运脾法在小儿肺系疾病中的运用

高旅+史正刚

摘要：本文阐释了运脾法在诸多小儿肺系疾病诊治中的应用。对于小儿急性肺系感染性疾病，应清热化痰以治标，运脾和胃以治本为原则；反复发作性肺系疾病应补脾助运以扶正，调和营卫以固表为主；感染后咳嗽等疾病应化痰消积以祛余邪，运脾和中以防病变为要。文中结合典型案例予以说明，从而得出脾运失健在肺系疾病中具有重要地位。运脾法治疗肺系疾病有一定疗效，值得临床进一步探究。

关键词：运脾法；小儿肺系疾病

DOI：10.3969/j.issn.1005-5304.2017.12.032

中图分类号：R272.956 文献标识码：A 文章编号：1005-5304（2017）12-0122-03

Application of Spleen Method in Children with Pulmonary Diseases GAO Lv， SHI Zheng-gang （Gansu University of Chinese Medicine， Lanzhou 730000， China）

Abstract： This article introduced the application of spleen method in children with pulmonary diseases. It pointed out that for children with acute pulmonary infectious diseases， clearing heat and reducing phlegm should be the treatment for temporary symptoms， strengthening the function of spleen and stomach should be the treatment for essence； recurrent pulmonary diseases should be treated with tonifying spleen to support right qi and adjust ying and wei to strengthen immune system； cough after infection can be treated with reducing phlegm to dispel rest pathogenesis， and mainly strengthen the function of spleen and harmonize zhong. In this article， the typical cases were described， which led to the importance of spleen deficiency in lung disease. Spleen method for treatment of lung diseases has a certain efficacy， which is worth further clinical study.

Key words： spleen method； children with pulmonary diseases

小兒脾常不足。江育仁提出了“脾健不在补而贵在运”的著名观点，认为运脾法是治疗小儿脾胃系疾病的基础法则[1]。在此基础上，笔者通过临床反复实践，将运脾法应用治疗小儿急性、反复发作性肺系疾病及病后调理，收效甚佳。现报道如下，以飨同道。

1 清热化痰以治标，运脾和胃以治本

本法主要用于小儿急性肺系感染性疾病。小儿肌肤嫩薄，卫外力弱，易感触外邪，致肺脏气机郁滞，引起感冒、咳嗽，甚则肺炎喘嗽等；又小儿纯阳之体，感邪易从化热，故多见热证或寒热夹杂证。治当疏风散邪，兼清内热。然而，治疗此类疾患尚需兼顾脾胃。因小儿脾常不足，外邪入侵，易困脾运，水湿不散而成痰，水谷不化而成滞，故临证多见夹痰、夹滞、纳呆等，治需辅以运脾和胃之品，以疏展脾气，恢复脾运胃纳之功用。脾运困遏，水湿不散，留而成痰成饮，致咳嗽频频者，可加苍术、陈皮、茯苓等运脾化湿，以期脾运复健，痰湿得消；……