从“邪伏气郁、痰瘀入络”论治感染后咳嗽

Treatment of Post-Infectious Cough from the Perspective of “Latent Pathogen with Qi Stagnation and Phlegm-Stasis Entering the Collaterals”

摘要: 本文从“邪伏气郁、痰瘀入络”的角度系统论述了感染后咳嗽的中医病机演变与辨治思路。认为该病以外感风邪伏留肺络为初始动因，正气亏虚、脏腑功能失调所致的气机郁滞为继发病机，痰浊与瘀血互结、阻滞肺络则是病情迁延难愈的关键环节。针对上述病机，提出治疗应以疏风散邪、解痉息风以透邪外出，并兼以祛痰化瘀、益气养血通补肺络，灵活配伍风药与络药。这一辨治策略将祛邪与通络有机结合，为感染后咳嗽的中医诊疗提供了系统思路。

Abstract: This paper systematically discusses the evolution of pathogenesis and treatment strategies for post-infectious cough from the perspective of “latent pathogen with qi stagnation and phlegm-stasis entering the collaterals”. It holds that exogenous wind pathogen lingering in the lung collaterals serves as the initial trigger, while qi stagnation resulting from healthy qi deficiency and dysfunction of the zang-fu organs constitutes the secondary pathogenesis. The key factor that makes the condition protracted and difficult to cure is the intermingling of phlegm turbidity and blood stasis, which obstructs the lung collaterals. In accordance with this pathogenesis, treatment should prioritize dispelling wind and releasing the exterior, and resolving spasms and calming wind to expel lurking pathogens, supplemented by eliminating phlegm, removing blood stasis, and supplementing qi and nourishing blood to unblock and tonify the lung collaterals, with flexible application of wind-dispelling and collateral-unblocking medicinals. This treatment strategy organically integrates pathogen elimination with collateral unblocking, offering a systematic approach for the TCM diagnosis and treatment of post-infectious cough.