中医药分期论治小儿哮喘的研究进展

Research Progress on the Traditional Chinese Medicine Staging Treatment of Pediatric Asthma

摘要: 小儿哮喘作为一种慢性气道炎症性疾病，近年来发病率持续上升，现代医学虽以抗炎治疗为主，但存在激素依赖、易复发等问题。中医秉承“急则治其标，缓则治其本”的原则，在发作期以祛邪平喘为重点，常用小青龙汤、麻杏石甘汤等方剂，并结合中药雾化、艾灸等外治法；缓解期则侧重扶正固本，常选用玉屏风散、人参五味子汤等方，配合穴位敷贴、推拿等手段。中西医结合治疗在改善症状、调节免疫、降低复发率方面显示出协同优势。当前研究已深入到炎症通路、免疫调节及肠道菌群等机制层面，但仍存在临床样本量有限、机制研究多源于动物实验等不足。未来需进一步开展高质量临床研究，深化“方–证–效”关联的现代科学阐释，并且完善中西医结合诊疗规范，提升小儿哮喘的整体防治水平。

Abstract: Pediatric asthma, a chronic airway inflammatory disease, has witnessed a continuous rise in its incidence in recent years. Although modern medicine primarily focuses on anti-inflammatory treatment, issues such as hormone dependence and easy recurrence persist. Adhering to the principle of “treating the symptoms urgently during acute episodes and addressing the root cause during remission,” Traditional Chinese Medicine (TCM) prioritizes eliminating pathogenic factors and relieving asthma during the acute phase, commonly employing formulas such as Xiaoqinglong Decoction and Maxing Shigan Decoction, combined with external treatment methods like traditional Chinese medicine aerosolization and moxibustion. During the remission phase, TCM emphasizes strengthening the body’s resistance and consolidating the constitution, often selecting formulas like Yupingfeng Powder and Renshen Wuweizi Decoction, along with techniques such as acupoint application and tuina (Chinese therapeutic massage). Integrated traditional Chinese and Western medicine treatment demonstrates synergistic advantages in improving symptoms, regulating immunity, and reducing recurrence rates. Current research has delved into mechanisms such as inflammatory pathways, immune regulation, and gut microbiota. However, limitations persist, including limited clinical sample sizes and a predominance of mechanism research derived from animal experiments. Future efforts should focus on conducting high-quality clinical studies, deepening the modern scientific interpretation of the “formula-syndrome-effect” relationship, and refining integrated traditional Chinese and Western medicine diagnosis and treatment protocols to enhance the overall prevention and treatment of pediatric asthma.