兰丹丹 贾新华

摘要：咳嗽变异性哮喘又称咳嗽型哮喘、过敏性咳嗽，是一种特殊类型的哮喘，其临床表现缺乏特异性，无明显的喘息、气促和呼吸困难等症状，故临床上容易漏诊、误诊，且近年来发病呈上升的趋势。由于其症状不典型，不少患者经过很长时间或反复发作后才被确诊，有些患者最终演变成典型哮喘，严重影响着患者身体健康和生活质量。因此，加强对本病的认识及早期治疗极为重要。西医对本病的认识有较完整的理论体系，治疗亦有一定疗效但易反复，中医通过辨证论治对本病的治疗具有独特优势。中医认为风、痰、瘀是其基本病理特点，根据其病理特点分为风邪侵袭期、痰瘀互结期、正气亏损期。通过从风痰瘀三期变化简单探讨咳嗽变异性哮喘，以期为临床诊治提供更好思路。

关键词：咳嗽变异性哮喘；中医病机；风咳

中图分类号：R256.12 文献标志码：A 文章编号：1007-2349（2018）02-0005-04

On Cough Variant Asthma from Wind Phlegm Stasis

LAN Dan-dan1， JIA Xin-hua2△

（1. Shandong University of Traditional Chinese Medicine， Jinan 250014， China；

2. The Affiliated Hospital of Shandong University of Traditional Chinese Medicine， Jinan 250011， China）

【Abstract】Cough variant asthma， also known as cough type asthma or allergic cough， is a special type of asthma. Its clinical manifestations are lack of specificity and have no symptoms of wheezing， shortness of breath and difficult breathing. Therefore， clinically miss diagnosis and misdiagnosis have showed an upward trend in recent years. Because of its atypical symptoms， many patients have been diagnosed definitely after a long period of time or recurrent episodes. Some patients eventually developed into typical asthma and seriously affected their health and quality of life. Therefore， to enhance awareness of this disease and make early treatment are extremely important. Western medicine has a more complete theoretical system and a certain curative effect on the treatment of the disease， but easy to repeat. Traditional Chinese medicine has unique advantages over the disease by treatment based on syndrome differentiation. Chinese medicine believes that the wind， phlegm and stasis are its basic pathological features. According to its pathological features the disease are divided into the epidemic of wind-evil invasion， phlegm and blood stasis and positive qi loss period. Through the three phases of wind phlegm and blood stasis， cough variant asthma is explored in order to provide a better idea for clinical diagnosis and treatment.

【Key words】cough variant asthma， TCM pathogenesis， wind cough

咳嗽變异性哮喘是以咳嗽为主要或唯一症状，无喘息气促等症状，常在运动、吸入冷空气、油烟刺激性气味、上呼吸道感染后诱发，在夜间或凌晨加剧，患者多有过敏性鼻炎或皮肤病病史，发作大多有一定的季节性，以春秋为多。GINA（全球哮喘防治倡议）中明确认为咳嗽变异性哮喘是哮喘的一种形式，它的病理生理改变与哮喘病一样，也是持续气道炎症反应与气道高反应性。虽然其也有支气管痉挛，但多发生在末梢的细小支气管或短暂性痉挛，因此体检时很少听到哮鸣音。……