肺系病阳邪致的证候演变规律.pdf

提 要 目的：探讨肺系病阳邪致病的证候演变规律。 方法：收集2010年10月～2011年12月期间，就诊于山东省中医院呼吸科的门 诊及住院患者病案资料。以“阳邪致病”为切入点，筛选出符合标准的临床病例，按 照统一标准进行不同观察点的中医证候分型并做统计；从整体上动态把握肺系病阳邪 致病的证候演变规律，为临床肺系病的诊疗和防治提供理论依据，更好地体现中医理 论强调的“动态观”和“治未病”思想。运用 SPSS17.0 统计软件处理数据，并分析 结果。 结果：证候是动态变化的，因而在不同的观察时段证候分型的分布具有一定的特 点。 慢性支气管炎阳邪致病发病时以痰热壅肺证、风燥伤肺证为主；迁延期、缓解期 多见肺燥阴虚证，其次为肺脾气虚证。咳嗽变异型哮喘阳邪致病发作期风邪犯肺证最 多；临床控制后以肺燥阴伤证为主，肺气亏虚证次之。社区获得性肺炎阳邪致病初期 风热闭肺证、痰热壅肺证为主；后期，多数患者向愈，余者多为肺燥阴虚证，其次为 肺脾气虚证、痰浊阻肺证，且两者差别不大。 总体而言，肺系病阳邪致病的证候演变过程中，肺燥阴虚证是共同的证型；慢性 支气管炎、社区获得性肺炎还会出现痰热壅肺证；疾病后期，阴伤较气虚为多，两者 或单见，或兼加，而涉及的脏腑则以肺、脾居多。 结论：通过观察不同时段的肺系病阳邪致病的证型分布，发现证候动态变化的规 律，为临床诊治中充分体现“既病防变”思想提供理论依据。 关键词 肺系病；阳邪；证候演变 The law of evolution of the syndrome caused by Yang-pathogenic factor regarding to the lung disease Speciality: Medical Department Of TCM Auther: Wang Heng Tutor: Prof. Zhang Wei Abstract Aim: Discuss the law of evolution of the syndrome caused by Yang-pathogenic factor regarding to the lung disease. Methods: Search the medical records in respiratory ward during October 2010 to December 2011 in Shandong Provincial Traditional Chinese Medical Hospital. Screen these clinical cases which caused by Yang-pathogenic factor regarding to the lung disease according with uniform standards. Then on the basis of integrate criterion, then, record syndrome type each at different observation points. After that, discuss the law of evolution of the syndrome caused by Yang-pathogenic factor regarding to the lung disease on the whole dynamically. It is the aim to provide the theory basis for clinical diagnosis and treatment as well as control of the lung disease. It reflects the ideas of “preventive treatment of disease” and