宋欢 史利卿 季坤 马建岭 白逸晨 王颖 杨凯 罗敬月 李佳珊 王亚杰 郭淑娟

摘要 目的：探讨中医药治疗慢性咳嗽的用药规律。方法：选取2009年2月至2017年12月北京中医药大学东方医院呼吸热病科咳嗽专病门诊收治的慢性咳嗽患者641例作为研究对象，通过因子分析及二元Logistic回归总结常用药物组合与证型的关联性，从而获得慢性咳嗽的治法及用药规律。结果：慢性咳嗽治疗主以祛风宣肺为主，常用药物有炙麻黄、黄芩、前胡、厚朴、炙紫菀、炙款冬花、细辛、青风藤等;兼湿热郁肺者，佐以清热化湿，常用药有薏苡仁、佩兰、白豆蔻、广藿香等;兼有肺阳亏虚者，佐以温阳健脾，兼寒饮伏肺者，佐以温阳化饮，此2证常用药有白术、茯苓、桂枝、炙甘草、细辛等;兼有痰湿阻肺者，佐治以理气燥湿、化痰止咳，常用药有紫苏子、紫苏梗、炒白芥子、炒莱菔子等;兼肺阴亏虚者，佐治以养阴清热、润肺止咳，常用药有麦冬、芦根、白茅根等。结论：慢性咳嗽以祛風宣肺为基本治法;遣方用药须兼顾宣降共施，寒温并用，肺脾同治。

关键词 慢性咳嗽;因子分析;二元Logistic回归分析;治法规律;用药规律;风邪伏肺;祛风宣肺;肺脾同治

Abstract Objective：To explore the rule of chronic cough treatments and medications by traditional Chinese medicine.Methods：A retrospective analysis of 641 effective cases of cough special disease outpatients was conducted.Through factor analysis and binary logistic regression，the correlation between commonly used drug combinations and syndrome types was summarized，so as to obtain the treatment of chronic cough and the rule of medication.Results：Chronic cough was mainly treated by dispelling wind and ventilating the lung; Commonly used drugs included roasted Herba Ephedrae，Radix Scutellariae，Peucedanum praeruptorum，Radix Peucedani，roasted Ziyuan，roasted Donghua，Herba Asari，Caulis Sinomenii etc; For those patients with damp-heat stagnation of lung，it was accompanied by clearing heat and eliminating dampness; the commonly used drugs included Semen Coicis，Herba Eupatorii，Fructus Ammomi Rotundus，Herba Pogostemonis etc.For patients with deficiency of lung yang，it was accompanied by warming yang and invigorating spleen，and for patients with cold drinking and subduing lung，it was accompanied by warming yang and transforming drinking.The commonly used drugs for these 2 syndromes included Atractylodes macrocephala Koidz，Poria，Ramulus Cinnamomi，roasted Radix Glycyrrhizae Preparata，Herba Asari，etc.For patients with phlegm-dampness blocking lung，the adjuvant therapy was to regulate qi and dry dampness，eliminate phlegm and relieve cough; the commonly used drugs included Rhizoma Atractylodis Macrocephalae，Poria，Ramulus Cinnamomi，roasted Radix Glycyrrhizae，Herba Asari etc; For patients with deficiency of lung yin，adjuvant treatment was to nourish yin and clear heat，moisten lung and relieve cough.The commonly used drugs included Radix Ophiopogonis，Rhizoma Phragmitis，Rhizoma Imperatae，etc.Conclusion：Dispelling wind and ventilating lung is the basic treatment principle of chronic cough.Prescription medicine must pay attention to dispersing and ventilating the lung qi and mildly regulating cold and heat，and the treatment of both lung and spleen

Keywords Chronic cough; Factor analysis; Binary logistic regression; Law of treatment; Law of treatment medication; Law of treatment; Wind pathogen in lung; Expelling wind and ventilating lung; Combined treatment of lung and spleen

中图分类号：R256.11文献标识码：Adoi：10.3969/j.issn.1673-7202.2021.10.022

慢性咳嗽是指以咳嗽为唯一或主要症状，持续8周以上，X线检查无明显异常的咳嗽[1]。该病发病率高、治疗难度大、复发率高，严重影响患者生命质量[2-3]。慢性咳嗽属中医“久咳”“久咳嗽”等范畴，中医药治疗慢性咳嗽疗效确切，不良反应少[4]。我们通过近15年来临床……