古代脓毒性休克证治规律研究

Research on Rules of Syndrome Differentiation and Treatment of Septic Shock in Ancient China

目的:探讨古代医家治疗脓毒性休克的证治规律。方法:以《中华医典》数据库内文献为主线,借助中医传承辅助系统(V1.1)软件,以古代主要医家医案医论为研究对象,系统搜集整理古代医家治疗脓毒性休克的文献资料,并加以分析总结。结果:最终收集到医案289诊次,数据分析结果表明:病因前3位分别是湿热、温热、风热;症状、舌象、脉象前3位分别是发热、烦躁、口渴,腻苔、绛舌、黄苔,数脉、滑脉、弦脉;单味中药、药物分类及常用药对前3位分别为连翘、生地黄、栀子,清热药、化痰止咳平喘药、解表药,"栀子、淡豆豉""石斛、连翘""连翘、栀子"。结论:脓毒性休克多属于温病范畴,除热邪、毒邪之外,湿邪、风邪是本病致病不可忽视的因素。治疗应以清热解毒、祛邪化痰为主,并在攻逐邪气的同时,不忘益气养阴,扶正固本。

Objective： To explore the rules of syndrome differentiation and treatment of septic shock by ancient Chinese doctors.Methods： With the help of the inheritance of traditional Chinese medicine auxiliary system 1. 1,we searched the medical records and medical works of ancient Chinese physicians,collected and sorted the ancient literature of septic shock systematically in the database of Zhong Hua Yi Dian(China Canon of Medicine） and then analysised it and summarized the rules. Results： Finally we collected 289 cases of medical records in all at last. The data analysis indicates that： The top 3 of the pathogens were Damp-heat,Warm-heat and Wind-heat Syndromes; the top 3 of the symptoms,tongues and pulses were fever,dysphoria,thirsty,greasy fur,crimson tongue,yellow fur,rapid pulse,smooth pulse and stringy pulse respectively; the top 3 of the single Chinese medicinal herb were Forsythia suspense,Root of rehmannia and Gardenia; the top 3 of the character classification of the Chinese medicinal herbs were Heat-clearing drugs,Phlegm dispelling,cough-stopping and anti-asthma drugs and exterior disorder relieving drugs; the top 3 of the drug efficacy and herbal pair were Gardenia ＆ Fermented soya bean,Dendrobium ＆ Forsythia and Forsythia ＆ Gardenia respectively. Conclusion： Most of ancient traditional Chinese medicine physicians thought that septic shock belonged to febrile disease,apart from heat-pathogen and toxic-pathogen,damp-pathogen and wind-pathogen are the factors that cannot be ignored in the disease. We should not only highlight the importance of clearing heat,removing toxicity and dissipating phlegm in the treatment but also should try to reinforce Qi and nourish Yin to support the healthy condition.