肺痈病因病机及证素规律研究

The Rules of Etiology,Pathogenesis and Syndrome Factors of Lung Abscess

目的:本文基于现代百余年名老中医诊治肺痈的文献,分析肺痈的病因病机与证素分布规律。方法:基于已建立的《现代名老中医肺病数据库》(1911-2011年),按照数据纳入标准和录入原则,最终录入数据19 277条,文献13 860篇,其中综述1 389篇,实验研究690篇,理论探讨1 042篇;涉及中医病证51种、西医疾病100种。获得计算机软件著作权后建立《现代名老中医诊治肺痈文献研究数据库》。结果:本研究纳入数据文献383条,涉及1 321位名老中医。肺痈病因有热邪、痰邪、风邪等24种病因。病机有61种,以肺热壅盛、痰热蕴肺、肺络损伤等较为常见。肺痈的10个证素中,病性证素以热、痰、风、阴虚较为常见;病位证素以肺为主,涉及胃、脾、肾;病性证素热与病位证素肺最相关。证素组合以两证素和三证素组合为主。病性证素组合以两病性证素和单一病性证素较为常见。结论:肺痈病因多样,病机复杂,证素规律有一定的规律性,本文可为进一步开展肺痈病因病机及证素规律提供参考和依据。

This study aimed at the analysis of the rules of etiology, pathogenesis and syndrome factors of lung abscess based on the literature study on the medications prescripted by veteran traditional Chinese medical（TCM） doctors of the last 100 years. Based on the inclusion criteria and means of data input, 19,277 data records from Modern Veteran TCM Doctors of Pulmonary Disease Database（1911-2011） were inputted, while 13,860 papers involving 1,389 reviews, 690 articles and 1,042 theoretical researches contained 51 TCM syndromes and 100 western medical diseases. Modern Literature Research Database on Veteran TCM Doctors in the Diagnosis and Treatment of Lung Abscess were established with the software copyright in force. In this study, 383 data records were included with 1,321 veteran TCM doctors as a result. The related 24 etiologies of lung abscess included pathogenic heat, pathogenic phlegm and pathogenic wind. The screened 61 items of pathogenesis were familiar in lung abscess, such as excessive acculation of the lung-heat, accumulation of phlegm-heat in the lung and injury to pulmonary vessels. In the 10 gleaned syndrome factors, those over the nature of disease involved heatness, phlegm, wind and yin deficiency, while those over the location of disease covered lung, gastric, spleen and renal, taking heat and lung as the most relevant factors in the each aspect. The syndrome elements of lung abscess often presented in the form of two-element group and three-element group. The nature of disease of syndrome factors commonly occurred featuring single and dual ones. In conclusion, lung abscess was a complicated disease with diverse etiologies and regular syndrome factors and entwined with multi-pathogenesis. This study laid a foundation for etiological and pathogenetic researches over lung abscess with various TCM syndrome patterns.