456例儿童大叶性肺炎中医证素分布与组合规律研究

发布时间：2018-05-19 14:52

  本文选题：儿童 + 大叶性肺炎　； 参考：《河南中医学院》2014年硕士论文

【摘要】：目的：通过对住院病例的回顾性调查，探讨儿童大叶性肺炎中医证素分布与组合规律，阐明中医病机，指导中医辨证及治疗。 方法：通过对456例住院的儿童大叶性肺炎患儿的病历调查，编制《儿童大叶性肺炎回顾分析调查表》，建立证素证侯研究数据库，通过SPSS19.0统计分析软件，进行统计描述。 结果：在本研究中共提取大叶性肺炎证素11个，其中病因/病性证素9个，病位证素2个。9个病因/病性证素中，热出现频率（占所有记录的百分比，下同）最高，为40.90%，其次为风、痰（饮）、血瘀、毒、气虚、阴虚等，频率分别为19.74%、17.19%、8.04%、5.90%等；病位主要在于肺，其频率为97.18%，其次为脾2.82%。大叶性肺炎证素的组合形式共有6种。其中，三证素组合的证型最多，其累积构成比为75.88%，其次为四证素组合，其累积构成比13.60%。两证素构成中仅有肺热壅盛证和气阴两虚证被诊断，前者为单一病性证素+靶点即热+肺，共9例占总比例1.97%，后者为两病性证素即气虚+阴虚构成，共6例占总比例1.32%。三证素构成中在两病性证素与单一靶点组合中，热+风和热+痰出现的频率最高，前者构成比分别为54.04%，后者构成比为36.70%，其作用靶点为肺。四证素组合情况：在三病性证素与单一靶点组合中，痰+热+血瘀，热+毒+血瘀，这两者出现频率最高，所占构成比同为38.71%；其组成为余风+热+血瘀，气虚+阴虚，痰+湿+血瘀，所占构成比分别为9.68%、3.23%、1.61%，其靶点均在肺。两病性证素与两靶点组合中，分别是气虚+阴虚，气虚+血瘀，各自所占构成比为3.23%和6.45%，其病位在肺与脾。四病性证素的组成为气虚+阴虚+血瘀+痰，无靶点，所占构成比1.61%。五证素组合情况：四病性证素与单一靶点组合中，分别为风+热+气虚+阴虚，热+毒+气虚+阴虚，痰+热+气虚+阴虚，毒+热+阴虚+血瘀，痰+热+湿+血瘀，毒+热+湿+血瘀其靶点均为肺，所占构成比依次为5.00%、20.00%、10.00%、5.00%、5.00%、5.00%。三病性证素与两靶点组合分别为气虚+痰+湿，气虚+痰+血瘀，气虚+风+热，其病位靶点均为肺与脾，所占构成比均为5.00%。五病性证素由气虚+阴虚+痰+湿+血瘀构成，其所占构成比35.00%。六证素组合情况：本组共有5例，在四病性证素与两靶点组合中，分别为气虚+风+热+血瘀，，痰+热+气虚+阴虚，两者靶点均为肺与脾，所占构成比依次为40%和20%。五病性证素与单一靶点组合分别为热+毒+气虚+阴虚+悬饮，其病位靶点为肺，所占构成比均为40%。 结论：儿童大叶性肺炎的主要病理因素为热、风、痰（饮）、血瘀、毒、气虚、阴虚等，主要病位在肺。本病病机为外感风温热毒之邪，入里灼津成痰，痰热互结壅堵肺络，肺失宣降，气血运行不畅，痰瘀互结，阻塞脉络。
[Abstract]:Objective: to investigate the distribution and combination of TCM syndromes in children with lobar pneumonia by retrospective investigation, to clarify the pathogenesis of TCM, and to guide the differentiation and treatment of TCM syndromes. Methods: according to the medical records of 456 hospitalized children with lobar pneumonia, the questionnaire of retrospective analysis of children with lobar pneumonia was compiled, and the database of syndromes and syndromes was established, and the statistical description was carried out by SPSS19.0 statistical analysis software. Results: in this study, 11 major leaf pneumonia syndromes were extracted, including 9 etiology / disease syndromes, 2 disease site syndromes, and the highest frequency of heat (the percentage of all recorded factors, the same below) in 9 etiology / disease syndromes. It was 40.90, followed by wind, phlegm (drink, blood stasis, toxin, deficiency of qi, deficiency of yin, etc.) the frequency was 19.74 and 17.197.19 and 8.045.90%, respectively, the disease was mainly in the lung, its frequency was 97.18, followed by the spleen 2.82. There are 6 kinds of syndromes of lobar pneumonia syndrome. Among them, the combination of three syndromes is the most, its cumulative composition ratio is 75.88, followed by the combination of four syndromes, its cumulative composition ratio is 13.60. Of the two syndromes, only the syndrome of excess of lung heat and deficiency of qi and yin were diagnosed. The former was the target of single disease syndrome element, that is, heat lung, and the latter was composed of two syndromes, namely deficiency of qi and yin, which accounted for 1.32% of the total. The frequency of hot wind and hot phlegm were the highest in the combination of two syndromes and one target, the former was 54.04, the latter was 36.70, and the target was lung. Combination of four syndrome factors: in the combination of three syndrome factors and a single target, phlegm, heat and blood stasis, heat and toxin and blood stasis, both of which appear the highest frequency, account for the same composition ratio is 38.71; its composition is excess wind heat and blood stasis, deficiency of qi and yin deficiency, The proportion of phlegm dampness and blood stasis was 9.68 and 3.23 and 1.61.The targets were in lung. In the combination of two disease syndromes and two targets, qi deficiency and yin deficiency, qi deficiency and blood stasis were respectively in the proportion of 3.23% and 6.45%, respectively. The disease was located in the lung and spleen. The composition of Qi-deficiency Yin deficiency and blood stasis phlegm, without target, was 1.61%. Combination of five syndrome factors: in the combination of four syndrome factors and a single target, they are respectively wind and heat qi deficiency yin deficiency, heat toxin qi deficiency yin deficiency, phlegm and heat qi deficiency yin deficiency, toxin heat yin deficiency and blood stasis, phlegm and heat dampness and blood stasis, etc. The targets of toxic heat, dampness and blood stasis were lung, and the proportion of them was 5.00 and 20.00, 10.00 and 5.00, 5.00 and 5.00 respectively. The combination of qi deficiency and phlegm dampness, qi deficiency phlegm and blood stasis, qi deficiency and wind heat were the targets of three disease syndromes. Five-disease syndrome element is composed of qi deficiency yin deficiency phlegm dampness and blood stasis and its proportion is 35.00. Combination of six syndromes: there were 5 cases in this group. In the combination of four disease syndrome factors and two targets, they were qi deficiency, wind heat and blood stasis, phlegm and heat deficiency yin deficiency, both of which were lung and spleen, the proportion of which was 40% and 20% respectively. The combination of five disease syndromes and single target is heat toxin qi deficiency yin deficiency suspension drink, and its disease position target is lung, the constituent ratio is 40% respectively. Conclusion: the main pathological factors of children's lobular pneumonia are heat, wind, phlegm, blood stasis, toxin, deficiency of qi, deficiency of yin and so on. The pathogenesis of the disease is exogenous wind warming heat toxin evil, into the heat into phlegm, phlegm and heat to block the lung collaterals, lung loss, blood flow, phlegm and blood stasis, blocking the choroid.
【学位授予单位】：河南中医学院
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R272

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