流行性乙型脑炎轻型、普通型中医证候特征研究

The Japanese Encephalitis Light Common Type of TCM Symptoms Characteristics

目的:探讨流行性乙型脑炎(乙脑)中医证候分布特点,并分析其证候。方法:收集武汉医疗救治中心、重庆医科大学附属儿童医院医院、贵阳市第五人民医院2012年7月至2012年9月176例确诊为流行性乙型脑炎的一般资料和详细记录临床资料,包括病史、体征、舌苔、脉象,按照轻型、普通型统计的流行性乙型脑炎症状、体征出现的频率,不同时间节点及不同地域比较,总结出中医证候分布特点,并分析其证候规律。结果:流行性乙型脑炎中医证候依次可归纳为两类:毒蕴肺胃证和毒损脑络证,主要以毒损脑络证为主。①证候中纳差出现频率最多,其次是发热、嗜睡、抽搐、精神萎靡出现的频率较大,舌象以绛红或淡红多见,苔多见黄腻或薄黄,其次是薄白,脉象以浮细数为主,小儿指纹以浮红多见,其次是浮紫。②8月15日以后组病例就诊时发热、嗜睡、抽搐、纳呆等症状明显多于8月15日以前组(P<0.05),以暑热毒邪侵袭卫分,说明病机特点以毒邪为主,暑热兼夹,出现易夹湿,易动风;8月15日以后组就诊时深昏迷、精神萎靡等症状明显多于8月15日以前组(P<0.05),以暑热毒邪易侵袭营分,说明病机特点是喜内陷。③不同地域证候特点发热、纳差等证候分布重庆与贵阳无明显变化,精神萎靡、面、口、眼部抽搐、强直性痉挛证候分布有差异,贵阳组多于重庆组;浅昏迷、深昏迷证候重庆组多于贵阳组。结论:流行性乙型脑炎的两类中医证候符合流行性乙型脑炎中医证候临床特点,流行性乙型脑炎基本病机为湿热疫毒为患,致使毒蕴肺胃,毒损脑络,久则耗伤阴血,出现气阴两伤,形成虚实夹杂的局面。

Objective： To explore the Japanese encephalitis （JE） TCM syndrome distribution characteristics, and to analyze its syndromes. Methods ： Collection of Wuhan Medical Treatment Center, children＇s Hospital Affiliated to Medical University Of Chongqing hospital,Guiyang Fifth People＇s Hospital from 2012 July to 2012 September, 176 cases of epidemic encephalitis B in general data and the clinical data was recorded, including medical history, symptoms, tongue, pulse condition, according to the light, common statistical epidemic encephalitis B symptoms, signs appear frequency, different time nodes and the different region comparison, summed up the TCM distribution characteristics, and analyses the regularity of TCM syndrome. Results：Epidemic encephalitis type of TCM in turn can be classified into 2 categories：poison accumulate lung and stomach poison, damaged brain collaterals;mainly to poison the damaged brain collaterals mainly. （1）in syndrome of anorexia appears most frequently ,followed by fever,lethargy, seizures, spirit is dispirited frequency appeared larger,tongue in red or reddish to see more, moss sees yellow greasy or thin yellow see more, followed by a thin white, floating pulse to count, infantile fingerprint to floating Red Multi see, followed by a floating purple. （2）after August 15th were fever, lethargy, seizures were, respectively, significantly more than the symptoms before August 15 th group （P 〈 0.05 ）, to the summer heat evil invasion of Wei,illustrate the pathogenesis characteristics with toxin, heat and clamp, appear easily clamped wet, easy to wind;August 15th after group treatment of deep coma, spirit is dispirited and other symptoms significantly more than before the August 15th group （P 〈 0.05 ）, to the summer heat evil easily invasion Camp Branch,illustrate the pathogenesis characteristics like invagination. （3）the different regional characteristics of syndrome of fever, anorexia and other syndromes distribution in Chongqing and Guiyang did not change significantly, spirit is dispirited, face, mouth, eye twitch, tetanic spasm syndrome distribution differences, Guiyang group and Chongqing group, coma, deep coma syndrome Chongqing group and Guiyang group. Conclusion ： Epidemic encephalitis B in 2 kinds of TCM syndrome type with epidemic encephalitis syndrome of traditional Chinese medicine clinical characteristics, epidemic encephalitis B basic pathogenesis for damp heat disease virus infestation, causing lung stomach poison, poison damaged brain collaterals, long time consumption of Yin Qi and Yin blood, appeared two injuries, forming the inclusion of actual authority surface.