Abstract:

Based on the therapeutic principle of "subduing what governs the disease and addressing the cause first" proposed in Suwen·Zhizhenyao Dalun, and considering the physiological and pathological characteristics of children, which are "the lung is often insufficient, the spleen is often deficient, and the liver is often in excess", the study explores the pathogenesis evolution rules and strategy of stage-based treatment for pediatric bronchopneumonia. The study indicates that pediatric bronchopneumonia belongs to the category of "pneumonia with dyspneic cough" in traditional Chinese medicine, and that its occurrence and progression are closely related to external pathogens invading the lung, endogenous phlegm accumulation, and the transformation of stagnation into heat. Phlegm-heat obstructing the lung and failure of the dispersing and descending of lung constitute the core pathogenesis in the acute stage, while deficiency of both the lung and spleen and relative hyperactivity of the liver form an important internal basis for prolonged disease and recurrence. In clinical practice, the dynamic relationship between "addressing the cause first" and "subduing what governs the disease" should be carefully grasped. In the initial stage, treatment should focus on dispelling wind to release the exterior and diffusing the lung to stop cough. In the peak stage, priority should be given to clearing heat and eliminating phlegm and diffusing the lung and relieving obstruction. During the prolonged stage, residual pathogenic factors should be cleared while Qi and Yin are simultaneously replenished. In the recovery stage, treatment should emphasize strengthening the spleen and lung, nourishing Qi and Yin, and regulating the constitution, with balance between eliminating pathogenic factors and supporting healthy Qi according to changes in the disease condition. On the basis of internal treatment, external therapies such as Fuxiong powder application may further promote phlegm resolution, lung diffusion, collateral unblocking, and relief of obstruction. Evidence from a representative clinical case suggests that therapeutic principle can effectively guide the dynamic transition of pediatric bronchopneumonia from pathogenic excess to deficiency of healthy Qi, thereby providing a relatively systematic clinical approach for stage-based syndrome-differentiated treatment and combined internal and external treatment in traditional Chinese medicine.

Key words: Bronchopneumonia, Subduing what governs the disease, Pneumonia with dyspneic cough, Traditional Chinese medicine treatment, Stage-based treatment, Child