一、80年代以前哮喘从肾辨治的研究进展:
Ⅰ. The progress of differential treatment of asthma that from the kidney before 1980s:
(一)哮喘辨治的基本框架:
(Ⅰ) The basic framework of Asthma Treatment:
《内经》虽无哮喘之名,但有关“喘鸣”的记载,即与本病的发作特点相似。金元以前,哮证和喘证统属于喘促一门,中医文献多不加区别。古代医家多宗丹溪“未发以扶正气为主,既发以攻邪气为急”之倡,以“发时治标,平时治本”为哮喘治疗原则,一直沿用至今。基本按发作期、缓解期辨证分型。发作期辨证分冷哮(射干麻黄汤、小青龙汤)、热哮(越婢加半夏汤、定喘汤)。缓解期辨证分肺虚(玉屏风散、桂枝加黄芪汤)、脾虚(六君子汤)、肾虚(金匮肾气丸、七味都气丸)。并强调肾虚、阳虚在本病中的重要性。
Though there was disease recorded as asthma in the book of < Yellow Emperor’s Canon of Internal Medicine>, but the record of stridor was similar to the asthma. Dyspnea syndrome and asthmatic syndrome were all belonged to breathe shortly, they were not distinguished in the literatures of TCM. Ancient doctors cased Danxi’s viewpoint that "Support the Positive Qi when the asthma was not occurred, attacking the Evil Qi is urgency when asthma occurred ", taking "Treating symptoms at the time of disease occurring, treating the root of disease at peacetime "as the principle of treating asthma, it has been in use ever since. Basically typed as attack stage and remission stageAttack stage can be classified as cold asthma (Sheganmanghuang Tang, Xiaoqinglong Tang),hot asthma(Yuebijiabanxia Tang, Ding chuan Tang) Remission stage can be classified as Lung Deficiency(Yupingfeng San, Guizhijiahuangqi Tang), Spleen Deficiency (Liujunzi Tang), Kidney Deficiency (Jinguishenqi Wan, Qiweiduqi Wan) and emphasized the importance of Kidney Deficiency and Yang Deficiency.
(二)80年代以前,哮喘的中西医结合研究对揭示肾虚在哮喘中的重要性起了较大作用,主要有以下几方面:
(Ⅱ) Before the 1980s, Western Medicine combined with traditional Chinese medicine to treat asthma played a great action in revealing the importance of kidney deficiency in the treatment of asthma:
华译网北京翻译公司翻译过大量有关哮喘辨治基本框架的文件资料,Beijing Chinese Translation Service Company has translated many technical documents about the basic framework of Asthma Treatment
1.异病同治:
1. Treating Different Disease With The Same Therapies:
1960年,沈自尹等总结中医治疗经验,发现功能性子宫出血、支气管哮喘、妊娠毒血症、红斑性狼疮、冠心病、神经衰弱等发展到一定阶段时,都可用补肾、调整阴阳的方法获效。
In 1960, Shen Ziyin and other doctors summed up their experience of TCM, they found that when dysfunctional uterine bleeding, bronchial asthma, toxemia of pregnancy, lupus, coronary heart disease and neurasthenia developed to a certain stage, all of these diseases can be treated with invigorating kidneys, adjusting Yin and Yang to achieve the purpose of curing the diseases.
张大宁等检查120例病程8年以上之慢性气管炎、支气管哮喘、高血压、冠心病、慢性肝炎、慢性泄泻、慢性肾炎等病人有肾虚证者占92%,补肾治疗后,85%不同程度好转。
Zhang Daning and others examined 120 cases whose diseases history of bronchial asthma, hypertension, coronary heart disease, Chronic hepatitis, chronic diarrhea, chronic nephritis had been over eight years, patients above who had kidney deficiency accounted for 92%, 85% of them got improvement in varying degrees after the treatment of invigorating the kidney.
2.缓解期补肾固本预防季节性发作:
2. Strengthening the kidney at catabatic stage to prevent attack:
许得盛等用温阳片(附子、生熟地、仙灵脾、菟丝子、补骨脂等)缓解期给药(每年从7月底至10月底3个月期间服用)防治哮喘季节性发作,观察6年疗效。142例显效56.3%,总有效率96.7%。治疗时间越长,疗效越显著。停药2~4年后仍保持一定疗效。内、外源性哮喘疗效相仿。肾虚和无特殊见证型疗效优于脾虚和脾肾两虚型(P<0.05),后两型中感染者比例明显高于前两型(P<0.05)。
Xu Desheng and others administrated the patient Warming-Yang pills (Aconite, Fresh Shudi, Epimedium, Dodder, Psoralen) at catabatic stage (annually from the end of July to the end of October, period of 3 months use) to combat seasonal attack of asthma, and observed the clinical effect for six years 56.3% of 142 cases show effect, the total efficiency is 96.7%. The longer of treatment, the obvious of the effect. The effect will be kept 2 to 4 years. Endogenic and exogenous asthma were similar. The effect of Kidney deficiency type and no special syndrome type were better than spleen deficiency type and both spleen and kidney deficiency type. (P<0.05), The portion of infection of the latter two type were higher than the former two type obviously (P<0.05)
1961年汪敏刚等针对支气管哮喘肾虚证,以河车大造丸为基础,肾阳虚加服金匮肾气丸、肾阴虚加服六味地黄丸治疗45例,有效38例。而对照组19例,仅5例有效。讨论中提出。肾中命门有真火,与肾上腺皮质功能有关,认为肾上腺皮质功能不全是本病发病的环节之一。
In 1961 Wang Min gang took Hechengdazaowan as a basic recipe to treat Bronchial asthma, the patient of Kidney-Yang deficiency were given Jingui Shenqiwan, the patient of Kidney-Yin deficiency were given liuwei Dihuangwan,38 cases taking effect of 45 cases, 38 cases were effective. But there were only 5 cases showed effect in the 19 cases of control group. Discussion referred that there was real fire in life gate of kidney, it has relation to the function of the adrenal cortex and supposed that adrenal insufficiency was one tache of the disease.