张伯礼教授从“湿浊痰饮”论治气道黏液高分泌经验

Professor ZHANG Boli’s experience in treating airway mucus hypersecretion based on the theory of “damp-turbidity and phlegm-rheum”

关键词:  气道黏液高分泌  湿浊  痰饮  名医经验  张伯礼

Key words:  airway mucus hypersecretion  damp-turbidity  phlegm-rheum  experience of famous doctors  ZHANG Boli

摘要:

总结张伯礼教授治疗气道黏液高分泌（AMH）的临证经验。张伯礼教授认为AMH的核心病机为正虚积损、类邪壅滞，以肺脾肾三脏虚损为本，湿浊痰饮类邪壅滞为标，主张扶三脏之虚以固本、从“湿浊痰饮”以治标论治AMH。治疗需细心权衡轻重，根据标本缓急、分而治之，通过补肺健脾益肾治其本，燮理脏腑气血阴阳，助消生痰之源；通过祛湿、化浊、消痰、逐饮治其标，用药不远温，同时注重调畅气机、化痰逐瘀、据舌施治，形成了标本兼顾，治病求早，各从其治，痰瘀并治，重视舌诊的综合治疗策略，减少黏液生化之源，消除已生之痰，改善AMH。

Abstract:

This paper summarized Professor ZHANG Boli’s clinical experience in treating airway mucus hypersecretion（AMH）. Professor ZHANG Boli believed that the core pathogenesis of AMH was healthy qi depletion and constraints accumulation，and similar pathogenic factors obstruction. He posited the deficiency of the lung，spleen，and kidney systems is the root cause，while the accumulation of dampness-turbidity-phlegm-rheum disorders is the secondary factors，and advocated reinforcing the three visceral systems to address the root deficiency，and eliminating pathogenic damp-turbidity-phlegm accumulations to alleviate symptomatic manifestations. The treatment requires judicious prioritization based on the urgency of root and branch deficiencies. Through systemic tonification of the lung，spleen，and kidney systems，coupled with holistic regulation of visceral harmony and qi-blood-yin-yang equilibrium to targets the root cause of phlegm production. By resolving dampness，dispersing turbidity，dissipating phlegm，and expelling rheum to address branch deficiencies，using warm-natured medicinal while prioritizing regulating qi dynamics，resolving phlegm-stasis complexes，and treating based on the tongue diagnosis. Formed a comprehensive therapeutic strategy integrates root-branch synergy，early intervention，targeted treatment protocols，phlegm-stasis co-management，and tongue diagnosis-guided modulation to reduce mucus production，eliminate sputum that has been generated，and improve AMH.