清肺通络方治疗儿童慢性咳嗽病例报告一例
增强出版A Case Report: Qingfei Tongluo Formula in Treatment of Chronic Cough in Children
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1.上海中医药大学附属龙华医院儿科,上海 200030
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刘安琪, 张奕星, 姜之炎. 清肺通络方治疗儿童慢性咳嗽病例报告一例[DB/OL].(2023-02-27)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=31892354&Fpath=home&index=0
LIU Anqi, ZHANG Yixing, JIANG Zhiyan. A Case Report: Qingfei Tongluo Formula in Treatment of Chronic Cough in Children[DB/OL].(2023-02-27)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=31892354&Fpath=home&index=0
刘安琪, 张奕星, 姜之炎. 清肺通络方治疗儿童慢性咳嗽病例报告一例[DB/OL].(2023-02-27)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=31892354&Fpath=home&index=0 DOI:
LIU Anqi, ZHANG Yixing, JIANG Zhiyan. A Case Report: Qingfei Tongluo Formula in Treatment of Chronic Cough in Children[DB/OL].(2023-02-27)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=31892354&Fpath=home&index=0 DOI:
病史摘要,2,患儿王某某,男,3岁7个月,主因“反复咳嗽半年余,加重1周”于2020年7月9日至上海中医药大学附属龙华医院儿科门诊就诊。患儿有过敏性鼻炎病史,长期鼻塞流涕,半年前曾患肺炎,经治出院后仍反复咳嗽,喉中有痰,痰黏难咯,每于受凉后咳嗽反复,伴见鼻塞流涕,发作时即至当地社区医院就诊,多次拍肺部X射线未见明显异常(报告未见),予“敌咳、切诺”等止咳化痰药对症治疗,经治后患儿咳嗽咯痰可缓解但仍有反复。1周前患儿受凉后咳嗽频作,无喘促,喉中有痰难咯,发热,体温最高38.4 ℃,呈不规则热,伴咽痛,鼻塞流清涕,恶心,曾呕吐胃内容物1次,否认喷射状呕吐,无头晕头痛,家长即予小儿豉翘清热颗粒、美林对症治疗2 d后热退,恶心呕吐缓解,但咳嗽仍有,鼻塞流浊涕,遂于7月9日至上海中医药大学附属龙华医院儿科门诊就诊。中医诊断 小儿咳嗽,痰瘀阻络证。西医诊断 儿童慢性咳嗽、上气道咳嗽综合征。干预措施 嘱停服小儿豉翘清热颗粒、美林,予自拟清肺通络方加减治疗,处方:桑白皮5 g、地骨皮5 g、紫苏子5 g、葶苈子5 g、苦杏仁5 g、桃仁5 g、甘草2 g、白芥子5 g、莱菔子5 g、鱼腥草5 g、白附子5 g、牡蛎9 g、 浙贝母2 g、竹茹2 g、辛夷3 g、白芷5 g、石菖蒲3 g、黄芩5 g、车前子5 g。上方14剂,为颗粒剂,开水冲服,每次1袋,每日2次。嘱患儿饮食忌生冷、油腻及刺激性食物,慎起居,避风寒,注意休息,避免剧烈运动。疗效转归 经治疗患儿咳嗽、自汗愈,随访6个月余患儿再未反复咳嗽咯痰,季节变化时偶有鼻塞流涕,呼吸道感染频率较前大大减低,继续予玉屏风散、运脾化痰通窍方加减调理6月余,益气健脾,增强体质。
Summary of case history ,Patient Wang, male, 3 years and 7 months. This patient went to the pediatric outpatient clinic on July 9, 2020 because of "repeated cough for more than half a year, aggravated by 1 week". The child has a history of allergic rhinitis, and always had nasal congestion and runny nose. He also had pneumonia six months ago, and still coughed repeatedly after discharge. There was sputum in his throat, which was difficult to stick. Symptoms got worse very time he caught cold. He went to the local community hospital for treatment. Lung X-rays showed no obvious abnormalities. He was given symptomatic treatment with cough and expectorant drugs such as "dicough, eucalyptol, limonene and pinene enteric capsules". After treatment, the child's cough and expectoration could be relieved, but there were still recurrences. One week ago, the child coughed frequently after catching cold, with sputum in the throat, fever, the highest body temperature was 38.4 ℃, accompanied by sore throat, nasal congestion with clear nasal discharge, nausea, vomited gastric contents once, denied jet vomiting, without dizziness and headache. His parents immediately treated him with Chiqiao Qingre granules and Ibuprofen Suspension. Then the fever subsided, nausea and vomiting relieved, but the cough still existed, with nasal congestion, turbid nasal discharge. So they went to the pediatric outpatient department of our hospital on July 9.,TCM diagnosis ,Cough, phlegm-stasis in lung channels.,Western medicine diagnosis ,Chronic cough, upper airway cough syndrome.,Therapeutic methods ,Qingfei Tongluo formula, which was composed of cortex mori radices , perillaseed, lepidium seed, almond, peach kernel and glycyrrhiza uralensis. Take it with boiled water, 1 bag each time, twice a day. Asked the children to avoid cold, greasy and irritating food in their diet, be careful in their daily life, avoid the wind and cold, take rest and avoid strenuous exercise.,Clinical outcomes ,After treatment, the children recovered from cough and spontaneous sweating. After a follow-up of more than 6 months, the children no longer coughed and expectorated repeatedly. They occasionally had nasal congestion and runny nose during seasonal changes, and the frequency of respiratory tract infection was greatly reduced. They continued to be treated with Yupingfeng powder and Yunpi Huatan Tongqiao formula for more than 6 months to replenish Qi, strengthen the spleen and enhance body quality.
儿童慢性咳嗽上气道咳嗽综合征清肺通络方
Childchronic coughupper airway cough syndromeQingfei Tongluo formula
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