ISSN 1674-3865  CN 21-1569/R
主管:国家卫生健康委员会
主办:中国医师协会
   辽宁省基础医学研究所
   辽宁中医药大学附属医院

中国中西医结合儿科学 ›› 2026, Vol. 18 ›› Issue (1): 40-44.doi: 10.20274/j.cnki.issn.1674-3865.2026.01.008

• 中医应用研究 • 上一篇    下一篇

“肝升肺降”论治儿童咳嗽变异性哮喘

韩斯昂1, 张鑫业1, 林一辰1, 蔡畅1, 吴振起2,3()   

  1. 110847 沈阳,辽宁中医药大学2023级中医儿科学专业研究生(韩斯昂,张鑫业,林一辰,蔡畅)
    110032 沈阳,辽宁中医药大学附属医院儿科(吴振起)
    110034 沈阳,沈阳市中医外感病重点实验室(吴振起)
  • 收稿日期:2025-10-22 修回日期:2025-12-16 出版日期:2026-02-25 上线日期:2026-02-25
  • 通讯作者: 吴振起 E-mail:lnzy_wuzhenqi@sina.com
  • 作者简介:韩斯昂(2001-),男,辽宁中医药大学2023级硕士研究生在读。研究方向:中医药防治小儿感染性疾病
  • 基金资助:
    辽宁省自然科学基金应用基础研究计划(2022JH2/101300088)

On the treatment for pediatric cough variant asthma from the theory of "liver ascending and lung descending"

Siang HAN1, Xinye ZHANG1, Yichen LIN1, Chang CAI1, Zhenqi WU2,3()   

  1. 1.Liaoning University of Traditional Chinese Medicine, Shenyang 110847, China
    2.The Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang 110032, China
    3.Shenyang Key Laboratory of Traditional Chinese Medicine Exogenous Diseases,Shenyang 110034, China
  • Received:2025-10-22 Revised:2025-12-16 Published:2026-02-25 Online:2026-02-25
  • Contact: Zhenqi WU E-mail:lnzy_wuzhenqi@sina.com
  • Supported by:
    Basic Scientific Research Project of Liaoning Provincial Department of Education

摘要:

儿童咳嗽变异性哮喘是儿童时期常见的慢性咳嗽性疾病,属中医学“咳嗽”“风咳”范畴。本病以气道高反应性为特征,病程迁延,易反复发作,严重影响患儿生活质量。现代医学虽以吸入性糖皮质激素等药物控制症状,但存在依从性差、易复发等局限。基于“肝升肺降”理论,本文系统阐述咳嗽变异性哮喘的中医病机与治法。肝主升发,肺主肃降,二者共司气机升降。小儿“肝常有余,肺常不足”,易致肝气郁遏化火、上逆侮肺,或肺失清肃、宣降失常,终致气逆而咳。病机演变涉及肝失疏泄、肝火亢逆、肝阳上扰及肝阴亏虚等多重状态。治疗上以恢复“肝升肺降”动态平衡为核心,分别施以疏肝理气、平肝降火、镇肝息风、柔肝滋阴等法,旨在调畅气机、协调脏腑,为儿童咳嗽变异性哮喘的中医辨治提供理论依据与临床思路。

关键词: 咳嗽变异性哮喘, 肝升肺降, 儿童

Abstract:

Cough variant asthma(CVA) in children is a common chronic cough disorder in pediatric period, which is classified under the traditional Chinese medicine(TCM) categories of "cough" and "wind-cough". Characterized by airway hyperresponsiveness, this condition features prolonged duration and recurrent episodes, significantly impacting patients' quality of life. While in modern medical treatments, inhaled corticosteroids are used to control symptoms, they face limitations such as poor patient compliance and frequent relapses. Based on the TCM theory of "liver ascending and lung descending", this study systematically explores the pathogenesis and therapeutic approaches of CVA. The liver governs ascending functions while the lung regulates descending functions, and they jointly control the ascending and descending of qi flow. In children, there exists "liver excess and lung deficiency", which brings about liver qi stagnation transforming into fire and invading the lungs, or impaired lung function leading to abnormal qi descending, and all these ultimately result in cough. Pathological evolution involves multiple states, including liver dysfunction, hyperactive liver fire, upward disturbance of liver yang, and liver yin deficiency. Treatment focuses on restoring the dynamic balance of "liver ascending and lung descending", employing methods such as regulating liver and smoothing qi, reducing liver fire, calming liver and suppressing wind, and softening liver and nourishing yin. These approaches are used to harmonize qi flow and coordinate organ functions, providing theoretical foundations and clinical guidance for TCM differential treatment of pediatric CVA.

Key words: Cough variant asthma, Liver ascending and lung descending, Child

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