談慢性支氣管炎之中醫治療

Discourse of Chinese Medical Treatment for Chronic Bronchitis

黃順傑(Shun-Chieh Huang)

《北台灣中醫醫學雜誌》 2卷1期 (2010/06) Pp. 49-63

https://doi.org/10.30127/BTWZYYXZZ.201006.0003

摘要

慢性支氣管炎（chronic bronchitis，簡稱慢支）是指氣管、支氣管粘膜及其周圍組織的慢性非特異性炎症。以咳嗽、喘息、喀痰，清晨和傍晚尤甚，痰呈白色粘液泡沫狀，粘稠不易咳出等多樣症狀為主，和反覆發作的慢性過程特癥。若每年發病持續3個月，並連續2年以上，可加以確診。病情緩慢進展中，常併發氣喘、支氣管擴張、肺炎甚至肺源性心臟病。它是一種嚴重危害人民健康的常見病，尤以老年人多見（下文以老慢支簡稱），症雖簡單，卻纏綿難癒。中醫認為本病的病因病機常與外邪的反覆襲表，肺、脾、腎三臟功能失調密切相關。急性發作期，表現實、熱、痰、濕、火的證候，形成正虛邪實的複雜辨證。病變經久未癒，則多屬虛寒、甚至血瘀的證候。依其臨床表現多分為實證，虛證兩大類。實證主要見於急性支氣管炎急性發作期和慢性遷延期包括痰濕蘊肺、痰熱郁肺、肝火犯肺。虛證主要見於慢性支氣管炎臨床緩解期包括肺陰虧耗、肺腎虛寒，分別治以燥濕化痰、理氣止咳治法；清熱肅肺、豁痰止咳；清肝瀉肺、化痰止咳；滋陰潤肺，化痰止咳；溫陽散寒，化氣行水為常用大法。中醫治療上，除了辨證內服中藥外，養生療法、穴位敷貼、針灸、蠟燭灸、耳穴法、推拿法等治療上都各有特色。

關鍵字

慢性支氣管炎 ； 咳嗽 ； 穴位敷貼療法 ； 冬病夏治 ； 老慢支 ； 蠟燭灸

並列摘要

Chronic bronchitis is the chronic non-specific inflammation of the trachea, bronchial mucosa and surrounding tissues. Major symptoms are coughing, wheezing, sputum coughing with mucus bubbles, which deteriorate mainly in early morning and evening. It presents multiple characteristic symptoms of foamy white grumous mucus hardly to be expectorated and episoded in recurrent chronic process. The definite diagnosis can be made if the chronic bronchitis happen in 3 months annually for 2 years. Slow in disease progression, it is often complicated by asthma, chronic obstructive pulmonary disease (COPD), bronchiectasis, pneumonia or pulmonary heart disease. It is a common disease seriously endangering people's health, especially more common in the elderly. Although the disease is simple in pathologic presentation, it is hard to be cured.In Chinese medicine theory, we held that this disease is closely correlated with repeated invasion of exogenous wind evil which leads to visceral dysfunction of lung, spleen, and kidney. In the acute attack stage, it present complicated syndromes of right vacuity and evil repletion due to syndromes of excessive evils, heat, humidity and internal fire. Chronic progression without healing would present syndromes of vacuity coldness and blood stagnation. Clinically it can be classified as two major categories of excess and vacuity syndromes. The excessive syndromes are mostly seen in the acute attack stage and chronic recurrent stage, including presentation of accumulation of pulmonary phlegm humidity, congestion of pulmonary phlegm heat and invasion of hepatic heat toward lung. The vacuity syndromes are mostly seen in the relief stage of chronic bronchitis, including presentation of asthenia of pulmonary yin fl and pulmonary and renal vacuity coldness. The common strategies of therapy can be applied as dry humidity to expel sputum and regulate the flow of vital energy to stop coughing, clear heat to eliminate pulmonary inflammation and dissolve phlegm to stop coughing, clear hepatic fever and pour down pulmonary inflammation to stop sputum and coughing, moisten renal and pulmonary vacuity coldness to reduce phlgm and coughing, warm up body vitality to expel hypothermia and regulate qi flowing and body fluid balance. In the therapeutics of Chinese medicine, except from orally intake herb medicine according to syndrome differentiation, therapy to maintain health, external Chinese herbal application on acupoints, acupuncture, candle cauterization, auricle acupoints application and message manipulation are also characteristic in the treatment of chronic bronchitis.

並列關鍵字

Chronic bronchitis ； Coughing ； External Chinese herbal application on acupoints ； Winter Diseases are treated in summer ； Elderly people with chronic bronchitis ； Candle cauterization