从“内风”论治慢性咳喘病的思路探讨

The approach of thought in chronic cough and dyspnea disease on TCM treatment from “endogenous wind”

关键词:  内风  咳喘病  思路

Key words:  endogenous wind  chronic cough and dyspnea disease  thought

摘要:

内风的形成与肝密切相关，是肝失疏泄的必然结果，而肝气、肝火、肝风的病理演变规律则反映了内风形成的具体过程。内风有虚实之分，慢性咳喘病中“虚风”的表现更为显著。虚风内伏，风火上扰，肺体被伤，易致咳喘。临床治疗中应肝肺同调，以恢复肝的疏泄和肺的宣降为原则，在补肺阴、敛肺气的基础上，针对肝肾阴虚、水不涵木致风者以滋补肝肾、柔肝息风为法，针对脾肾阳虚、土壅木郁生风者则以温阳暖土、疏木息风为要。外风引动内风是咳喘类疾病复发的主要诱因，临床应重视对外风的判断，加强对表邪的疏散，促进风火外透，防止闭门留寇。

Abstract:

Liver is closely related with the formation of endogenous wind, which is the inevitable outcome of liver dysfunction. Pathological changes of liver-qi, liver-fire and liver wind reflect the whole formation of endogenous wind. There is a distinction between deficiency and excess in endogenous wind, while the former (vacuity wind) figured prominently in chronic cough and dyspnea disease. The insufficiency of Lung-yin caused by the vacuity wind makes the occurrence of cough and dyspnea. Simultaneous treatment of liver and lung is recommended in clinic. On the base of nourishing qi and yin of lung, the drugs that can nourish the liver and kidney should be used to the ones with yin deficiency of liver and kidney, while the drugs that can reinforce the spleen and kidney should be used to the ones with yang deficiency of spleen and kidney. External wind is the main cause of recrudescence of the cough and dyspnea disease. The judgment of the external wind should be payed more attention in clinic. It is vital to strengthen evacuation of evil influence and prevent it stay in the body.