从万全“育婴四法”谈儿童哮喘的三级预防

Tertiary Prevention of Asthma in Children from Wanquan’s “Four Principles of Child Rearing”

摘要: 儿童哮喘作为全球高发的慢性呼吸系统疾病，严重影响患儿生长发育并造成显著社会经济负担。其发病机制涉及遗传易感性、环境致敏原、营养失衡等多因素交互作用，现代医学强调三级预防的管理策略，即病因预防、早诊早治、临床预防。明代医家万全的“育婴四法”蕴含了丰富的预防保健思想，其提出的预养、胎养、蓐养、鞠养的四个阶段构建了与三级预防高度契合的中医“治未病”体系，为中西医协同的儿童哮喘全周期防治模式提供了创新性理论框架，对降低儿童哮喘发病率、改善长期预后具有重要的临床指导意义。

Abstract: Childhood asthma, as a prevalent chronic respiratory disease worldwide, imposes substantial burdens on children’s growth and development along with considerable socioeconomic costs through its recurrent exacerbations. The pathogenesis involves multifactorial interactions including genetic predisposition, environmental allergens, and nutritional imbalances. Modern medicine advocates a three-tiered prevention strategy encompassing primary prevention (etiological control), secondary prevention (early diagnosis and intervention), and tertiary prevention (disease management). Notably, the Ming Dynasty physician Wan Quan’s “Four Principles of Child Rearing” (Yuanyang, Taiyang, Ruyang, and Juyang) embodies profound preventive healthcare wisdom. These four phases—preconception preparation, antenatal care, perinatal nurturing, and postnatal cultivation—establish a Traditional Chinese Medicine (TCM) “preventive treatment” framework that systematically aligns with contemporary preventive tiers. This integration provides an innovative theoretical foundation for developing a comprehensive lifecycle management model combining TCM and Western medicine approaches, demonstrating significant clinical potential for reducing asthma incidence and improving long-term outcomes.