| 引用本文: |
李南羽, 雷西熙, 魏村, 李辉, 邓可斌.从“玄府-鼻络”理论探讨儿童变应性鼻炎的辨证思路[J].湖南中医药大学学报,2026,46(6):1192-1197[点击复制] |
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| 从“玄府-鼻络”理论探讨儿童变应性鼻炎的辨证思路 |
| 李南羽,雷西熙,魏村,李辉,邓可斌 |
| (湖北中医药大学, 湖北 武汉 430061;湖北中医药大学附属医院湖北省中医院, 湖北 武汉 430061) |
| 摘要: |
| 儿童变应性鼻炎（AR）是免疫球蛋白E介导的Ⅰ型变态反应性慢性炎症性疾病，临床以鼻痒、鼻塞、喷嚏、流涕为特征，患病率持续上升且常伴有多种并发症，现代医学治疗效果有限。本文基于“玄府-鼻络”理论，认为儿童AR的核心病机在于玄府失序、鼻络阻滞，其病机演变具有鲜明的阶段性特征：急性期因外邪侵袭致玄府开阖失序，鼻络失养；缓解期因肺、脾、肾三脏功能失调，玄府失权，鼻络失荣；迁延期则久病入络，痰瘀互结，玄府郁闭。据此提出“启玄通络”的总治则，进行分期论治：急性期以风药辛散开窍，启玄通络，透邪外达；缓解期健脾、益肺、温肾，补络开玄，通补兼施；迁延期化痰通络，逐瘀开玄。从“玄府-鼻络”理论探析儿童AR，揭示疾病的动态演变，以期为儿童AR的中医治疗提供新的辨证思路与实践指导。 |
| 关键词: 儿童变应性鼻炎 玄府 鼻络 辨证思路 分期论治 启玄通络 |
| DOI：10.3969/j.issn.1674-070X.2026.06.014 |
| 投稿时间：2026-03-04 |
| 基金项目:湖北省卫生健康委员会中医药科研项目（ZY2025L250）；2026年省自然科学基金创新发展联合基金项目（2026AFCO932）。 |
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| Pattern differentiation approach to pediatric allergic rhinitis based on the “mysterious mansion-nasal collaterals” theory |
| LI Nanyu, LEI Xixi, WEI Cun, LI Hui, DENG Kebin |
| (Hubei University of Chinese Medicine, Wuhan, Hubei 430061, China;Hubei Provincial Hospital of Traditional Chinese Medicine, Affiliated Hospital of Hubei University of Chinese Medicine, Wuhan, Hubei 430061, China) |
| Abstract: |
| Pediatric allergic rhinitis (AR) is a chronic inflammatory disease mediated by immunoglobulin E and characterized by type I hypersensitivity, with typical symptoms including nasal itching, congestion, sneezing, and rhinorrhea. Its prevalence is continuously increasing, and it is often accompanied by various complications, with limited therapeutic efficacy from modern medicine. Based on the "mysterious mansion-nasal collaterals" theory, this paper proposes that the core pathogenesis of pediatric AR lies in the dysfunction of the mysterious mansion (a collective term for the minute pathways and gates for dispersion and flowing of qi and fluid) and obstruction of the nasal collaterals. The pathogenesis evolution exhibits distinct stage-specific characteristics: in the acute stage, the invasion by exogenous pathogenic factors leads to disordered opening and closing of the mysterious mansion, resulting in malnourishment of the nasal collaterals; in the remission stage, dysfunction of the lung, spleen, and kidney causes loss of proper function of the mysterious mansion, leading to undernourishment of the nasal collaterals; in the protracted stage, prolonged illness enters the collaterals with intermingling of phlegm and stasis, resulting in stagnation and closure of the mysterious mansion. Accordingly, the general therapeutic principle of "opening the mysterious mansion and unblocking the collaterals" is proposed, with stage-based treatment: in the acute stage, wind-dispelling herbs with pungent flavor and dispersing action are used to open the orifices, open the mysterious mansion and unblock the collaterals, and expel pathogenic factors outward; in the remission stage, the approach of strengthening the spleen, benefiting the lung, and warming the kidney is applied, so as to nourish the collaterals and open the mysterious mansion through a combination of unblocking and tonifying; in the protracted stage, attention is paid to resolving phlegm, unblocking the collaterals, eliminating blood stasis, and opening the mysterious mansion. Exploring pediatric AR from the perspective of the "mysterious mansion-nasal collaterals" theory reveals the dynamic evolution of the disease, aiming to provide a new pattern differentiation approach and practical guidance for the TCM treatment of pediatric AR. |
| Key words: pediatric allergic rhinitis mysterious mansion nasal collaterals pattern differentiation approach stage-based treatment opening mysterious mansion and unblocking collaterals |
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