咳嗽思維辨臟腑，中醫並非粗線條
在生活的喧囂裏，咳嗽聲常常不經意間響起。它或許只是偶爾的輕咳，宛如微風拂過枝頭；又或許是一連串劇烈的咳聲，似驚雷炸響，打破平靜。你可曾想過，這看似平常的咳嗽，背後竟隱藏着五臟六腑的微妙變化？“五臟皆令人咳”，中醫這一古老而深刻的論斷，如同一把精準的鑰匙，爲我們打開了探索咳嗽奧祕的大門，也讓我們領略到中醫思維的細緻入微與精妙絕倫。
咳嗽聲聲，臟腑有別
肺，主氣司呼吸，爲華蓋之髒，居於胸腔，覆蓋諸髒。當肺臟受邪，宣發肅降功能失常，便引發“肺咳”。此時，咳嗽聲聲，喘息間伴有明顯聲響，嚴重時甚至唾血。想象一下，一位長期在粉塵環境中工作的工人，每日吸入大量有害顆粒，肺臟不堪重負，逐漸出現咳嗽、氣喘，嚴重時痰中帶血，這便是肺咳的典型表現。據相關統計，在工業污染較爲嚴重的地區，因肺部疾病引發咳嗽的患者比例顯著升高，這充分說明了外界環境對肺臟的影響，以及肺咳在特定人羣中的高發性。
心，爲君主之官，主血脈，藏神明。心咳之時，咳則心痛，喉中介介如梗狀，彷彿有異物卡在喉嚨，嚴重時咽喉腫痛。曾有一位中年職場人士，長期處於高壓狀態，精神高度緊張。一段時間後，他開始頻繁咳嗽，且每次咳嗽都伴隨着心前區疼痛，喉嚨也總感覺有東西堵着，經中醫診斷爲心咳。這便是情志因素影響心臟，進而導致咳嗽的生動案例。現代醫學研究也發現，長期的精神壓力與心血管疾病的發生密切相關，而心咳正是這種內在聯繫在咳嗽這一症狀上的體現。
肝，主疏泄，調暢氣機，喜條達而惡抑鬱。肝咳發作，一咳嗽兩側肋骨部便疼痛難忍，甚至不敢轉身，一轉身則兩肋脹滿。比如，一位性格內向、長期情緒壓抑的女性，在一次與家人爭吵後，突然出現咳嗽症狀，且每次咳嗽都伴有兩肋疼痛，活動受限。這正是肝氣鬱結，氣機不暢，影響肝臟正常功能，引發肝咳的表現。有調查顯示，在情緒波動較大的人羣中，肝咳的發病率明顯高於情緒穩定者，這進一步證明了情志與肝咳之間的緊密聯繫。
脾，主運化，爲後天之本，氣血生化之源。脾咳時，咳嗽會引發右肋下痛，牽引肩背疼痛，患者甚至不敢稍動，動則咳嗽加劇。一位農民，在農忙時節過度勞累，飲食又不規律，一段時間後出現咳嗽症狀，且伴有右肋下及肩背疼痛，活動時疼痛和咳嗽加重。這就是典型的脾咳，因過度勞累損傷脾氣，導致脾失健運，痰溼內生，上犯於肺而引發咳嗽。相關統計表明，在體力勞動者中，由於長期勞累和飲食不節，脾咳的患病率不容小覷。
腎，主藏精，主水液，爲先天之本。腎咳發作，咳嗽時腰背相引而痛，嚴重時咳吐涎沫。一位老年人，身體虛弱，腎氣不足，每到冬季，咳嗽便頻繁發作，且伴有腰背冷痛，咳吐清稀涎沫。這正是腎陽虛弱，不能溫化水液，水溼上泛，影響肺臟功能，導致腎咳。隨着人口老齡化的加劇，腎咳在老年人羣中的發病率呈上升趨勢，這提醒我們要重視老年人的腎臟健康，預防腎咳的發生。
除了五臟咳嗽，還有胃咳、膽咳、大腸咳、膀胱咳和三焦咳等。胃咳時，咳嗽伴有噁心、嘔吐；膽咳甚至會嘔吐膽汁；大腸咳一咳嗽就放屁；膀胱咳一咳嗽便出現尿失禁；三焦咳則表現爲咳嗽伴有脘腹脹滿、不思飲食。這些不同類型的咳嗽，都反映了相應臟腑功能的失調，充分體現了中醫對人體生理病理的深刻認識。
中醫思維，細緻入微
與西醫針對咳嗽症狀的對症治療不同，中醫強調整體觀念和辨證論治。中醫認爲，人體是一個有機的整體，五臟六腑相互關聯、相互影響。咳嗽不僅僅是肺臟的問題，而是五臟六腑功能失調的外在表現。因此，中醫在治療咳嗽時，會根據不同的病因病機，針對不同的臟腑進行調理。這種細緻入微的思維方式，使得中醫在治療咳嗽方面具有獨特的優勢。
以一位反覆咳嗽的患者爲例，西醫可能通過檢查診斷爲支氣管炎，給予抗生素和止咳藥物治療，但效果往往不盡如人意。而中醫通過詳細的問診、望診、聞診和切診，判斷患者屬於肝咳，採用疏肝理氣、止咳化痰的方劑進行治療，經過一段時間的調理，患者的咳嗽症狀明顯改善，且不易復發。這充分說明了中醫辨證論治的準確性和有效性，也體現了中醫思維的細緻和全面。
傳承中醫，守護健康
在現代社會，隨着生活節奏的加快和環境的變化，咳嗽的發病率越來越高，且病因更加複雜多樣。中醫作爲我國傳統醫學的瑰寶，其獨特的理論體系和治療方法在咳嗽的防治中發揮着重要作用。我們應該重視中醫，傳承和發揚中醫文化，讓更多的人瞭解和認識中醫的精妙之處。
同時，我們也要樹立正確的健康觀念，注重日常的養生保健。保持良好的生活習慣，合理飲食，適量運動，調節情志，避免過度勞累和情緒波動，從源頭上預防咳嗽的發生。當出現咳嗽症狀時，不要盲目自行用藥，應及時就醫，根據醫生的建議選擇合適的治療方法。
咳嗽聲聲，蘊含着五臟六腑的奧祕；中醫精微，彰顯着傳統文化的魅力。讓我們走進中醫的世界，探尋咳嗽的根源，感受中醫思維的細緻入微，用中醫的智慧守護我們的健康，讓生活充滿陽光和歡笑。
作者簡介：梁世傑 中醫高年資主治醫師，本科學歷，從事中醫臨牀工作24年，積累了較豐富的臨牀經驗。師從首都醫科大學附屬北京中醫院肝病科主任醫師、著名老中醫陳勇，侍診多載，深得器重，盡得真傳！擅用“商湯經方分類療法”、專病專方結合“焦樹德學術思想”“關幼波十綱辨證”學術思想治療疑難雜症爲特色。現任北京樹德堂中醫研究院研究員，北京中醫藥薪火傳承新3+3工程—焦樹德門人（陳勇）傳承工作站研究員，國際易聯易學與養生專委會常務理事，中國中醫藥研究促進會焦樹德學術傳承專業委員會委員，中國藥文化研究會中醫藥慢病防治分會首批癌症領域入庫專家。榮獲2020年中國中醫藥研究促進會仲景醫學分會舉辦的第八屆醫聖仲景南陽論壇“經方名醫”榮譽稱號。2023年首屆京津冀“扁鵲杯”燕趙醫學研究主題徵文優秀獎獲得者。事蹟入選《當代科學家》雜誌、《中華英才》雜誌。
Coughing and thinking discern the inner and outer parts of the body. Traditional Chinese Medicine is not a coarse line
In the hustle and bustle of life, the cough often sounds inadvertently. It may be just an occasional cough, like a breeze blowing through the branches; Or perhaps a series of violent coughs, like thunder, broke the peace. Have you ever thought that behind this seemingly ordinary cough is a subtle change in the inside of your gut? The ancient and profound claim of traditional Chinese medicine, "All the organs cause cough," is like a precise key that opens the door to exploring the mystery of cough, and also allows us to appreciate the meticulous and exquisite nature of traditional thinking.
The coughing sound is different from the inside.
The lung governing qi is the viscera of the body, which resides in the chest cavity and covers the viscera. When the lungs are poisoned and the lowering organs are malfunctioning, this can lead to a "pulmonary cough." At this time, there is a distinct noise between coughing, wheezing and, in severe cases, saliva. Imagine a worker who has been working in a dust environment for a long time, and who inhales a lot of harmful particles every day, the lungs are overwhelmed, and gradually develop cough, wheezing, and in severe cases, blood in the sputum, which is typical of lung cough. According to relevant statistics, in areas with more severe industrial pollution, the proportion of patients who develop cough due to lung disease has increased significantly, which fully illustrates the impact of the external environment on the lungs and the high prevalence of lung cough in specific populations.
The heart is the office of the king, the blood of the lord, and the repository of the gods. When the cough, cough is heartache, throat intermediate such as stalk-like, as if a foreign body stuck in the throat, serious swelling and pain in the throat. There was once a middle-aged professional who had been in a high-pressure state for a long time and was highly nervous. After a while, he began to cough frequently, and each cough was accompanied by pain in the pre-cardiac area, and he always felt something blocked in his throat, which was diagnosed as heart cough by traditional Chinese medicine. This is a vivid example of emotional factors affecting the heart and leading to coughing. Modern medical research has also found that long-term mental stress is closely related to the occurrence of cardiovascular disease, and heart cough is the embodiment of this intrinsic link in the symptom of cough.
The liver controlling conveyance and dispersion, regulating qi movement. A liver cough strikes. When coughing, both sides of the ribs become so painful that you don''t even dare turn, and when you turn, both sides swell. For example, an introverted, long-term emotionally depressed woman suddenly developed symptoms of cough after an argument with her family, and each cough was accompanied by abdominal pain and restricted movement. This is the stagnation of liver qi, qi, affect the normal liver function, cause the performance of liver cough. According to a survey, the incidence of a disease in the mood swings is significantly higher than those in the mood stability, which further proves the close relationship between mood and hepatic cough.
The spleen governing transportation and transformation is the foundation of the day after tomorrow. When a spleen cough occurs, the cough can cause pain in the lower right rib and cause shoulder and back pain. The patient is afraid to even move, and the cough worsens. One farmer, who was overworked during busy farming season and had an irregular diet, developed cough symptoms after a period of time, with pain in the lower right rib and shoulder and back, and the pain and cough worsened when he moved. This is a typical spleen cough, due to overwork damage to temper, resulting in dysfunction of spleen in transportation, phlegm-dampness, on the lung caused by cough. Relevant statistics show that in manual workers, due to long-term fatigue and improper diet, spleen cough sickness rate can not be underestimated.
The kidney, which holds sperm and water, is the innate basis. A kidney cough occurs, and when coughing there is pain in the back and lower back, and in severe cases coughs and drool. An elderly man, weak and without enough kidneys, had frequent cough attacks during the winter, with cold pain in the back and cold cough and thin saliva. This is precisely the case of weakened kidneys, which cannot warm the water, and the water becomes wet, which affects lung function and causes coughing of the kidneys. With the aggravation of the population, the incidence of a disease in the elderly population is on the rise, which reminds us to pay attention to the kidney of the elderly to prevent the occurrence of renal cough.
In addition to coughs on the five hearts, there are also coughs of the stomach, the gallbladder, the large intestine, the bladder and the triceral cough. When the stomach coughs, the cough is accompanied by nausea and vomiting; Biliary cough can even vomit bile; A cough in the large intestine makes a fart whenever you cough; A cough in the bladder leads to urinary incontinence. Treponemy cough is a cough accompanied by abdominal bloating and a lack of appetite for food. These different types of cough reflect the disorders of the corresponding organ function, fully reflecting the profound understanding of the physiological pathologies of the human body in TCM.
Traditional Chinese Medicine Thinking, nuanced in detail
Unlike Western medicine, which treats the symptoms of cough, traditional Chinese medicine emphasizes holistic concepts and dialectical treatment. According to traditional Chinese medicine, the human body is an organic whole, with the five organs and six hearts connected and affecting each other. A cough is not just a problem of the lungs, but an outward manifestation of dysfunction in the inner and outer organs. Therefore, when treating cough, traditional Chinese medicine will apply adjustments to different internal organs according to different causes and mechanisms. This nuanced way of thinking makes traditional Chinese medicine uniquely advantageous in treating cough.
In the case of a patient who had a repeated cough, Western medicine may have diagnosed bronchitis by examination and given antibiotics and cough medicine, but the results are often unsatisfactory. Traditional Chinese medicine, through detailed consultations, observations, smells and examinations, determined that the patient belonged to liver cough. The treatment was based on prescriptions for liver detoxification, cough cessation and spitting. After a period of conditioning, the patient''s cough symptoms improved significantly and were not easily relapsed. This fully demonstrates the accuracy and effectiveness of traditional Chinese dialectical treatment, and also reflects the meticulous and comprehensive nature of traditional thinking.
Traditional Chinese Medicine to Protect Health
In modern society, with the rapid pace of life and the changing circumstances, the incidence of a disease is getting higher and higher, and the causes are more complex and diverse. As a treasure of traditional Chinese medicine, traditional Chinese traditional medicine plays an important role in the prevention and treatment of cough. We should attach great importance to traditional Chinese medicine, carry forward and promote traditional Chinese culture, and let more people know and know the essence of traditional Chinese Medicine.
At the same time, we should also establish a correct concept of health and pay attention to daily health care. Maintain good lifestyle habits, eat properly, exercise in moderation, regulate mood, avoid overwork and mood swings, and prevent cough from occurring at the source. When cough symptoms appear, do not blindly use your own medication, see a doctor in time, and choose the appropriate treatment according to the doctor''s advice.
The sound of cough reveals the secrets of the insides; The subtlety of traditional Chinese medicine reveals the charm of traditional culture. Let us enter the world of traditional Chinese medicine, explore the roots of cough, feel the nuance of traditional thinking, protect our health with the wisdom of traditional medicine, and make life full of sunshine and laughter.
Author Bio: Liang Shijie is a senior medical practitioner in traditional Chinese medicine with an undergraduate degree. He has been engaged in traditional medicine clinical work for 24 years and has accumulated a wealth of clinical experience. Following Chen Yong, chief physician of liver disease at Beijing Traditional Medicine Hospital, affiliated with Capital Medical University, and renowned old Chinese medicine, he has been treated for many years and received great attention. He specializes in the treatment of difficult diseases using "conversational traditional therapy" and special treatments combined with the academic ideas of Jiao Shude and Guan Yubo''s ten-level diagnosis.He is currently a researcher at the Shude Tang TCM Research Institute in Beijing, a fellow at the new 3 + 3 project of traditional Chinese medicine flame inheritance in Beijing - a scholar at the inheritance workstation of Jiao Shude''s protégés (Chen Yong),He is a standing committee member of the International Expert Committee on E-learning and Health Care, a member of the Jiao Shude Academic Heritage Special Committee of the Chinese Association for the Advancement of Chinese Medicine Research, and the first cancer specialist to be included in the chapter of the Chinese Pharmaceutical Culture Research Association. Won the 2020 China Association for the Promotion of Traditional Chinese Medicine Zhongjing Medical Branch held the eighth session of the Medical Saint Zhongjing Nanyang Forum "Classic Prescription Famous Doctor" honorary title. The winner of the first Beijing-Tianjin-Hebei "Pingui Cup" Yanzhao Medical Research Essay Award in 2023. His work was featured in the journal Current Scientist and the journal Chinese Talent.
