现代名老中医诊治肺炎的病因病机分析

A study on the etiology and pathogenesis of treating pneumonia by modern famous doctor of TCM

目的:基于现代百余年名老中医诊治肺炎的文献,揭示肺炎的病因、病机及证素分布与组合规律。方法:基于已有的《现代名老中医肺病数据库》和《期刊中医肺病数据库》,建立《现代名老中医诊治肺炎文献研究数据库》,运用SPSS 22.0软件对肺炎的病因、病机、证素进行频次频率统计分析;并对证素采用相关分析。结果:肺炎的常见病因有温邪、外风、内因、外感以及痰。病机以肺热炽盛、痰浊阻肺、肺失宣降、痰热壅肺、风热犯肺、热邪犯肺较为常见。证素中病性证素以热、痰、外风、阴虚、气虚、毒出现频率较高;病位证素以肺为主,涉及胃、心神、脾。两证素组合以热+肺、痰+肺、阴虚+肺出现频率较高,三证素组合痰+热+肺、热+外风+肺、热+毒+肺、气虚+阴虚+肺、寒+外风+肺较常见。结论:现代名老中医对肺炎病因病机的见解与目前教材及专著大体一致,尚可见外湿等病因及邪袭肺胃等病机,这在以往的专著中少有报道,丰富了肺炎的病因病机理论。

Objective:To explore the etiology and pathogenesis of pneumonia,as well as the syndrome elements distribution andcombination rules through studying the experience of modern famous doctors of TCM for treating pneumonia.Methods:Literatures whichmet the inclusion criteria were retrieved from Lung Disease Database of Journals for the Establishment of Literature Research Databaseof Modern Famous Doctors of Chinese Medicine in Treating Pneumonia which was established based on The Existing Lung DiseaseDatabase of Modern Famous Doctors of Chinese Medicine and Journal of TCM Pulmonary Disease Database.SPSS22.0software wasused to statistically analyze frequency of pneumonia's etiology,pathogenesis and the relevant evidences.Results:The common etiologiesof pneumonia include warm pathogen,external wind,internal cause,external infection and phlegm.The main pathogenesis is exuberanceof lung heat,turbid phlegm obstructing lung,impairment of dispersing and descending function of the lung,phlegm-heat obstructing lung,wind-heat invading lung and heat pathogen invading lung.The pathogenic syndrome elements of pneumonia are basically composedof heat,phlegm,external wind,deficiency of Yin,deficiency of vital energy,and toxin.The pathogenic location syndrome elements isprincipally in the lung,involving the stomach,the mind and the spleen.In the combination of two syndrome elements,the much morecommon include heat combined with lung,phlegm combined with lung,and Yin deficiency combined with lung.The combination of threesyndrome elements usually are the combination of phlegm,heat and the lung,the combination of heat,external wind and the lung,thecombination of heat,toxin and the lung,the combination of deficiency of vital energy,deficiency of Yin and the lung and the combination ofcold,external wind and the lung.Conclusion:The views of modern famous doctors of TCM on the etiology and pathogenesis of pneumoniaare roughly consistent with the current textbooks and monographs.The etiology such as external dampness and the pathogenesis such aspathogen attacking the lung and stomach also can be seen,which are rarely reported in previous monographs,thus enrich the etiology andpathogenesis theory of pneumonia.