从“一气周流，土枢四象”理论探析儿童呼吸道感染后咳嗽的辨治

Analysis of Pattern Identification and Treatment for Post-Respiratory Infection Cough in Children Based on the Theory of “One Qi Circulating and Earth Pivoting the Four Phases”

摘要: 儿童呼吸道感染后咳嗽是儿科临床中常见的呼吸系统疾病，也是儿童慢性咳嗽的主要病因之一，其病程迁延影响患儿生活质量。现代医学认为该病发病机制复杂，由多种因素共同作用，临床以白三烯受体拮抗剂、糖皮质激素等对症治疗为主。本文基于黄元御“一气周流，土枢四象”理论，从气机升降角度系统探讨儿童呼吸道感染后咳嗽的辨治，提出本病的主要病位在肺、脾、胃、肝，中土失健，枢轴不利为关键病机。脾胃是气机升降的枢轴，居于中焦，斡旋气机，治疗上确立“调中气以和四维”的治疗原则，以恢复脏腑气机升降动态平衡为要点，促使周身气机复常而疾病自愈，为感染后咳嗽的中医临床治疗提供新的思路。

Abstract: Post-respiratory infection cough in children is a common respiratory disease in pediatric clinical practice and one of the main causes of chronic cough in children. Its prolonged course has an adverse effect on the quality of life of affected children. Modern medicine suggests that the pathogenesis of this condition is complex, involving multiple factors, and clinical management primarily relies on symptomatic treatments such as leukotriene receptor antagonists and glucocorticoids. Based on Huang Yuanyu’s theory of “One Qi Circulating and Earth Pivoting the Four Phases,” this paper systematically explores the pattern identification and treatment of post-respiratory infection cough in children from the perspective of qi movement—ascending and descending. It proposes that the primary disease locations are the lung, spleen, stomach, and liver, with the dysfunction of the central earth (spleen-stomach) and impaired pivotal movement as the key pathological mechanisms. The spleen and stomach serve as the crucial axis of qi movement, located in the middle energizer, regulating the dynamic balance of qi. The treatment principle of “regulating central qi to harmonize the four phases” is established, emphasizing the restoration of the dynamic equilibrium of visceral qi movement to promote systemic qi circulation and spontaneous recovery. This approach provides new insights into the traditional Chinese medicine clinical management of post-infection cough.