关于慢性呼吸衰竭中医诊断及辨证治疗标准的研究

Study on the Treatment Summary Based on Syndrome Differentiation with Traditional Chinese Medicine on Chronic Respiratory Failure

目的:探讨慢性呼吸衰竭中医诊断依据和证治规律。方法:参阅近年来有关中医药诊疗慢性呼吸衰竭文献研究,结合长期的临床实践,探讨了慢性呼吸衰竭临床特点。认为病机为本虚标实、虚实间杂,本虚多为肺、心、肾虚损,邪实多为痰、热(火)、瘀血。病情发作时,以痰(痰热、痰浊)瘀互阻为关键,时或累及脑窍、大肠;病情缓解稳定时,痰瘀减轻但稽留难除,正虚显露而多表现为肺、心、肾虚损。结果:提出了慢性呼吸衰竭常见证候为虚证类(心肺气虚证、肺肾气虚证)、实证类(痰热壅肺证、痰湿壅肺证、兼血瘀证)、危重变证类(痰蒙神窍证、正虚喘脱)三证类七证候及其临床特征。拟订了有关证候诊断标准,并总结了辨证治疗规律。结论:慢性呼吸衰竭的诊断依据及证候标准的拟定为中医药辨证治疗提供了重要依据。

Objective：The article summarized the clinical characteristics about Chronic Respiratory Failure.Methods：based on literature research with TCM diagnosising and treatmenting Chronic Respiratory Failure the recent years and combined with long-term clinical practice,we study the clinical characteristics of chronic Respiratory Failure.The pathogenesis for Chronic Respiratory Failure was root deficiency and branch excess and intermingled deficiency and excess.The root deficiency many were lung deficiency,heart deficiency and kidney deficiency.The pathogenic factors excessive were sputum,hot（fire） and blood stasis.The key pathogenesis was phlegm（phlegm-heat and phlegm-dampness） and blood stasis while involved brain orifices and colorectal sometimes at the episode period.The key pathogenesis were lung deficiency,heart deficiency and kidney deficiency while the phlegm stasis was alleviated but not cleard and the root deficiency was exposed at the stable stage.The research summarized the usual syndromes（three categories and seven syndromes） and their clinical characteristics for Chronic Respiratory Failure included deficiency syndrome category（heart-lung qi deficiency syndrome,lung and kidney qi deficiency syndrome）,excess syndrome category（phlegm-heat obstructing lungs syndrome,phlegm-damp stagnating lung syndrome,or associating blood stasis syndrome） and critical altered syndromes category（mental confusion due to phlegm syndrome,root deficiency and dyspnea exhausted syndrome）.The study drawed up the diagnostic criteria of syndrome and summarized regularity of syndrome differentiation and treatment in order to provided the important evidence for the syndrome differentiation and treatment with Chronic Respiratory Failure.