浅谈咳嗽的四季分治

目的]浅论四季咳嗽的不同证候特征及辨治要点.方法]结合历代中医文献的相关记述,运用中医基础理论,对春夏秋冬四季咳嗽的不同证候特征进行辨析,并提出相应的治法方药及注意事项.结果]春夏秋冬四季均有咳嗽发生：春季多感风温而咳嗽,治以辛凉解表法为主,方当选银翘散合止嗽散加减;夏季易患风热而咳嗽,治以疏风解热、宣肺止咳为主,方选桑菊饮加止嗽散加减;秋季多伤燥邪而咳嗽,且分凉燥和温燥,凉燥治以温润止咳为主辛温疏表为辅,多用杏苏散加减化裁,温燥治当清凉甘润、宣肺润燥,方以桑杏汤加止嗽散加减为主;冬季易感风寒而咳嗽,治当解表散寒、宣肺肃降,方选三拗汤加止嗽散化裁.结论]咳嗽四季皆有,临证需以辨证论治为总则,因时制宜,依据不同证候特征远方用药,切实提高临证效果.

On Seasonal Treatment of Cough

Objective] To investigate the different syndromes features and differentiation points of signs of the four seasons cough.Method] Combine the relative records in generations of TCM documentaries,apply TCM basic theories,make differentiation and analysis on different syndromes characteristics of the cough in spring,summer,autumn,winter,and put forward corresponding formula and notes.Result] In the four seasons,the cough often happens：in spring,one will cough over wind-warm,mainly treated with pungent and cool drugs to relieve the exterior syndromes,i.e.Yinqiao Powder combined with Zhisou Powder in revision; in summer,one will cough over wind-hot,mainly treated with relieving wind to remove heat and stretching lung to stop cough,choosing Sangju Drink and Zhisou Powder in combination and revision; in autumn,one will cough over dryness evil,which can be divided into cool dryness and warm dryness,the cool dryness shall be treated mainly with warm and humid drugs coordinated with pungent and warm drugs for relieving exterior syndromes,often applying revised Xiansu Powder; the warm dryness shall use cool sweet and moist drugs to open the lung and moisten dryness,mainly using Sangxing Decoction and Zhishou Powder in revision; in winter,one often coughs over wind-cold,which shall be treated with relieving exterior syndromes to remove cold,open lung for purifying and descending,using revised Sanao Decoction and Zhishou Powder.Conclusion] Although cough is a disease in four seasons,there is a general rule of treatment based on diferentation of signs,choosing formula according to circumstances and different syndromes and characteristics,to practically improve clinical efficacy.