基于现代名老中医经验的咳嗽病因病机及证素规律研究

Regularity of etiology, pathogenesis and syndrome factors of cough based on the experience of modern famous doctors of traditional Chinese medicine

目的:基于现代名老中医经验文献,分析咳嗽病因病机和证素规律,为揭示病因病机提供依据。方法:基于已建立的《现代名老中医肺病数据库》和《期刊肺病数据库》中符合纳入标准的文献资料,建立《现代名老中医诊治咳嗽文献研究数据库》,运用SPSS 17.0软件统计分析。结果:咳嗽常见病因有外感、风邪、热邪、痰邪、内伤、寒邪、燥邪、湿邪、七情所伤等。病机中以肺气不宣、痰湿阻肺、痰热蕴肺、肺阴亏虚、风寒袭肺、肺气上逆、脾气虚、肺气亏虚、风热犯肺、肝火犯肺等常见。病性证素以风、热、寒、痰、气虚、阴虚为主;病位证素以肺为主。单一病性证素以阴虚、气虚、热邪、燥邪常见,病位涉及肺、脾、肾。二病性组合以风+寒、风+热、痰+湿、痰+热较为常见,病位在肺。结论:名老中医诊治经验所反映的咳嗽病因病机理论与目前教材等文献有一致的内容,也有着更丰富的内涵,有待进一步总结。

Objective： To analyze the regularity of etiology and pathogenesis and syndrome factors of cough, and to provide reference for revealing the pathogenesis of the disease based on the literature of the modern traditional Chinese medicine. Methods： Based on Modern Famous TCM Doctor＇s Pulmonary Disease Database and Journal Pulmonary Disease Database, the literatures meeting the inclusion criteria were collected to establish a Modern Famous TCM Doctor＇s Diagnosis and Treatment ofCough Literature Research Database that would be statistically analyzed with SPSS 17.0 software. Results： The common causes of cough included the exogenous evil, wind evil, heat evil, phlegm, internal injury, pathogenic cold, dryness evil, dampness, seven emotions. The common pathogenesis included the failure of lung qi in dispersion, accumulation of phlegm-dampness in the lung, accumulation of phlegm and heat in the lung, deficiency of the lung-yin, attack of wind-cold on the lung and abnormal rising of the lung qi, deficiency spleen qi, deficiency of lung qi, wind-heat invading lung, liver-fire attacking lung, and so on. The nature of disease syndrome factors focused on the wind, heat, cold, phlegm, qi deficiency and yin deficiency. The location of disease syndrome factor was mainly the lung. The yin deficiency, qi deficiency, heat evil and dryness evil were common in single nature of disease syndrome factors, which usually involved in the locations of disease such as lung, spleen and kidney. In addition, wind evil＋ cold evil, wind evil＋heat evil, phlegm＋dampness and phlegm＋heat evil were common in two nature of disease syndrome factors, which influenced the lung. Conclusion： The etiology and pathogenesis theory of cough reflected by famous TCM doctor＇s diagnosis and treatment experience was partly consistent with current documents like the teaching materials. But, the former also has a richer connotation that remains to be further summarized.