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李臻怡, 唐凌, 方泓.吴银根治疗老年持续性变应性鼻炎的经验[J].湖南中医药大学学报,2026,46(9):1948-1952[点击复制] |
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| 吴银根治疗老年持续性变应性鼻炎的经验 |
| 李臻怡,唐凌,方泓 |
| (上海中医药大学附属龙华医院, 上海 200032) |
| 摘要: |
| 吴银根教授认为，老年持续性变应性鼻炎（AR）以肺肾阳虚、卫外不固为根本原因，以伏痰阻肺为核心病机，以风寒外袭为发病诱因，形成虚实夹杂的病理状态。治疗上强调标本兼顾、表里合治。发作期以祛风散寒、化痰通窍为主，常用咳喘落（麻黄附子细辛汤化裁）合苍耳子散加减，注重辛温宣散以祛邪外出；缓解期以温补肺肾、益气固表为要，善用玉屏风散固护卫表，并以二仙汤（淫羊藿、巴戟天）配伍葫芦巴、山茱萸等温补肾阳、填精益髓，且主张温阳培元之治贯穿疾病全程。临床用药擅将通窍药苍耳子、辛夷、白芷、紫苏叶等合用，并灵活化裁经方，稳定期配合膏方冬病夏治以巩固疗效，充分体现“既病防变”之防治理念。并附验案一则，为临床治疗老年持续性AR提供参考。 |
| 关键词: 持续性变应性鼻炎|鼻鼽|老年|中医经验|吴银根 |
| DOI：10.3969/j.issn.1674-070X.2026.09.029 |
| 投稿时间：2026-03-07 |
| 基金项目:吴银根上海市名中医工作室基层工作站(JCGZZ2023076);中医治未病专科联盟建设项目(2024LM01);上海市科学技术委员会中药配方颗粒生产工艺和全新产业链智能控制体系建设项目[沪科合(2020)18号]。 |
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| WU Yingen's experience in treating persistent allergic rhinitis in the elderly |
| LI Zhenyi, TANG Ling, FANG Hong |
| (Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China) |
| Abstract: |
| Professor WU Yingen holds that persistent allergic rhinitis (AR) in the elderly is fundamentally caused by the deficiency of the lung and insecurity of the defensive exterior, with lurking phlegm obstructing the lung as the core pathogenesis and exogenous wind-cold attack as the triggering factor, thus forming a pathological state of intermingled deficiency and excess. In treatment, he emphasizes addressing both the manifestations and the root and treating the exterior and interior simultaneously. During the acute stage, the main approach is to dispel wind and dissipate cold, resolve phlegm, and unblock the orifices, commonly using Kechuanluo (a modified Mahuang Fuzi Xixin Decoction) combined with modified Cangerzi Powder, with attention to diffusing and dispersing with pungent-warm-natured medicines to expel pathogenic factors outward; during the remission stage, the key is to warmly supplement the lung and kidney and tonify qi to secure the exterior, skillfully using Yupingfeng Powder to protect and secure the defensive exterior, and employing Erxian Decoction [Yinyanghuo (Epimedii Folium) and Bajitian (Morindae Officinalis Radix)] combined with Huluba (Trigonellae Semen), Shanzhuyu (Corni Fructus), etc., to warmly supplement kidney yang and replenish essence and marrow, and he advocates that the treatment of warming yang and nourishing the Yuan-primordial qi should run through the entire course of the disease. In clinical medication, he is skilled at combining orifice-unblocking drugs such as Cangerzi (Xanthii Fructus), Xinyi (Magnoliae Flos), Baizhi (Angelicae Dahuricae Radix), and Zisuye (Perillae Folium), and flexibly modifies classical formulas; during the stable stage, he combines paste formulas with the treatment of winter diseases in summer to consolidate therapeutic effects, fully embodying the preventive and therapeutic concept of "preventing transmission of a disease after its onset." A verified medical record is also attached to provide reference for the clinical treatment of persistent AR in the elderly. |
| Key words: persistent allergic rhinitis|allergic rhinitis|the elderly|TCM experience|WU Yingen |
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