ObjectiveTo investigate the mechanism of the Qufengxuanfei Decoction (QFXFD) in improving airway neurogenic inflammation in chronic cough through network pharmacology and animal experiments.MethodsThe active components and potential targets of QFXFD were identified using the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP). Disease-related targets associated with chronic cough were retrieved from the GeneCards, OMIM, and TTD. The intersection of drug targets and disease targets was determined, and a “TCM–bioactive compounds–intersection targets” network was constructed using Cytoscape software. Protein–protein interaction (PPI) analysis of the intersecting targets was performed via the STRING database to identify core genes. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were subsequently conducted. Molecular docking was performed using AutoDock and related tools to validate the interactions between key active compounds and core targets. A guinea pig model of heightened cough sensitivity was established, followed by intervention with QFXFD. Cough frequency, differential cell counts in bronchoalveolar lavage fluid (BALF), and histopathological changes in lung tissue were evaluated. In addition, the expression levels of PLC-β, PKC, TRPA1, TRPV1, and SP/NK-1R in lung tissues were assessed.ResultsThe key bioactive constituents of QFXFD responsible for alleviating airway neurogenic inflammation in chronic cough were identified as quercetin, β-sitosterol, luteolin, kaempferol, stigmasterol, and tanshinone IIA. A total of 207 intersecting targets between QFXFD and chronic cough were identified, with core targets including TP53, AKT1, IL6, MAPK1, MAPK3, TNF, BCL2, CASP3, ESR1, CCND1, HSP90AA1, and MYC. These shared targets were significantly enriched in 838 biological processe (BP), 188 molecular function (MF), 104 cellular component (CC), and 179 KEGG pathways. Molecular docking analyses demonstrated favorable binding affinities between tanshinone IIA and TP53, luteolin and TP53, kaempferol and TNF, as well as quercetin and TNF. Animal experiments showed that the QFXFD could significantly improve the peripheral cough hypersensitivity state of guinea pigs with increased cough sensitivity, reduce the frequency of cough, decrease the proportion of neutrophils and eosinophils in BALF, improve the pathological damage of lung tissue, and also reduce the expression levels of PLC-β, PKC, TRPA1, TRPV1, and SP/NK-1R.ConclusionQFXFD exerts its therapeutic effects through a multi-component, multi-target, and multi-pathway mechanism. Its diverse active constituents modulate a variety of signaling pathways and regulate key biological processes related to inflammation and immune responses, thereby contributing to the improvement of airway neurogenic inflammation and airway hyperresponsiveness. These findings provide a valuable theoretical and experimental basis for the clinical application and further development of QFXFD as a potential therapeutic strategy for chronic cough.

Objective To investigate the therapeutic effects and mechanisms of Qufeng Xuanfei Formula in guinea pigs with cough hypersensitivity induced by neurogenic inflammation. Methods According to the random number table method, 30 guinea pigs were randomly divided into the blank group, model group, Qufeng Xuanfei Formula group, pregabalin group, and voltage-gated sodium channel (Nav) 1.7 inhibitor group, with 6 animals per group. Except the blank group, the guinea pigs of the other groups were immunocompromised by intraperitoneal injection of cyclophosphamide (3u00D710-2 g/kg); 2 days later, they were sensitized by intraperitoneal injection of 1 mL normal saline containing 2 mg ovalbumin and 100 mg aluminum hydroxide; 3 weeks later, they received booster sensitization by intraperitoneal injection of 1 mL normal saline containing 0.01 mg ovalbumin and 100 mg aluminum hydroxide. The blank group was injected intraperitoneally with the same volume of normal saline. Three weeks after booster sensitization, 1% ovalbumin solution was administered by aerosol inhalation for challenge. Successful modeling was defined as cough frequency u226510 times within 3 minutes after challenge and was accompanied by typical coughing behaviors. After successful modeling, the Qufeng Xuanfei Formula group was given Qufeng Xuanfei Formula (5 g/kg) by gavage; the blank group and model group were given an equal volume of normal saline by gavage; the pregabalin group was given pregabalin solution (3u00D710-2 g/kg) by gavage; the Nav1.7 inhibitor group received aerosol inhalation of Nav1.7 inhibitor PF-05089771 solution (100 u03BCmol/L) for 20 minutes each time; all interventions were administered once daily for 7 days. The general condition of guinea pigs was observed. Cough frequency was measured by capsaicin aerosol stimulation. Serum levels of interleukin (IL)-4, IL-6, IL-1u03B2, and tumor necrosis factor-u03B1 (TNF-u03B1) were detected by enzyme-linked immunosorbent assay. The mRNA expressions of Nav1.7, substance P (SP), and nuclear factor-u03BAB (NF-u03BAB) p65 in the dorsal root ganglia were detected by real-time PCR. The protein expressions of Nav1.7, SP, NF-u03BAB p65, and phosphorylated NF-u03BAB p65 (p-NF-u03BAB p65) in the dorsal root ganglia were detected by western blotting. Results Compared with the blank group, guinea pigs in the model group exhibited typical behavioral characteristics including increased respiratory rate, frequent coughing, obvious abdominal muscle contraction, forelimb extension, neck extension, and open-mouth breathing. Their general condition was poor, manifested as reduced food and water intake, decreased activity, preference for curling up, listless mental state, and fluffy coat. After capsaicin stimulation, cough frequency increased, serum levels of IL-4, IL-6, IL-1u03B2, and TNF-u03B1 increased, and the mRNA expressions of Nav1.7, SP, and NF-u03BAB p65 in dorsal root ganglia, as well as the protein expressions of Nav1.7, SP, p-NF-u03BAB p65, and p-NF-u03BAB p65/NF-u03BAB p65 were all elevated (Pu0026lt;0.05). Compared with the model group, guinea pigs in each treatment group showed decreased spontaneous cough frequency over time, gradual recovery of food and water intake, increased activity, improved mental state, and gradually lustrous coat. Cough frequency induced by capsaicin decreased, serum levels of IL-4, IL-6, IL-1u03B2, and TNF-u03B1 decreased, and in the Qufeng Xuanfei Formula group and Nav1.7 inhibitor group, the mRNA expressions of Nav1.7, SP, and NF-u03BAB p65 in the dorsal root ganglia, as well as the protein expressions of Nav1.7, SP, p-NF-u03BAB p65, and p-NF-u03BAB p65/NF-u03BAB p65 were all decreased (Pu0026lt;0.05). Conclusion Qufeng Xuanfei Formula can effectively alleviate cough symptoms in guinea pigs with cough hypersensitivity. Its mechanism may involve inhibiting the activity of the NF-u03BAB signaling pathway in the dorsal root ganglia, thereby down-regulating Nav1.7 expression and alleviating neurogenic inflammation.

[This corrects the article DOI: 10.3389/fmed.2026.1748916.].

Objective To explore pattern distribution characteristics of chronic cough.Methods A total of 771 chronic cough patients were included. A clinical questionnaire for TCM syndromes of chronic cough designed by us was used to collect four TCM diagnostic information, including TCM symptoms, signs, tongue and pulse. SPSS 22.0 was used for frequency statistical analysis. Pathological factors, positional factors and syndrome distribution characteristics of chronic cough patients were discussed based on the exploratory factor analysis.Results Thirty six variables with frequency＞8% were selected from 76 information variables of four diagnostic information, then factor analysis was conducted as observation indexes of four diagnostic information.The KMO value was 0.620（＞0.5） and Bartlett ball type test result was F =630, P ＜0.001, indicating it was suitable for factor analysis. A total of 12 common factors with initial eigenvalue ＞ 1 were extracted. The cumulative contribution rate was 59.368%. The common factor scores of 771 cases were calculated by the regression method. Pathological factors of 771 chronic cough patients were wind（77.43%）, dampness-heat（62.13%）, phlegm dampness（35.15%）, Yang deficiency（29.31%）, cold rheum（26.98%） and Yin deficiency（11.41%）. Positional factors were the lung（88.98%）, spleen（79.77%）, stomach（39.43%） and kidney（30.35%）. Syndrome distribution characteristics of 771 chronic cough patients were wind hidden in the lung pattern（71.85%）, dampness heat retained in the lung pattern（47.86%）, phlegm dampness blocking the lung pattern（25.42%）, cold fluid hidden in the lung pattern（21.14%）, the lung and spleen Yang deficiency pattern（10.89%） and lung Yin deficiency pattern（0.91%）.Conclusion The most common traditional Chinese medicine pattern type of chronic cough is wind hidden in the lung pattern, followed by dampness heat blocking the lung pattern, phlegm dampness blocking the lung pattern, cold rheum hidden in the lung pattern, the lung and spleen Yang deficiency pattern and the lung Yin deficiency pattern. Each pattern can exist alone, but also often coexist with each other. The characteristics of the chronic cough pattern reflect the complicated etiology and pathogenesis of chronic cough. The common pathogenesis of chronic cough is wind hidden in the lung. Pathogenesis characteristics of chronic cough include combination of internal and external pathogenic factors, viscera and bowels interrelated, mixed deficiency and excess. The chronic cough is characterized by a long course of disease, relapsed attacks, protracted and difficult to cure.

什么是痰证 "痰证"是中医原创的概念."痰"大家都很熟悉,但在中医里,"痰"的概念更为广泛,它是津、液因气化功能失常在人体内逐渐积聚形成的产物,而"痰证"是体内水液输布、运化失常,停积于某些部位的一类病证.

This work aimed to clarify the potential regulating effects of Qufeng Xuanfei formula (QFXF) on airway neurogenic inflammation and its underlying target signal pathway. Guinea pig model of airway hyperergy (AHR) was used. The relative susceptibility of major proteins to airway neurogenic inflammation was assessed using Western blot immunoassay followed by being separated by SDS-PAGE. Compared to the model group, QFXF of all concentrations effectively depressed the capsaicin enhanced cough in guinea pigs and the peak values of airway resistance significantly decreased. The results illustrated that QFXF alleviated cough symptom in guinea pigs and reduced airway neurogenic inflammation when compared to AHR model group. Airway inflammation and damage, as well as the levels of NGF, SP and c-Fos in QFXF decreased the most in the high-dose group. The mechanism of antitussive activity may be associated with reducing airway inflammation. QFXF displayed effect on chronic cough through reducing the levels of neuropeptides, attenuating airway inflammation and promoting recovery from disease to decrease the airway neuro sensitivity, suggesting that the potential mechanism may be related to Ras/ERK/c-Fos pathway.

咳嗽为临床上常见症状,近年胸部影像无明显异常的慢性咳嗽发病率升高,其病因复杂,误诊误治率高,受到重视.目前研究认为咳嗽高敏感性是其重要的临床与病理生理学特征,与瞬时受体电位通路激活、气道炎症、神经通路及咳嗽中枢的易化等相关,然而其机制复杂,仍需深入研究.咳嗽机制的研究对于新药物的开发、临床疗效的提高、社会经济负担减轻等方面有着重要意义.而咳嗽动物模型对于咳嗽实验研究开展以及其机制阐明具有至关重要的作用,目前咳嗽动物模型分为单纯咳嗽模型和疾病咳嗽模型,但因为咳嗽发病机制复杂,病因较多,尚无统一的咳嗽模型制备标准,且仍处于不断的补充与完善之中.针对咳嗽动物模型建立的机制方法和研究进展,通过查阅和整理近年来国内外的相关文献,从模型动物的选择、单纯及疾病咳嗽动物模型的建立和应用等方面综合概述该类模型的研究现状,并进行比较评价,对当前咳嗽模型制备中的问题进行了思考与阐述,以期为实验研究中制备咳嗽动物模型、深入研究咳嗽的发病机制、治疗方法等提供参考.

创新临床教学方法、提高教学效果是教学医院临床科室落实国家"深化医教协同"新要求的重要举措,有助于中医临床人才的培养.中医临床型研究生是未来建设祖国中医药事业的高级人才,他们需要掌握扎实的中西医理论知识,具备清晰的中西医诊疗思维等专业能力以及良好的医患沟通、团队合作等非专业能力,而中医临床教学是培养以上能力的关键环节.单一的教学模式不能解决中医临床教学的诸多问题,因此文章基于线上线下教学模式,探索具有中医特色的混合式临床教学模式,以期对临床教学改革有借鉴意义.

目的 基于肺脾同治法探讨四君子汤合三子养亲汤改善慢性阻塞性肺疾病(COPD)小鼠气道黏液高分泌的作用机制.方法 将40只C57BL/6N雄性小鼠随机分为空白组、模型组、西药组(盐酸氨溴索)、中药组(四君子汤合三子养亲汤),每组10只,采用烟熏联合脂多糖的方法建立COPD小鼠模型.酶联免疫吸附测定法检测血清中白细胞介素-4(IL-4)、白细胞介素-8(IL-8)、白细胞介素-13(IL-13)水平;HE染色观察肺组织病理学变化;蛋白免疫印迹法检测肺组织STAT6、SPDEF、FOXA2蛋白表达水平;实时荧光定量聚合酶链式反应检测肺组织STAT6、Muc5ac mRNA水平.结果 与空白组比较,模型组血清中IL-4、IL-8、IL-13水平,肺组织STAT6、SPDEF蛋白表达水平,STAT6、Muc5ac mRNA显著升高(P＜0.01);FOXA2蛋白表达水平显著下降(P＜0.01).与模型组比较,中药组血清中IL-4、IL-8、IL-13和西药组血清中IL-4、IL-13水平明显下降(P＜0.05或P＜0.01),西药组血清中IL-8水平下降不明显(P＞0.05);与模型组比较,用药组STAT6、SPDEF蛋白表达水平,STAT6、Muc5ac mRNA较模型组显著下降(P＜0.01),FOXA2蛋白表达水平升高(P＜0.01).结论 四君子汤合三子养亲汤可能通过抑制STAT6-SPDEF-MUC5AC信号通路的活性改善COPD小鼠气道黏液高分泌.

Objective:To observe the effects of Qufeng Xuanfei recipe on cough frequency, airway responsiveness, and related indexes of transient receptor potential vanilloid 4 (TRPV4)/P2X3 signal pathway in guinea pigs with increased cough sensitivity, and to explore its therapeutic mechanism.Methods:This was an experimental study.Using the random number table method, 25 SPF male healthy guinea pigs were randomly divided into blank group, model group, traditional Chinese medicine group, TRPV4 inhibitor group, and P2X3 inhibitor group, with five animals in each group.Except for the blank group, a guinea pig model with increased cough sensitivity was established in other four groups.After successful modeling, the blank and model groups were given normal saline, the traditional Chinese medicine group was given Qufeng Xuanfei Recipe, and the TRPV4 inhibitor group and P2X3 inhibitor group were given GSK2193874 and AF-353, respectively, for 7 days of intervention.The TRPV4 agonist GSK1016790A was used to measure the number of coughs of guinea pigs in each group.Pulmonary function test was used to detect airway resistance in guinea pigs.The expression levels of serum IL-6, IL-8, IL-1β, and TRPV4, P2X3 and SP in bronchoalveolar lavage fluid (BALF) were detected by ELISA, and the protein expressions of TRPV4, P2X3, and SP in lung tissue were detected by Western Blot.Results:Compared with the blank group, the number of coughs ([4.00±0.82] times vs [14.75±2.22] times, P<0.01), airway resistance (acetylcholine chloride: concentration of 400 mg/L [2.32±1.07] cmH 2O·s/L vs [6.50±2.03] cmH 2O·s/L, 800 mg/L[2.88±0.86] cmH 2O·s/L vs [9.47±3.52] cmH 2O·s/L), serum inflammatory factors (IL-6, IL-8, IL-1β: [16.32±0.17] ng/L vs [24.49±0.19] ng/L, [33.48±1.36] ng/L vs [59.33±2.15] ng/L, [10.71±1.22] ng/L vs [38.79±2.22] ng/L respectively), and the expressions of TRPV4, P2X3, and SP in BALF ([46.14±0.35] μg/L vs [91.62±0.25] μg/L, [78.37±0.35] μg/L vs [156.62±0.25] μg/L, [38.20±1.75] μg/L vs [79.84±2.45] μg/L respectively) and lung tissue ([0.34±0.01] vs [1.09±0.12], [0.28±0.09] vs [0.77±0.18], [0.26±0.04] vs [0.87±0.09] respectively) were all increased ( P<0.01) in the model group.Compared with the model group, the number of coughs ([2.00±0.82] times), airway resistance (acetylcholine chloride: concentration of 400 mg/L [4.01±0.43] cmH 2O·s/L, 800 mg/L [3.77±0.73] cmH 2O·s/L), serum inflammatory factors (IL-6, IL-8, IL-1β: [18.94±0.43] ng/L, [36.42±1.60] ng/L, [25.20±3.22] ng/L respectively), and the expressions of TRPV4, P2X3, and SP in BALF ([82.24±0.33] μg/L, [141.09±0.88] μg/L, [59.74±2.75] μg/L respectively) and lung tissue ([0.45±0.02], [0.38±0.09], [0.47±0.05] respectively) were reduced ( P<0.05 or P<0.01) in traditional Chinese medicine group. Conclusions:Qufeng Xuanfei Recipe can reduce cough sensitivity and airway responsiveness of model guinea pigs, which may be related to inhibiting TRPV4/P2X3 signaling pathway and reducing neurogenic airway inflammation.

目的 基于真实世界临床数据,探讨感染后咳嗽(PIC)湿热郁肺证临床特点及中医辨证规律.方法 选取2009年1月-2021年12月北京中医药大学东方医院呼吸热病科PIC患者病案661份,筛选、合并后共收集243例患者一般资料、病史资料、中医四诊等信息,分析湿热郁肺证患者性别及年龄特征、发病特点及中医证候特征,并对高频症状、药物进行系统聚类分析.结果 243例PIC患者中湿热郁肺证155例(63.79%);男女比例1∶2.04;平均发病年龄(52.12±14.26)岁;性别与年龄分布差异无统计学意义(P= 0.074),不同年龄组性别分布经两两比较差异有统计学意义(P=0.033),其中青年组男性多见,老年组女性多见.发病季节以秋、冬为主;感冒为最常见病因(76.13%);咳嗽程度以轻度为主(65.16%),中度次之(28.39%);痰量以少痰最多(62.58%);痰色以白痰最多(54.84%);咽喉部症状以咽痒最常见(66.45%);口味情况以口苦最常见(32.90%),口黏腻次之(29.68%).常见中医症状及舌脉为咳嗽、咽痒、口干、少痰、痰白、阵咳、口苦、口黏腻、口渴欲饮、饮不解渴,舌红、苔黄腻,脉滑、脉弦滑;系统聚类得到5个关联组合,其中以肺系症状及中焦湿热症状为主要表现.处方共涉及中药103种,使用频率>10%的药物经系统聚类可分为化痰止咳药、清热利湿药、健脾化湿药3类.结论 湿热郁肺证在PIC临床辨证中多见,临床表现多见肺系症状及中焦湿热症状.

总结史利卿运用温阳化湿通络法治疗特发性肺纤维化(IPF)经验.史利卿认为阳虚寒凝为IPF发病的病机关键.湿热、血瘀是主要病理要素,贯穿IPF疾病各个阶段.病位在肺、肺络,兼及脾、肾等多个脏腑.病性本虚标实,因虚致实,因实致虚,虚实夹杂、寒热错杂,相兼共存,互为影响,故预后不佳.史利卿主张临证以温阳化湿通络为治疗大法,注重标本兼顾、寒温并用、补泻兼施、肺脾肾多脏同调.通络之法不限于活血通络,尤为注重开宣肺气、温通阳气以通络开痹,补而不滞,宣通肺络,清化湿热,疗效显著.

沈金鳌是清代著名医家,其代表作《杂病源流犀烛》设咳嗽专篇,汇诸家之言法古而创新.本文总结了沈金鳌对于咳嗽病因病机、临证辨治、选方用药的认识以及咳嗽病脉等.在病因病机上,外感咳嗽以风、寒、暑热、湿邪为主,强调湿邪,内伤咳嗽重视肺脾肾的联系.在治疗上,首以顺气消痰为要法,辛温散表,甘润养内.新咳实则泻之,久咳以虚为主从气血从论治,分别以补中益气汤及四物汤加减,以郁为主从火从痰论治,重视桔梗的使用.治疗五脏咳选用归经药,治疗六腑咳选引上引下药使得升降相应.协调肺脾肾,重视补水培土以养金.细分发病时间,选方多用二陈汤加减.同时重视脉诊,并创造性地使导引运功与药物治疗相辅相成.

目的 通过真实世界研究方法评价祛痹化纤方治疗特发性肺间质纤维化(IPF)的临床疗效.方法 选取2013年1月1日—2020年12月31日在北京中医药大学东方医院呼吸科就诊的气阴两虚、痰瘀互结证的IPF患者,根据是否使用祛痹化纤方分为试验组230例和对照组87例.通过倾向性评分匹配(PSM)平衡基线特征后,对两组患者进行疗效评价.结果 经PSM分析后,共82对患者匹配成功.匹配后,两组在基线特征方面差异均无统计学意义.疗效评价:①治疗后,试验组胸部CT积分、一氧化碳弥散量(DLCO)、6 min步行距离(6MWD)较治疗前均有明显变化(P＜0.05),试验组明显优于对照组(P＜0.001);②治疗后,试验组中医证候评分较治疗前无明显变化(P＞0.05),试验组明显低于对照组(P＜0.001).结论 祛痹化纤方可减轻IPF患者的中医临床症状,延缓肺功能恶化程度,提高活动耐力,值得临床推广和应用.

难治性慢性咳嗽(chronic refractory cough,CRC)是经过全面检查仍无法明确病因,或经过常规治疗后仍无明显缓解的咳嗽,其发病率在5％～12％,严重影响患者的生活质量.目前对CRC的研究尚在探索阶段,缺少专业、深入、系统的认识.关于发病机制,目前认为咳嗽高敏感性是CRC的关键特征和重要病理生理基础,与气道炎症反应、咳嗽中枢敏化、TRP通路激活有关;关于治疗,目前主要集中在药物治疗和非药物治疗两个方面,药物治疗主要包括中枢神经调节剂、受体拮抗剂以及大环内酯类抗生素、异丙托溴铵等,非药物治疗手段主要由言语病理治疗(speech pathology treatment,SPT)及咳嗽抑制性生理治疗构成.该文对CRC发病机制及治疗的研究进展进行了总结,旨在为CRC的防治和相关研究提供参考.

上气道咳嗽综合征/鼻后滴流综合征是慢性咳嗽常见病因之一,鼻炎、鼻窦炎等是其主要原因.西医治疗本病不良反应较多,且复发率相对较高.中医治疗本病源流悠久,临床效果较好,且副作用相对较少.结合中医古籍文献、古今医家理论及课题组经验,提出以"鼻咳"来命名上气道咳嗽综合征/鼻后滴流综合征,认为本病病位主要在鼻、肺,基本病机为鼻窍壅塞、肺失宣降,病性属虚实夹杂,基本治则为祛邪通窍、宣肺止咳,临床可视具体情况辨证论治.

胃食管反流性咳嗽(GERC)是慢性咳嗽的常见病因之一,近年来发现GERC的比例较高,长期使用抑酸剂会造成一定的不良反应且对难治性GERC的效果较差,反复发作的咳嗽严重影响患者的生活质量.GERC发病机制尚未完全明确,感觉神经贯穿GERC的多个环节.外周与中枢神经敏化之间相互作用,可能放大了炎症效应,触发机体的咳嗽冲动.瞬时受体电位离子通道作为感觉神经纤维的重要通道蛋白,参与、介导神经纤维信号的形成与传导,能够加强外周与中枢神经之间的联系,可能是GERC的重要发病机制.因此,基于外周与中枢神经敏化对GERC发病机制的进一步探究可能为其治疗提供新思路.

This study aimed to conduct a meta-analysis to investigate whether short-term exposure to fine (PM2.5) and coarse (PM10) particulate matter was associated with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) hospitalization, emergency room visit, and outpatient visit at different lag values. PubMed, Embase, and the Cochrane Library were searched for relevant papers published up to March 2021. For studies reporting results per 1-mu g/m(3) increase in PM2.5, the results were recalculated as per 10-mu g/m(3) increase. We manually calculated the RRs for these two studies and transferred the RRs to estimate 10 mu g/m(3) increases in PM2.5. Automation tools were initially used to remove ineligible studies. Two reviewers independently screened the remaining records and retrieved reports. Twenty-six studies (28 datasets; 7,018,419 patients) were included. There was a significant association between PM2.5 and AECOPD events on lag0 (ES = 1.01, 95%CI: 1.01-1.02, p < 0.001; I-2=88.6%, P-heterogeneity<0.001), lag1 (ES = 1.00, 95%CI: 1.00-1.01, p < 0.001; I-2=82.5%, P-heterogeneity<0.001), lag2 (ES = 1.01, 95%CI: 1.01-1.01, p < 0.001; I-2=90.6%, P-heterogeneity<0.001), lag3 (ES = 1.01, 95%CI: 1.00-1.01, p < 0.001; I-2=88.9%, P-heterogeneity<0.001), lag4 (ES = 1.00, 95%CI: 1.00-1.01, p < 0.001; I-2=83.7%, P-heterogeneity<0.001), and lag7 (ES = 1.00, 95%CI: 1.00-1.00, p < 0.001; I-2=0.0%, P-heterogeneity=0.743). The subgroup analyses showed that PM2.5 influenced the rates of hospitalization, emergency room visits, and outpatient visits. Similar trends were observed with PM10. The risk of AECOPD events (hospitalization, emergency room visit, and outpatient visit) was significantly increased with a 10-mu g/m(3) increment in PM2.5 and PM10 from lag0 to lag7.

难治性慢性咳嗽(CRC)是经过全面检查仍无法明确病因,或经过常规治疗后咳嗽仍无明显缓解的咳嗽,越来越成为临床亟待解决的棘手问题.CRC在中医学系统中暂无特定命名,但根据其迁延难治特点可命名为"顽咳".纵观中医历史源流,"顽咳"相关的论治可散见于中医临床理论与实践过程中,但缺乏较为系统的梳理.本文以"多维度"作为切入点,分别从病因、病性、病位、证候不同方面去理解CRC的病机,并对其辨治思路进行总结,认为CRC属于虚实夹杂、寒热错杂的疾病,病位在肺,病机与脏腑密切相关,以"肺脾相关"尤为重要,风邪伏肺是其基本病机,也是贯穿该病发生发展始终的核心病机.在治法用药方面以祛风宣肺为主,重点关注肺脾两脏,结合辨证予清热化湿、健脾温肺化饮、除湿化痰,同时也注意疏肝调木法的运用,随证灵活加减,圆机活法.