六经辨证理论治疗登革热疫病证候及病机分析

Analysis of Syndrome and Pathogenesis of Dengue Fever Epidemic Disease by Syndrome Differentiation Theory

目的回顾分析2019年广东省中医院登革热病例,从中医六经辨证角度探讨并总结登革热诊疗思路。方法运用回顾性分析方法,对本院2019年7月6日—2019年11月3日收治的登革热患者基本资料、临床主要症状、辅助检查、六经病位、病机及辨证处方进行整理分析。结果登革热病例以中青年人(<60岁)发病人数最多,占81.3%;所有病例均治愈或好转出院,无一例进展为重症登革热;平均退热时间为5.94 d;病位多数在少阳阳明合病,其次为少阳病及阳明病;病机上存在虚实夹杂,水火互兼,表里合病的状态;使用最高频次的方药为小柴胡汤、葛根四物解肌汤、千金葛根柴胡汤、千金百痛壮热方。结论登革热疫病的临床救治可以通过中医经典理论六经辨证思路入手,疗效确切,缩短病程,为登革热中医辨证依据及诊疗指南的制定提供参考。

Objective To retrospectively analyze the cases of dengue fever in Fangcun Hospital of Guangdong Provincial Hospital of Traditional Chinese Medicine in 2019,and discuss and summarize the ideas of dengue fever diagnosis and treatment from the perspective of syndrome differentiation of traditional Chinese medicine.Methods Using retrospective analysis methods,we analyzed the basic data,clinical main symptoms,auxiliary examinations,six-meridian syndrome differentiation,pathogenesis and prescription of the patients with dengue fever admitted to our hospital from July 6,2019 to November 3,2019.Results Among the cases of dengue fever,the younger(<60 years old) had the highest number of cases,accounting for 81.3%.All cases were cured or improved,and no cases progressed to severe dengue.The average fever time was 5.94 days.Most of the cases were in Shaoyang Yangming,followed by Shaoyang disease and Yangming disease.The pathogenesis was deficiency mixed with excess and combination of water and fire,and the condition of the disease was exterior-interior related.The most high-frequency prescription was Xiaochaihu Decoction(小柴胡汤),Gegen Siwu Jieji Decoction(葛根四物解肌汤),Qianjin Gegen Chaihu Decoction(千金葛根柴胡汤) and Qianjin Baitong Zhuangre Formula(千金百痛壮热方).Conclusion The clinical treatment of dengue fever disease can be started through the syndrome differentiation of classical traditional Chinese medicine theory and the curative effect is exact.It can shorten the course of disease,and provide reference for the development of dengue fever TCM syndrome differentiation and diagnosis and treatment guidelines.