had obtained better clinical effect. [Conclusion] The theory of “liver is often in superabundance” can be used to guide the treatment of chronic cough in children. The use of Huagan Decoction in the treatment of chronic cough in children is evidence-based and has significant therapeutic effects， which can provide broader ideas and methods for early intervention and treatment of chronic cough in children with traditional Chinese medicine in the future， in order to improve clinical efficacy. |
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