咽源性咳嗽的针灸辨治体会.doc

咽源性咳嗽的针灸辨证论治体会罗云波成都市锦江区中医医院摘要:咽源性咳嗽是内科常见病。以局部和辨证选穴相结合为基本原则,针刺、艾灸、火罐等方法综合运用,并结合中药治疗咽源性咳嗽疗效显著。关键词:咽源性咳嗽、针灸,辩证。 Acupuncture Treatment Experience To P haryngeal C ough LuoYunBo T raditional Chinese Medicine Hospital of Chengdu Jinjiang District Abstract: cough. mon i nternal disease . Based the basic principles of bination s elect ing points of local and points according to syndrome differentiation , we prehensive use ofa cupuncture,moxibustion,cupping and P haryngeal other methods , combinat ing Chinese m edicine , to treat p haryngeal cough .As the result , the effect is significant. Key words: pharyngeal cough ; acupuncture ; TCM syndrome differentiation . 咽源性咳嗽是内科门诊常见病,是慢性咽喉炎、声门上区变态反应等疾病的一种症状,多在慢性咽喉炎的基础上,受烟酒、辛辣、寒热等刺激而诱发,以咽痒如蚁行及异物阻咽喉之不适感而干咳无痰或痰粘难咯为主要特征。咽部检查可见咽粘膜慢性充血、,严重者咽后壁粘膜萎缩,而肺部检查无明显阳性体征。由于此类咳嗽与咽部的急、,亦称喉源性咳嗽。咽源性咳嗽症状单纯,,病程多长达数周、数月甚至数年。西医治疗主要是应用抗生素、镇静及止咳药物治疗,效果不满意。临床上多运用中药辨证治疗,取得了较好的效果,然许多患者由于病程久远,又经常受到各种不良因素的刺激,疗效仍难如人意[1]。笔者在临床上探索针灸为主治疗咽源性咳嗽,见效快,效果显著,不易复发。今将体会简述于下。 1辩证分析咽源性咳嗽属中医学久咳、咽痒、慢喉痹范畴,多属于本虚标实证候。其本虚为脾肾阳气亏虚或者肺肾阴津亏虚,其标实多为痰湿、痰热、风寒、寒湿、风热等。脾肾阳虚则阳气运化无力,常常致湿阻痰声,又易感受风寒、寒湿之邪,形成脾肾阳虚,痰湿内阻,风寒外束的证候,表现为咽痒则咳,痰多或易咯或难咯, 咽中‘有如炙臠, 咯之不出,咽之不下’,恶寒肢软,头痛身痛,食欲减退,舌淡苔白腻,脉沉细;肺肾阴津亏虚,易受风热邪气,形成肺肾阴亏,虚火上炎, 风热外感的证候,阴津亏虚、虚火上炎不能濡润咽喉,风热外邪熏灼咽喉,则患者咽干咽痛,咽痒,咳嗽痰少难咯,头昏乏力,怕热盗汗,手足心灼热,颧红口干,腰酸腿软,舌红赤太少或根黄,脉细弦。若患者脾虚痰浊内生,热邪熏灼, 则致痰热阻滞咽喉,患者还可表现为痰黄稠痰粘,苔黄腻,脉细弦滑。亦有咽源性咳嗽日久致气阴两虚或者阴阳两虚,受外感浊