名老中医诊治胸腔积液文献分析

Literature Analysis on the Diagnosis and Treatment of Pleural Effusion by Famous and Old TCM Doctors

目的:通过整理名老中医诊治胸腔积液的文献,研究胸腔积液的病因病机与证素分布组合规律。方法:检索已有的《现代名老中医肺病数据库》和《期刊中医肺病数据库》,建立《现代名老中医诊治胸腔积液文献研究数据库》,运用SPSS22. 0软件采用频数统计、相关分析等统计方法进行分析。结果:胸腔积液常见病因有内因、内热、虚邪、内湿、水邪、饮、瘀血等,病机以痰热蕴肺、水饮内停、痰瘀互结、气阴两虚、肺脾两虚、血瘀较为常见; 13个证素中,病性证素以热、饮、痰出现频率较高;病位证素以胸膈为主,涉及肺、脾、半表半里、肾;证素组合以两证素、三证素组合为主;病性证素常见组合为痰+热、阴虚+热,病位在胸膈,病变脏腑多在肺。结论:现代名老中医对胸腔积液病因病机的认识,除与目前教材、专著论述相同外,尚可见以往少有报道的内湿等病因,肝胆湿热、肝脾不和等病机,丰富了胸腔积液的病因病机理论。

Objective:By sorting out the literature on the diagnosis and treatment of pleural effusion of famous and old TCM doctors,we studied the etiology and pathogenesis of pleural effusion and the distribution and combination of syndrome elements.Methods:We retrieved the existing"Modern Famous and Old TCM Doctors Pulmonary Disease Database"and"Journal TCM Pulmonary Disease Database"and established the"Modern Famous Old TCM Doctors’Diagnosis and Treatment of Pleural Effusion Literature Research Database",and used SPSS22.0 software to do frequency statistics,correlation analysis and other statistical methods for analysis.Results:The common etiologies of pleural effusion include internal causes,internal heat,deficiency pathogen,internal dampness,water pathogen,fluid retention,blood stasis,etc.The pathogeneses include phlegm-heat accumulation of lung,water retention,phlegm-blood stasis,qi-yin deficiency,lung-spleen deficiency and blood stasis.Among the 13 syndrome elements,heat,water retention and phlegm are the most common syndromes.The chest diaphragm is the main syndrome in terms of location,involving the lung,spleen,half exterior and half interior and the kidney.The combination of two syndromes and three syndromes is the main combination.Phlegm plus heat,yin deficiency plus heat are the common disease natures.The location of the disease is in the chest diaphragm,and the pathological changes of the viscera are mostly in the lung.Conclusion:The understanding of the etiology and pathogenesis of pleural effusion by modern famous and old TCM doctors is similar to the current textbooks and monographs.Besides,the etiology of internal dampness,dampness-heat of liver and gallbladder,disharmony between liver and spleen,which is rarely reported in the past,enrich the etiology and pathogenesis theory of pleural effusion.