咳嗽并见背冷症证因特点临床研究

Clinical research on pattern characteristics features of cough with a cold feeling of sensation in the back: a clinical survey

目的观察咳嗽并见背冷症患者的临床表现及中医证候特点,探讨分析其病因病机,为咳嗽的临床诊疗提供依据。方法选取以"咳嗽"为主诉且并见背冷症的患者作为研究对象,就其一般性资料、所患呼吸系统基础疾病、咳嗽及背冷症发生的临床特点、相关因素进行分析,总结其发病特点、病因病机及证候学特点。结果咳嗽并见背冷症临床常见,背冷症与咳嗽症状密切相关,病理要素包含湿热、阳虚、痰饮、风邪等。中医辨证分型可见脾胃湿热证占22.8%、脾胃湿热证兼肺阳虚证占21.3%、肺阳虚证占17.3%、肺脾阳虚证占12.7%等。结论背冷症与咳嗽常相兼而见,可见于不同年龄段、不同肺系疾病中,轻重程度各异,且与季节、气候变化等有关。脾胃湿热证、肺阳虚证及其相兼证为咳嗽并见背冷症的常见证候,湿热邪气阻滞气机及肺脾阳虚、卫阳失布而致肺失宣肃是主要病机。

Objective To observe clinical manifestations and TCM pattern features of cough with a cold sensation in the back （ back cold） , and to discuss and analyze its etiology and pathogenesis, in the hope of providing evidence for the treatment of cough.Methods Cases with cough as a chief complaint accompanied by a cold sensation in the back were selected.We analyzed the general information, underlying respiratory diseases, clinical characteristics of and relevant factors for cough with a cold sensation in the back, and summarized the onset characteristics, etiology, pathogenesis, and TCM pat-terns.Results Cough with a cold sensation in the back was common in clinical practice.Moreover, a cold sensation in the back was closely related to cough. Common pathological elements included dampness-heat, yang deficiency, retention of phlegm and morbid fluid, and pathogenic wind, etc.The pattern identification of TCM showed that spleen-stomach dampness-heat pattern accounted for 22 .8%of all cases;dampness-heat pattern complicated with lung yang deficiency, 21.3%;lung yang deficiency, 17.3%;and yang deficiency of the lung and spleen, 12.7% respectively, etc.Conclusion A cold sensation in the back often accompanies cough, closely related to seasons, climate changes and etc.This symptom of varying degrees could be present in people of different ages and with different respiratory diseases.Most commonly-seen TCM patterns are retention of dampness-heat in the spleen and stomach and yang deficiency of the lung.Pathogenic dampness and heat may hinder qi movement.Moreover, the lung-spleen yang is deficient, and defensive yang fails to distribute.Consequently, the lung fails to spread and depurate.This is probably its main disease mechanism.