病毒性心肌炎中医证候要素文献研究

Literature Study on the TCM Syndrome Factors of Viral Myocarditis

目的探讨病毒性心肌炎常见证候要素、证候类型及其分布规律。方法对中国知网学术期刊数据库1978年1月～2010年1月的全部期刊进行高级检索,从符合研究标准的30篇文献中提取证候要素,对证候要素进行归类合并,总结证候类型。结果 1439例病毒性心肌炎患者中共有证候要素9个,主要为气虚659例(45.80%),阴虚652例(45.31%),热(火)毒邪403例(28.01%);共有证候类型28种,主要为气阴两虚453例(31.48%)和邪毒侵心195例(13.55%)。全部病例中虚证774例(53.79%),虚实夹杂证170例(11.81%),实证495例(34.40%)。气虚、阴虚是主要的虚性证候要素;热(火)毒邪、瘀血、痰(湿)浊是主要的实性证候要素。结论气虚、阴虚、热(火)毒邪、瘀血、痰(湿)浊是病毒性心肌炎中较为重要的证候要素。邪(风、热)毒侵心、挟瘀挟痰伴气阴亏虚和气阴两虚、挟瘀挟痰伴阳亏血虚是病毒性心肌炎的两大基本证型。

Objective To summarize the basic syndromes,syndrome factors,and syndrome distribution of viral myocarditis.Methods All the literature on viral myocarditis during January 1978 to January 2010 in the CNKI database was searched and 30 of them up to the standard of enrolment were obtained.The syndrome factors from the enrolled were extracted and classified to summarize the syndromes.Results A total of 9 syndrome factors were found out from 1 439 viral myocarditis cases,and the main ones were qi deficiency in 659 cases（45.80%）,yin deficiency in 652 cases（45.31%）,and toxin-based heat（fire）in 403 cases（28.01%）.There were all together 28 syndromes,and the important ones were qi and yin deficiency in 453 cases（31.48%）and evil pathogen invading the heart in 195 cases（13.55%）.Of all the cases,deficiency syndrome realized in 774 cases（53.79%）,complicated syndrome of deficiency with excess appeared in 170 cases（11.81%）,and excess syndrome existed in 495 cases（34.40%）.Qi deficiency and yin deficiency were the deficiency syndrome factors,while the toxin-based heat（fire）,blood stasis,and phlegm（damp）turbidity were the excess syndrome factors.Conclusion Qi deficiency,yin deficiency,toxin-based heat（fire）,blood stasis,and phlegm（damp）turbidity are the important syndrome factors of viral myocarditis.Evil toxin-based（wind,heat）virus invading the heart complicated with blood stasis and phlegm damp which are associated with qi and yin deficiency and both qi and yin deficiency complicated with blood stasis and phlegm damp which are associated with yang deficiency and blood deficiency are the main basic syndromes of viral myocarditis.