本文關(guān)鍵詞：仲景祛痰法治療上氣道咳嗽綜合征理論與臨床研究　出處：《南京中醫(yī)藥大學(xué)》2017年博士論文　論文類(lèi)型：學(xué)位論文

  更多相關(guān)文章： 上氣道咳嗽綜合征 痰飲 慢性咳嗽 臨床研究

【摘要】：背景:上氣道咳嗽綜合征(upper airway cough syndrome,UACS)是臨床上慢性咳嗽的常見(jiàn)原因之一。患者多見(jiàn)咳嗽、鼻塞、咽癢、鼻后滴流感等癥狀。但長(zhǎng)期、頻繁、劇烈的咳嗽將影響患者的工作和生活。本課題是對(duì)仲景祛痰法治療上氣道咳嗽綜合征應(yīng)用的研究,以希望對(duì)這類(lèi)人群的治療和保健作出貢獻(xiàn)。目的:導(dǎo)師經(jīng)過(guò)長(zhǎng)期治療上氣道咳嗽綜合征后,發(fā)現(xiàn)無(wú)論是在治法或用方方面都符合《傷寒雜病論》。在此,通過(guò)對(duì)上氣道咳嗽綜合征的診治進(jìn)行中醫(yī)辨治分析、研究、歸納,從而找出上氣道咳嗽綜合征的病因病機(jī)、證型規(guī)律及上氣道咳嗽綜合征復(fù)方的遣方用藥的特色,以期更好地指導(dǎo)臨床診斷及治療。除此之外,也將南京的上氣道咳嗽綜合征患者與新加坡的患者作比較,以便找出他們之間的證治的異同。方法:是通過(guò)臨床研究調(diào)查統(tǒng)計(jì)120例,從2015年3月至2016月6月來(lái)南京明基醫(yī)院求診的患者。分析臨床資料,并從中醫(yī)的辨證基礎(chǔ)上,對(duì)臨床運(yùn)用加以剖析;對(duì)上氣道咳嗽綜合征復(fù)方中常用中藥的臨床應(yīng)用和藥理,加以分析整理,以期在臨床的治療時(shí)提供更加全面的理論依據(jù)。結(jié)果:分析上氣道咳嗽綜合征患者的相關(guān)特征,發(fā)現(xiàn)其成因、辨證論治及治法等方面與張仲景《傷寒雜病論》的祛痰法較為切合,可以鞏固患者的療效、改善癥狀,降低發(fā)病和復(fù)發(fā)率。結(jié)論:患者在久咳中累及脾、肝、腎等各臟腑,治療過(guò)程中需考慮到肺與其他臟腑之間的關(guān)系,加以治療。此外導(dǎo)師也十分重視辨證,由于上氣道咳嗽綜合征的主要病理因素是痰,因此在復(fù)方中使化痰止咳平喘藥最多占86%,常用的化痰藥有浙貝母、桔梗、陳皮、半夏和枳殼等化痰止咳藥物。除此之外,上氣道咳嗽綜合征還涉及鼻和咽喉等多種疾病,臨床特點(diǎn)以咳嗽、咯痰、鼻后滴流感為主,還伴有咽癢和咽喉黏液附著感。因此在解表藥中,有一部分是針對(duì)鼻淵和喉痹等疾病,如白芷常于辛夷配對(duì),用于解表散寒之外,也有通鼻竅的作用。還有解表兼治喉痹、喉癢等癥狀的藥物,如牛蒡子、桔梗、薄荷等。上氣道咳嗽綜合征復(fù)方能改善上氣道咳嗽綜合征的臨床癥狀,在臨床上能廣泛的應(yīng)用,有較強(qiáng)的可行性。希望本論文從從病因病機(jī)、辨證論治、遣方用藥等角度探討的上氣道咳嗽綜合征的辨治規(guī)律,復(fù)方方劑的組方配伍規(guī)律能為上氣道咳嗽綜合征的辨治提供新的思路與方法。除此之外,將南京的上氣道咳嗽綜合征患者與新加坡的患者作比較之后,發(fā)現(xiàn)無(wú)論是在地域、氣候、環(huán)境、飲食或生活習(xí)慣都會(huì)直接影響上氣道咳嗽綜合征的證型分布,比如新加坡以痰濕蘊(yùn)肺為多,占41.3%,南京的痰濕蘊(yùn)肺,則占2.5%。這主要是新加坡為一個(gè)處在四面圍海,濕氣很重的熱帶國(guó)家,居民長(zhǎng)期在空調(diào)的地方作息。在飲食方面,居民多愛(ài)喝冷飲,又嗜食油炸及辛辣的食品。由于很多患者素體脾虛,加之飲食不當(dāng),助濕生痰,以致痰濕蘊(yùn)肺。當(dāng)天氣溫度稍有變化,而自身的免疫力下降時(shí),特別容易感受寒邪、濕邪,引起上氣道咳嗽綜合征。
[Abstract]:Background: upper airway cough syndrome (upper airway cough syndrome, UACS) is one of the common causes of chronic cough in clinic. Patients with more common cough, stuffy nose, throat itching, nasal drops after flu symptoms. But in the long term, frequent cough will affect the patient's life and work. This topic is the study of syndrome the application of cough and phlegm Zhongjing treatment of upper airway, in the hope of treatment and care for this population. Objective: to contribute to the teacher after long-term treatment of upper airway cough syndrome, found both in the treatment or are consistent with this theory. "Typhoid miscellaneous diseases with the party, the upper airway cough syndrome the diagnosis and treatment of traditional Chinese medicine research, analysis, induction, so as to identify the etiology and pathogenesis of upper airway cough syndrome, syndrome type of prescription and upper airway cough syndrome of characteristics, in order to guide the clinical diagnosis and treatment in addition. In addition, Nanjing will also be the patients with upper airway cough syndrome patients compared with Singapore, in order to find out the similarities and differences between them and treatment. Methods: through clinical investigation of 120 cases of statistics, from March 2015 to June to 2016 month from Nanjing BenQ hospital. Clinical data analysis, and from the basis of TCM syndrome differentiation on the clinical application analysis of upper airway cough; clinical application and pharmacological syndrome commonly used in compound prescription of traditional Chinese medicine, will be analyzed, in order to provide theoretical basis in a more comprehensive clinical treatment. Results: the analysis of upper airway cough syndrome related characteristics, find the causes, treatment based on syndrome differentiation and treatment and phlegm and the Zhang Zhongjing "Shanghanzabinglun" more realistic, can consolidate the therapeutic effect, improve symptoms, reduce the incidence and recurrence rate. Conclusion: patients involved in chronic cough in the spleen, liver, kidney and other viscera Fu, need to consider the relationship between lung and other organs in the treatment process to treatment. In addition to instructors also attaches great importance to differentiation, because the main pathological factors of upper airway cough syndrome is phlegm, so in the compound Huatanzhike asthma drugs accounted for 86%, apophlegmatisant are commonly used in Fritillaria thunbergii, Platycodon grandiflorum, tangerine peel. Pinellia and Fructus aurantii etc. Huatanzhike drug. In addition, upper airway cough syndrome also relates to the nose and throat and other diseases, the clinical characteristics of cough, expectoration, nasal drops after the flu, accompanied by itching throat and throat mucus. Therefore in diaphoretic, one part is for nasosinusitis and pharyngitis other diseases, such as Angelica in Xinyi often paired for the table of cold dispelling, also have a nose. There are jiebiao symptoms due to drugs, symptoms such as itching of the throat, burdock, Platycodon grandiflorum, mint. Upper airway cough syndrome compound can improve the upper airway cough The clinical symptoms of cough syndrome, can be widely used in clinic, there is a strong possibility. I hope this paper from the etiology and pathogenesis, syndrome differentiation, treatment of upper airway cough syndrome of prescription compatibility law angle, compound prescription for gas channel cough syndrome and provide new ideas and methods. In addition, the Nanjing patients with upper airway cough syndrome patients compared with Singapore, found both in geography, climate, environment, diet or lifestyle will directly affect the upper airway cough syndrome distribution comprehensive syndromes, such as Singapore with phlegm dampness the lung is more, accounted for 41.3% of Nanjing's phlegm retention in the lung, which is mainly accounted for 2.5%. of Singapore in an enclosed sea, humid tropical countries, long-term residents in the air conditioning place to rest. In the diet, many residents love cold drink and eat Fried and spicy food. Because many patients with deficiency of spleen, inappropriate diet, so as to help wet phlegm, phlegm retention in the lung. When the weather temperature change slightly, but their immunity drops, especially easy to feel cold evil, dampness, causing upper airway cough syndrome.

【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：博士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R256.11

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