淺談小兒哮喘的辨證與治療

A Brief Discussion of Differentiation of Patterns and Treatment of Asthma in Children

10.6968/TJCCM.200509.0216

楊正成(Zheng-Cheng Yang)

哮喘 ； 祛邪 ； 扶正固本 ； asthma xiao chuan ； dispel evil ； support right and secure the root

台灣中醫臨床醫學雜誌

11卷3期（2005 / 09 / 01）

216 - 221

繁體中文

哮喘是小兒時期常見的疾病之一。臨床上以發作性哮鳴、氣促、張口抬肩、不能平臥為特點。中醫診為哮喘是肺、脾、腎三臟不足，尤其是先天稟賦不足，脾氣虛弱，痰濁內生為發病的主因。當氣候突然轉變，或吸入異物，或飲食不慎等因素的影響下，引動伏痰，阻塞氣道，肺氣上逆，導致哮喘發作。 發作期當以祛邪為先，可用宣肺、化痰、平喘為主。緩解期則多有虛象，當以補虛為主，可採用健脾、補肺、盆腎等“扶正固本”的方法。本病的病程較長，且易反覆發作，遷延不癒，病程愈長，對病兒愈不利，因此必須堅持及早治療，適當調理，隨著小兒年齡增長，生長發育漸臻完善，則發作次數可逐漸減少，而獲痊癒。但若年長後仍反覆發作，將難以根除，而成終生痼疾。因此，小兒哮喘的防治，遠較成人重要。

Asthma is one of many common illnesses of childhood. It is characterized by spontaneous wheezing, rapid breathing, gaping mouth and raised shoulders, and inability to lie horizontally. In Chinese medicine, asthma is said to be due to an insufficiency in the lung spleen and kidney. Congenital insufficiencies, spleen qi weakness and phlegm turbidity are the principal causes. A sudden change in weather, inhalation of foreign particulates or an indiscretion in food intake can all induce movement of latent phlegm which obstructs the airways and causes reversal of lung qi, thereby inducing an asthma attack. During an attack the first treatment protocol is to dispel evil qi. The primary methods that can be employed are diffusing the lung, transforming phlegm and calming gasping. In between episodes vacuity signs are more prevalent and supplementing vacuity should be the principal treatment method. Methods such as building the spleen, supplementing the lungs, and boosting the kidneys i.e. ”Supporting right and securing the root” can be used. The course of disease is rather long for asthma and recurrences are common, thus it can be difficult for the child. Early treatment and persistence is necessary and a suitable treatment that is adjusted to the age and growth development of the child will help gradually reduce the frequency of attacks and lead to complete recovery. However if episodes continue into adulthood is can be difficult to expel the root cause and may become a lifelong illness. Therefore it is of great importance to treat and prevent asthma in children.