基于“肺鼻同治”理论辨治上气道咳嗽综合征

Management of Upper Airway Cough Syndrome Based on the “Lung-Nose Co-Treatment” Theory

摘要: 本文以“肺鼻同治”理论为指导，结合儿童“稚阴稚阳”、肺脾不足、卫外不固的体质特点，探析上气道咳嗽综合征(Upper Airway Cough Syndrome, UACS)的中医病因病机。认为“风为首因、痰为核心、虚为根本”，乃本病迁延难愈之关键。外感风邪易伏于肺鼻，反复诱发咳嗽；痰湿内阻则为疾病缠绵不愈之标；肺脾气虚则为反复发作之本。提出“肺鼻同治”的思路，即以疏风宣肺、清利鼻窍、化痰祛湿、扶正固本为治，分期施治：急性期以祛风通窍、止咳化痰为要，兼顾固护正气；缓解期则以健脾益肺、扶正祛邪为主，调和气机，防止复发。文中结合刘小凡教授临床指导下的典型病例，论证“肺鼻同治”在上气道咳嗽综合征中的疗效与优势，为小儿慢性咳嗽类疾病的辨证施治提供了可循路径，具有重要理论意义与临床价值。

Abstract: This study, guided by the “Lung-Nose Co-Treatment” (Fei-Bi Tong Zhi) theory, investigates the pathogenesis of Upper Airway Cough Syndrome (UACS) in children, considering their characteristics of “immature yin and yang”, lung-spleen deficiency, and unstable defensive qi. It identifies wind as the primary cause, phlegm as the core, and deficiency as the root, underlying the chronicity and recurrence of the disease. Exogenous wind pathogens tend to lodge in the lung and nasal passages, repeatedly triggering cough, while phlegm-damp retention perpetuates symptoms, and lung-spleen qi deficiency predisposes to relapse. The “Lung-Nose Co-Treatment” strategy emphasizes dispersing wind and facilitating lung function, clearing nasal passages, resolving phlegm and dampness, and reinforcing the body’s root. Treatment is staged: the acute phase focuses on expelling wind, opening nasal passages, relieving cough, and resolving phlegm, while supporting defensive qi; the remission phase aims to strengthen the spleen and lung, consolidate upright qi, harmonize qi movement, and prevent recurrence. Representative clinical cases under Professor Liu Xiaofan’s guidance illustrate the efficacy and advantages of this approach, providing a practical framework for syndrome differentiation and management of pediatric chronic cough, with significant theoretical and clinical implications.