燮理五脏并消风宣窍法治疗儿童慢性鼻窦炎及验案举隅

基于燮理五脏并消风宣窍法探究儿童慢性鼻窦炎的临床因机证治。结合“清阳清窍”学说及五脏辨证,认为鼻渊病位在鼻,又与五脏清升浊降之病机密切相关,总属本虚标实之证。临证审机,辨证论治,其一为燮理五脏,重清阳升散之源泉,着眼于五脏不足或枢机不利之处,和合五脏;其二为脏时同调,以四时六气为根本,关注小儿脏腑娇嫩,使饮食运动不失其度,合于四时以御外风;其三为消风宣窍,祛伏风、化痰浊以成清升浊降,“消风”重在引经、疏散以升清阳,“宣窍”重在治痰、祛湿以化浊阴,从而切实改善患儿鼻塞、流脓涕等不适,使其复归于清升浊降畅然往复,五脏合和,九窍通利。

Treatment of Chronic Nasosinusitis in Children with the Method of Regulating the Five Zang Organs and Dispersing Wind and Diffusing Orifices with Case Reports

This article explores the clinical causes, mechanisms, syndrome, and treatment of chronic sinusitis in children based on the method of regulating the five zang organs and dispersing wind and diffusing orifices. Based on the theory of "clear yang and seven orifices" and five zang organ syndrome differentiation, it is believed that the location of nasosinusitis is around the nose, and the disease is closely related to the pathogenesis of the five zang organs'' ascending the clear and descending the turbid. This disease generally belongs to the pattern of deficiency in the root and excess in the superficiality. Based on pathogenesis exploration and syndrome differentiation, the clinical treatment is first to regulate and harmonize the five zang organs, paying attention to the source of clear yang and focusing on the deficiency area of the five zang organs or inhibited cardinal mechanism. The second method is to regulate the zang organs and time. Based on the four seasons and six qi, the practitioners should pay attention to the delicate organs of children, ensure proper diet and exercise, and coordinate with the four seasons to ward off external wind. The third method is to dispersing wind and diffusing orifices. The latent wind needs to be dispersed, and turbid phlegm should be resolved in order to raise the clear and down bear the turbid. The focus of "dispersing wind" is on guiding the medicinals into the meridians to raise clear yang; while the focus of "diffusing orifices" is on resolving phlegm and eliminating dampness to resolve turbid yin. In this way, we can effectively improve the discomfort of nasal congestion, purulent discharge, and other symptoms in children, so that they can return to a state of smoothly raising the clear and down bearing the turbid, with the five zang organs in harmony and the nine orifices unblocked.