张雁南

【摘 要】 腺樣体肥大是儿童临床的常见病，可合并多种近期或远期的并发症，严重影响儿童的生长发育。西医以对症治疗为主，有一定的局限性。中医认为该病的病因病机主要是外邪侵袭，内有禀赋不足，故气血运行不畅，局部瘀肿积存于鼻咽部，致使长期肿大难以消散。其病理因素以血瘀为主，可有气虚、痰凝、阴虚、气滞的不同。依据瘀血理论，运用会厌逐瘀汤随证加减治疗，并附验案一则。

【关键词】 瘀血;腺样体肥大;会厌逐瘀汤

【中图分类号】R272.6   【文献标志码】 A    【文章编号】1007-8517（2021）21-0118-02

Treatment of Adenoid Hypertrophy in Children with Blood Stasis

ZHANG Yannan

The Affiliated Wuxi Children's Hospital of Nanjing Medical University，Wuxi 214000，China

Abstract：Adenoid hypertrophy is a common clinical disease in children， which can be combined with a variety of short-term or long-term complications， seriously affecting the growth and development of children. The main method of western medicine is symptomatic treatment， which has certain limitations. According to Chinese medicine， the etiology and pathogenesis of this disease are mainly exogenous pathogens， lack of natural endowment， poor operation of Qi and blood， and accumulation of local blood stasis in the nasopharynx. Blood stasis is the main factor， which can be different from Qi deficiency， phlegm coagulation， yin deficiency and qi stagnation. According to the theory of blood stasis， Huiyan Zhuyu decoction was used to add and subtract the syndrome， and a case was attached， the curative effect was remarkable.

Key words：Blood Stasis; Adenoid Hypertrophy; Huiyan Zhuyu Decoction

腺样体肥大是儿童临床上常见的因反复炎症刺激而发生病理性增生肥大的一种疾病[1]。临床以鼻塞、打鼾、张口呼吸、流涕、耳闷为主要症状，长期张口呼吸，可引起面腭骨发育异常，形成“腺样体面容”，严重者可出现儿童阻塞性睡眠呼吸暂停综合征，并伴随出现多种全身并发症，涉及到神经、内分泌和心血管等系统[2]。流行病学显示，腺样体肥大发病年龄多在10岁以下儿童，6～7岁最为常见，发病率约为9.9%～29.9%[3]。西医的治疗措施大致有鼻用糖皮质激素、手术切除及射频消融术等，均存在引起相关并发症以及复发的可能，治疗效果尚不明确。中医根据症状或病机特点，将其归属于“鼾眠”“乳蛾”“痰核”“鼻鼽”“颃颡”“鼻窒”“窼囊”等范畴[4]。腺样体肥大与肺脾气虚、痰湿凝结;肺肾阴虚、虚火上炎;邪毒久留、气血瘀阻等因素密切相关[5]。而瘀存在于整个疾病始终，也是导致本病长期肿大难以消散的主要因素。中医药从整体观念出发，辨证论治，从瘀论治腺样体肥大有较好的临床疗效。……