鼾症病机探研与诊疗述要

基于临证对鼾症(睡眠呼吸障碍)病因病机与诊疗思路及方法进行探讨。睡眠打鼾是为鼾症,本病发生主要与生活方式以及禀赋、情志、年龄增长、体脂增多、鼻与咽喉局部形态异常等因素关系密切。各种因素导致脏腑失调,气化失常,营卫失和,膏脂堆积,形体失塑,或致痰结血瘀,壅阻气机,壅滞肺系,气道受阻,呼吸不畅为基本病机。病性分虚实,大致可归于实责阳明,虚责太阴。鼾症可引起一系列病机变化,常见有形邪结壅阻气机;邪阻咽喉,妨碍升降;呼吸障碍,危害周身;损伤心脉,形成脉积;损伤营卫,扰络伤神等。鼾症发病率高,临床表现复杂,识证需细致。若疑为本病,需通过望形体、问症状,加以识别。早期发现、综合干预是处置鼾症的基本原则,内科辨治有助于改善患者脏腑功能,调畅气道及营卫气血,以期减少继发性损害。

Research on the Disease Mechanism of Snoring Disease and the Diagnosis and Treatment

Based on clinical evidence,the cause,mechanism,diagnosis and treatment of snoring disease(sleep apnea syndrome)were discussed.Snoring disease is characterized by snoring during the sleep.It usually caused by various factors mainly including lifestyle,body constitution,emotions,aging,body weight,local morphological abnormalities of nose and throat.These factors could cause disturbance of zang-fu organs,disorders of qi transformation,disharmony of nutritive and defensive qi,overweight,phlegm accumulation and blood stasis,which would cause qi stagnation,blockage of lung qi and airway obstruction,resulting into dyspnea.This disease could involve deficiency or excess.The excess usually affects yangming while the deficiency involves taiyin.Snoring disease can cause a series of changes of disease mechanism as follows:evil qi accumulation affecting qi movement;evil qi blocking laryngopharyngeal to affect ascending and descending;disorder of breath to affect the whole body;impairment of heart vessels to form vessel accumulation;impairment of nutritive and defensive qi with damage of collaterals and mind.Snoring disease is of high incidence with complicated clinical manifestations,and therefore the doctors should be cautious to identify the patterns.If the patients were suspected of suffering from this disease,doctors should diagnose by inspecting the physique and inquiring the symptom.Early detection and comprehensive intervention are the basic principles in the treatment of snoring disease.Pattern differentiation of internal medicine is beneficial for improving the function of zang-fu organs,regulating the airway,harmonizing nutritive and defensive qi,and smoothing qi and blood so as to reduce secondary damage.