宋康教授"祛风脱敏"法治疗咳嗽变异性哮喘临床经验OA

[Objective]To summarize Professor Song Kang's core academic thoughts and clinical experience in treating cough variant asthma(CVA)with the"dispel wind and desensitize"method,and to offer new perspective for the traditional Chinese medicine(TCM)treatment of CVA.[Methods]Through clinical observation under mentorship,collection and analysis of representative medical records,and review of relevant literature,Professor Song Kang's clinical experience in treating CVA with the"dispel wind and desensitize"method was summarized focusing on the etiology and pathogenesis of CVA,the connotation and theoretical origin of the"dispel wind and desensitize"method,the medication characteristics of the four methods of dispelling wind and relieving spasm,resolving phlegm and dredging collaterals,cooling blood and desensitizing,and strengthening healthy Qi to consolidate the root,the stage-based treatment strategies for the attack stage and remission stage,and the diagnostic and therapeutic process of a representative case was attached.[Results]Professor Song holds that"wind pathogen lodged in the lung and airway spasm"is the core pathogenesis of CVA,"external wind triggering latent wind"is its pathogenic feature,and healthy Qi deficiency with susceptibility to pathogenic invasion is its internal basis.In terms of the therapeutic system,the"dispel wind and desensitize"method takes the coordination of four methods—dispelling wind and relieving spasm,resolving phlegm and dredging collaterals,cooling blood and desensitizing,and strengthening healthy Qi to consolidate the root—as its basic framework.The method of dispelling wind and relieving spasm focuses on dispelling wind pathogen,relieving spasm and stopping cough;the method of resolving phlegm and dredging collaterals focuses on diffusing and descending lung Qi,clearing latent phlegm and unblocking lung collaterals;the method of cooling blood and desensitizing focuses on clearing latent heat,cooling blood and dispersing pathogen,and reducing airway hyperresponsiveness;the method of strengthening healthy Qi to consolidate the root focuses on tonifying earth to generate metal,supplementing Qi and consolidating the exterior,and guarding against wind to prevent recurrence.In terms of stage-based treatment,the attack stage is mainly treated by dispelling wind and relieving spasm,combined with resolving phlegm and dredging collaterals,cooling blood and desensitizing,with strengthening healthy Qi to consolidate the root as an auxiliary method;the remission stage gives priority to strengthening healthy Qi to consolidate the root,combined with clearing residual pathogens,thus forming a diagnostic and therapeutic approach characterized by"stage-based treatment and integrated prevention and treatment".In the presented case,the patient was diagnosed with CVA with the syndrome of wind pathogen lodged in the lung and phlegm-heat disturbing the collaterals.After Professor Song treated the patient by closely following the"dispel wind and desensitize"method and dynamically adjusting the prescription according to different stages,the cough symptom score decreased from 9 to 1,symptoms such as throat itching and chest distress were completely resolved,and no recurrence was observed during the one-month follow-up.[Conclusion]Based on the theory of wind pathogen,the"dispel wind and desensitize"method integrates the understanding of airway hyperresponsiveness,allergic constitution and lung collateral pathogenesis,reflecting the combination of pathogenesis analysis,therapeutic innovation and stage-based management.It may provide a referential approach for the TCM syndrome differentiation and treatment of CVA.Further clinical studies with larger sample sizes are still needed to verify its efficacy and scope of application.