中医 “温阳法” 治疗难治性哮喘的临床研究进展
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摘要
支气管哮喘是全球第二大呼吸慢病（患者超过4570万）。难治性哮喘是指经规范西医治疗后仍然未能控制的哮喘患者，是临床难题之一。中医学认为：难治性哮喘以“病程日久、反复发作致阳虚寒凝、痰饮不化”为主要特征，以“阳虚痰阻”为核心病机，累及肺脾肾三脏，以“温阳化饮”为基本治法。“温阳法”思想最早见于《黄帝内经》，张仲景《伤寒论》首次提出“病痰饮者，当以温药和之”，创立小青龙汤、射干麻黄汤、苓甘五味姜辛汤等众多经典方剂，初步形成“温阳法”治哮的理论体系，后经历代医家不断发展完善。众多学者开展“温阳法”治疗哮喘的临床研究，发现：“温阳法”联合西药可更好提高哮喘临床控制率、改善临床症状、改善肺功能指标、减少急性发作和提高生活质量，并针对其潜在机制开展探索性研究；但目前 “温阳法”治疗哮喘的效应机制和物质基础仍然不清楚。未来亟待借助多学科交叉技术精准阐释“温阳法”治疗哮喘的科学内涵，不断丰富完善中医温阳法治疗哮喘的理论体系，为难治性哮喘患者提供有效的中医药治疗方案。
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