基于地域分布的我国儿童变应性鼻炎的中医辨治特点分析

Title:

Analysis on Characteristics of TCM Syndrome Differentiation Treatment of Children with Allergic Rhinitis in China Based on Regional Distribution

文章编号:

2095-5707(2019)06-0010-06

作者:

白一帆¹; 龙旭蕾¹; 李敏¹; 2*

1.首都医科大学附属北京中医医院，北京 100010；2.首都儿科研究所附属儿童医院，北京 100020

Author(s):

BAI Yi-fan¹;  LONG Xu-lei¹;  LI Min¹; 2*

1. Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing 100010, China; 2. Children Hospital Affiliated to Capital Institute of Pediatrics, Beijing 100020, China

关键词:

儿童变应性鼻炎; 中医; 地域; 辨证论治

Keywords:

children with allergic rhinitis;  TCM;  regions;  syndrome differentiation treatment

分类号:

R276.1

DOI:

10.3969/j.issn.2095-5707.2019.06.003

文献标志码:

A

摘要:

目的 探究南北方地域医家中医辨治儿童变应性鼻炎的异同，以便更好地揭示该病的病因病机及辨治方法。方法 对我国近十年中医辨治儿童变应性鼻炎的原始文献进行比较、分析，通过检索中国学术期刊网络出版总库、中国核心期刊（遴选）数据库、中文科技期刊数据库，使用Endnote X8软件进行文献的查重、合并，以2个人背对背查阅、筛选文献，由一名主任医师级专家以质量控制的方式进行文献的总结，最后通过Excel 2007进行数据的分类整理、总结分析。结果 ⑴南北方地域医家对儿童变应性鼻炎的中医病因病机认识基本相同，均认为乃肺脾肾三脏不足，感受外邪所致。⑵治疗以扶助正气、祛风通窍为基本原则，辨证分型南北方地域认识虽大体相同，但在临床应用上，各辨证分型所占比例南北方有明显差异。北方地域以表证、气虚证、里实证偏多，南方地域以气虚证、阴虚证、阳虚证偏多。按脏腑辨证分类，南北方地域均以肺脏论治为主，同时南方地域在其基础上更侧重于结合从脾论治。⑶南北方地域辨治用药均以祛风药、补益药为主，同时兼用清热、化痰、祛湿药。根据药物使用频率，北方地域祛风、清热药物频率高，南方地域使用补益、温里、理气药物频率高于北方。在同样是祛风药、补益药等具体药物的应用上，南北方医家也会根据同类药物之间的差异进行更为细致地选择。结论 由于南北方地域气候、饮食习惯等不同因素的影响，儿童变应性鼻炎的中医辨治在寒热、虚实、脏腑辨证及用药特点等诸多方面有所不同，充分体现了中医因人因地因时制宜的整体思想。

Abstract:

Objective To explore the similarities and differences of TCM syndrome differentiation treatment of allergic rhinitis in children by southern and northern TCM practitioners in China; To better reveal the etiology, pathogenesis and TCM syndrome differentiation treatment of the disease. Methods The original literature on the treatment of children with allergic rhinitis by TCM syndrome differentiation treatment in the past ten years was compared and analyzed. Through the search of China Academic Journals Network Publishing Library, China Core Journals (Selection) Database, and Chinese Science and Technology Journal Database, literature was checked and merged through Endnote X8 Software. Two persons back-to-back searched and selected literature. A chief physician-level expert summarized the literature in the form of quality control, and finally the data were sorted and summarized through Excel 2007. Results (1) Doctors in northern and southern regions had basically the same understanding of TCM etiology and pathogenesis of allergic rhinitis in children, which was the deficiency of lung, spleen, and kidney, and the perception of external pathogenic factors. (2) The treatment was based on the basic principles of reinforcing healthy Qi, dispelling wind and opening orifices. Although the understanding of syndrome differentiation types in the northern and southern regions was basically the same, the proportion of each was obviously different in the clinical application. There were more external syndrome, Qi deficiency syndrome, and interior-excess syndrome in northern regions, while the south had a higher proportion of Qi deficiency syndrome, yin deficiency syndrome, and yang deficiency syndrome. According to the classification of viscera syndrome differentiation, lung therapy was the main treatment in both northern and southern regions, while more emphasis was placed on the combination of spleen therapy in the southern region. (3) According to the types of medication, the syndrome differentiation treatment in the north and the south was mainly based on medicine for dispelling wind and tonifying, and combined with medicine for clearing heat, reducing phlegm and dissipating dampness. According to the frequency of medication, the frequency of medicine for dispelling wind and clearing heat were high in the northern region, and the frequency of medicine for tonifying, warming interior, and regulating Qi were high in the southern region. In terms of the specific application of medicine for dispelling wind and tonifying, TCM practitioners in northern and southern regions would also make more carefully choice based on the differences between similar medicine. Conclusion Due to the influence of different factors such as climate and diet habits in the north and the south, TCM syndrome differentiation treatment of children with allergic rhinitis is different in many aspects such as syndrome differentiation of cold and heat, deficiency and excess syndrome, viscera syndrome and medication characteristics, which fully reflects the overall view of TCM on theory of treatment in accordance with individuals, time and local conditions.