干祖望教授治疗喉源性咳嗽经验

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干祖望教授治疗喉源性咳嗽经验

The treatment of cough of throat origin by Dr. Zuwang Gan

 

喉源性咳嗽是干祖望教授所定的病症名.其主要临床表现是喉间作痒则咳,  不痒不咳, 无痰或少痰,  甚则咳引胸痛. 喉痒多因风,  ,  燥等异气侵袭咽喉所致. 现将干老治疗本症的经验整理介绍如下:

The cough due to something wrong in the throat is the medical term developed by Dr. Zuwang Gan. The main clinic manifestation of such cough is the cough onset whenever there is itch in throat. If there is no itch,  there would have no cough. The cough is not accompanied by phlegm or the phlegm is very little in amount. In severe case,  the cough may cause pain in chest. The itch in throat is mostly due to the attack by Wind,  Fire,  or Dryness to the throat. Here we introduce the clinic experience by Dr. Zuwang Gan in the treatment of such throat-origin cough:   

 

1宣肺散邪法   适用于风寒之邪上犯咽喉, 以致肺气失宣, 喉痒干咳, 或有少量痰液之证.方用三拗汤加味: 麻黄,  杏仁,  甘草,  蝉衣,  防风,  桔梗,  贝母.

1. To disperse Lung and to dispel the Xie:  This therapeutical principle is used in case in which the Wind-Cold Xie Qi attacks the throat,  so as to cause the disorder in the disperse of the Lung Qi. The throat felt itch and the patient had cough with or without little phlegm. The formula used is San Ao Tang with additions:  Mahuang,  Xingren,  Gancao,  Chanyi,  Fangfeng,  Jiegen and Beimu.

若痰色白者,  加陈皮, 苏子, 僵蚕;

If the phlegm is white in color,  add Chenpi,  Suzi and Jiangcan.

痒咳剧烈,  且咽喉粘膜充血者,  系风寒化热之征, 可加薄荷, 天竺黄, 芦根, 射干等.

If the cough is to violent,  with blood congestion in the mucus of the throat,  it indicates the Fire-developing from the Wind-Cold Xie. Add herb Bohe,  Tianzhuhuang,  Lugen and Shegan,  etc.

2清心泻火法   适用于心火偏亢,   循经犯喉所致之喉痒干咳. 频作清嗓,  咽干喜饮, 心烦失眠, 咽喉粘膜充血, 小血管网布.舌尖红.脉细弦.方用导赤散加减: 生地, 竹叶, 茅棍, 灯芯, 玄参, 丹皮, 芦根, 天竺黄, 知母, 杏仁, 石膏.

2. Fire-clearing and Heart-cooling therapy. This principle is suitable for the overwhelming of Heart Fire,  which attacks the throat through the throat. The patient feels urgent to clear the throat again and again,  feels dry in throat with desire to drink water,  and feels annoyed,  poor sleep. There is blood congestion in the mucus in the throat with net-like small blood vessels. The tongue tip is red in color. The pulse is thin and string. The herbal formula should be used is Dao Chi San with modification:  Shengdi,  Zhuye,  Baimaogen,  Denxingcao,  Xuanshen,  Danpi,  Lugen,  Tianzhuhuang,  Zhimu,  Xingren and Shigao. 

3滋阴降火法   适用于肾阴不足, 虚火上炎, 循经犯喉所致之喉痒干咳, 夜间卧则尤甚, 口燥咽干, 饮水不解, 咽喉粘膜暗红干燥, 咽后壁淋巴滤泡散在增生.舌红苔薄白, 脉细数.方用知柏地黄汤加减: 知母, 黄柏, 生地, 山萸肉, 山药, 牛膝, 丹皮, 百合, 麦冬, 玄参.

3. Yin-nourishing and Fire-clearing therapy. It is used for Kidney Yin deficiency with weakness Fire rushing up to the throat. The patient feels inch to cough, which is worse as night. The patient feels dry in mouth and throat. Water drink does not solve the dryness. The throat mucus is dark red and dry. There is hyperplasia of lymphoid follicles in the back of the throat. The tongue is red in color. The tongue cover is thin and white. The pulse is thin and frequent. The herbal formula is Zhi Bo Dihuang Tang with modification: Zhimu, Huangbo, Shengdi, Shanyurou, Shanyao, Niuxi, Danpi, Baihe, Maidong, and Xuanshen.

4. 滋阴润燥法   适用于肺阴不足, 燥火上冲咽喉而作痒干咳, 甚则咳引胸痛, 偶有粘痰带血, 因喉干燥, 粘膜慢性充血, 或部分粘膜萎缩.舌偏红, 苔薄, 脉细.方用养阴清肺汤加减: 沙参, 麦冬, 生地, 知母, 石膏, 桑叶, 杏仁, 茅根, 天竺黄, 川贝母.

4. Yin-nourishing and Dryness-wetting therapy. This principle is suitable for the Lung Yin deficiency, in which the Dryness-Fire rushes up to the throat to cause itch in throat and cough. In severe case, the severe cough is accompanied with chest pain. Occasionally there is blood in sticky phlegm. The throat is dry. The throat mucus is with chronic blood congestion, with or without atrophy in part of mucus. The tongue tends to be slight red in color. The tongue cover is thin. The pulse is thin. The herbal formula should be Yang Yin Qing Fei Tang with modification: Shashen, Maidong, Shengdi, Zhimu, Shigao, Sangye, Xingren, Baimaogen, Tianzhuhuang, and Chuan Beimu.

5活血化瘀法  适用于瘀血阻滞,  津不上承,  致咽喉干燥作痒而咳,  经久不愈,  渴喜温饮,  咽喉粘膜慢性充血干燥,  咽后壁淋巴滤泡增生. 舌有紫气,  苔薄,  脉细涩. 方用桃红四物汤加减: 桃仁, 红花, 当归, 生地, 赤芍, 蝉衣, 干地龙, 炙苏子, 贝母, 桔梗, 甘草.

5. Blood-activating and blood stagnation-dissolving therapy. This principle is suitable to the blood stagnation, in which the liquid part fails to move up to wet the throat, due to the blood stagnation. The throat feels dry, itch and cough. The cough would last for a long time and dark to stop. The patient feels thirsty and has desire to drink warm water. There is dry and chronic blood congestion in the throat mucus. There is hyperplasia of lymphoid follicles in the back of the throat. The tongue shows purple tint. The tongue cover is thin. The pulse is thin and not smooth. The formula used is Tao Hong Si Wu Tang with modification: Taoren, Honghua, Danggui, Shengdi, Chishao, Chanyi, Dilong, Zhi Suzi, Beimu, Jiegen and Gancao.

6. 脱敏敛肺法   适用于禀质特异,  异气刺激咽喉引动肺气上逆,  咽喉作痒干咳,  咳甚呕恶. 方用脱敏汤加减: 紫草, 茜草, 旱莲草, 蝉衣, 干地龙, 金沸草, 桑白皮, 荆芥炭, 乌梅, 诃子肉, 甘草.

6. Allergy-releasing and Lung-restraining therapy. It is used for special body constitution. The person is easy to have Lung Qi reversely rush up to the throat, after stimulation by strange gas, air, or smell. The throat feels itch and the person has dry cough. When the cough is very strong, the person may feel nausea. The herbal formula is Tuo Ming Tang with modification: Zicao, Qiancao, Hanliancao, Chanyi, Dilong, Jinfeicao, Sangbaipi, Jingjie Tan, Wumei, Hezirou, and Gancao.