从李杲“脾胃虚则九窍不通”论治小儿腺样体肥大

On the Treatment of Adenoid Hypertrophy in Children from Li Gao’s “Deficiency of the Spleen and Stomach Leads to Obstruction of the Nine Orifices”

摘要: 小儿腺样体肥大是耳鼻喉科常见病，中医学无此病名，据其鼻塞、张口呼吸、打鼾、听力下降等症，可归为“鼻窒”、“鼾眠”、“耳胀”等范畴。文章深入阐释李东垣“脾胃虚则九窍不通”之经典理论，系统论述脾胃虚弱导致气血津液代谢失常，进而痰瘀互结、壅塞鼻咽，最终形成腺样体肥大的病理过程。并详细剖析本病由虚生实的核心病机链条，提出以“补脾胃、升清阳、泻浊阴”为核心，分期论治的完整诊疗思路，为临床提供一种安全、有效、固本的治疗范式。

Abstract: Adenoid hypertrophy in children is a common disease in otorhinolaryngology. There is no such disease name in traditional Chinese medicine. According to its symptoms, such as nasal congestion, mouth breathing, snoring, and hearing loss, it can be classified into the categories of “nasal obstruction”, “snoring sleep”, and “ear distension”. This article deeply expounds the classic theory of Li Dongyuan that “if the spleen and stomach are weak, the nine orifices will not be unobstructed”, systematically discusses the pathological process in which spleen and stomach weakness leads to abnormal metabolism of qi, blood, and body fluids, and then phlegm and blood stasis interweave and obstruct the nasal and pharyngeal passages, eventually resulting in adenoid hypertrophy. The article will thoroughly analyze the core pathogenesis chain of this disease evolving from deficiency to excess, and propose a complete treatment approach centered on “tonifying the spleen and stomach, elevating clear yang, and purging turbid yin”, with staged treatment strategies, providing a safe, effective, and fundamental treatment model for clinical practice.