儿童变应性鼻炎–哮喘综合征急性发作期的中西医治疗策略

Integrated Chinese and Western Medical Treatment Strategies for Acute Exacerbations of Pediatric Combined Allergic Rhinitis-Asthma Syndrome

摘要: 本文围绕儿童变应性鼻炎–哮喘综合征(CARAS)急性发作期诊疗，结合“肺鼻同治”中医理论与“同一气道，同一疾病”西医理念展开探讨。中医将CARAS归为“鼻鼽”“哮喘”范畴，小儿肺脾不足体质为发病基础，痰湿内蕴为核心病机，风邪引动为发病诱因，肺鼻生理病理相通为同治提供理论依据；西医则认为其关键发病机制为气道慢性炎症、Th1/Th2免疫失衡。临床西医以短效β₂受体激动剂、鼻用糖皮质激素等为核心阶梯治疗；现代中医医家秉持肺鼻同治原则形成特色辨证，研究证明多种中药可通过调节免疫、抑制炎症通路发挥多靶点作用。中西医结合治疗实现肺鼻同调、标本兼顾，能有效缓解急性症状，减少复发，为临床诊疗提供重要支撑。

Abstract: This article focuses on the diagnosis and treatment of acute episodes of pediatric combined allergic rhinitis-asthma syndrome (CARAS), and explores the topic by integrating the traditional Chinese medicine (TCM) theory of “lung-nose co-treatment” with the Western medical concept of “one airway, one disease”. In TCM, CARAS is classified under the categories of “rhinitis” and “asthma”, with the deficiency of lung and spleen in children as the basis for the disease, internal accumulation of phlegm and dampness as the core pathogenesis, and wind pathogen as the trigger. The theory that the lung and nose are interconnected in physiology and pathology provides the theoretical basis for co-treatment. Western medicine considers the key pathogenesis to be chronic airway inflammation and Th1/Th2 immune imbalance. In clinical practice, Western medicine uses short-acting β₂ receptor agonists and nasal glucocorticoids as the core stepwise treatment. Modern TCM practitioners adhere to the principle of lung-nose co-treatment to form characteristic syndrome differentiation. Research has shown that many traditional Chinese medicines can exert multi-target effects by regulating immunity and inhibiting inflammatory pathways. The combination of TCM and Western medicine achieves the co-regulation of the lung and nose, addressing both symptoms and root causes, effectively alleviating acute symptoms, reducing recurrence, and providing important support for clinical diagnosis and treatment.