反复呼吸道感染（RRTIs）是儿科常见病、难治病。郝宏文教授认为，中医药在防治儿童RRTIs 方面具有优势，提出脾 胃积滞为儿童RRTIs 最常见的诱因及加重因素；该病虽起于肺，但根本病位在脾胃；脾胃虚损，内有积热，外有表虚为儿童 RRTIs 缠绵反复的关键病机。临证治疗时分急性感染期与感染间歇期进行辨治，治疗全程注重顾护脾胃。急性感染期在常规 的疏风散热、宣肺止咳基础上，兼顾脾胃；感染缓解期则清解内热、扶正固表。急性感染期表现为上呼吸道感染者，治疗 主要采用荆防败毒散或银翘散加减为基础方；急性感染期表现为下呼吸道感染者，分初期、极期、后期进行论治，分别治 以麻杏石甘汤加减、黄连解毒汤合麻杏石甘汤加减、泻白散合沙参麦冬汤加减。感染间歇期分为4 个证型进行辨治：证属肺 胃蕴热、余邪未尽者，予升降散合保和丸加减；证属胃肠积热、表虚不固者，予保和丸合玉屏风散加减；证属肺脾气虚、 气虚不固者，予参苓白术散合玉屏风散加减；证属肝气不畅、肺脾不足者，予四逆散合六君子汤加减。郝宏文教授辨治 RRTIs 之思路可为儿童RRTIs 的治疗提供参考。

Recurrent respiratory tract infections（RRTIs）represent a common and refractory pediatric condition. Professor Hao Hongwen contends that traditional Chinese medicine（TCM）offers distinct advantages in the prevention and treatment of RRTIs in children，and identifies spleen-stomach indigestion as the most frequent trigger and exacerbating factor. Although RRTIs originates in the lung，its fundamental pathological location lies in the spleen and stomach. The key pathogenesis underlying the protracted and recurrent nature of RRTIs in children is due to spleen-stomach deficiency and depletion，which results in internal accumulated heat and external exterior deficiency. Clinically，treatment is differentiated according to the acute infection phase and the infection remission phase. Throughout the entire treatment course，emphasis is placed on protecting the spleen and stomach. During the acute infection phase，routine therapies of dispersing wind and dissipating heat，diffusing the lung and suppressing cough are adopted，concurrently supplemented with the protection of spleen and stomach. In the infection remission phase，the focus shifts to clearing and resolving internal heat，reinforcing healthy qi，and securing the exterior. For the treatment of RRTIs patients at acute infection phase presenting as upper respiratory tract infection，modified Jingfang Baidu San or modified Yinqiao San is chosen as the basic formula. For the RRTIs patients at acute infection phase manifesting as lower respiratory tract infection，treatment is performed according to the initial，extreme，and later stages，respectively with modified Ma Xing Shi Gan Decoction， modified Huanglian Jiedu Decoction plus Ma Xing Shi Gan Decoction，and modified Xiebai San plus Shashen Maidong Decoction. During the infection intermission phase，four syndrome types are differentiated and their treatment are as follows：syndrome of lung-stomach heat accumulation with lingering residual pathogen is treated with modified Shengjiang San plus Baohe Pills，syndrome of gastrointestinal heat accumulation and exterior deficiency with insecure defensive qi should be treated with modified Baohe Pills plus Yupingfeng Powder， syndrome of lung-spleen qi deficiency and insecurity due to qi deficiency，can be treated with modified Shenling Baizhu San plus Yupingfeng San，and syndrome of liver qi stagnation and lung-spleen insufficiency is treated with modified Sini San plus Liujunzi Decoction. Professor Hao’s approach to the differentiation and treatment of RRTIs provides valuable reference for the management of pediatric patients with RRTIs

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国家自然科学青年科学基金项目（编号：82004422）；儿科专委会青年医师创新发展项目（编号：2018-JYBZZ-JS127）