基于现代文献探讨流行性出血热的证候分布规律

Discussion on the Syndrome Distribution of Epidemic Hemorrhagic Fever Based on Modern Literature

目的:探讨流行性出血热疾病转归过程中证候分布规律。方法:检索1980年~2019年中国知网网络出版总库(CNKI)、万方数据资源库、维普期刊资源整合服务平台(VIP)数据库,收集流行性出血热疾病5个分期的证候及症状进行统计分析。结果:本研究共收集92篇具有明确症状描述的流行性出血热疾病相关文献;流行性出血热疾病5个分期证型分布,发热期以气营两番证(31.03%)、卫气同病证(17.24%)为主;低血压休克期以气阴欲脱(15.15%)、气阴耗竭(12.12%)为主;少尿期以热郁津伤证(40.91%)、热入营血证(13.04%)为主;多尿期以阴虚热郁证(33.33%)、肾气不固证(25.00%)为主;恢复期以气阴两伤证(66.67%)、肾阴亏虚证(33.33%)为主。结论:流行性出血热疾病转归过程中,病机以温热和湿热为主,整体存在以卫气营血辨证为主结合脏腑辨证的卫气同病、气营两番、热毒炽盛、热入营血、气阴耗竭、正虚阳亡、肾气不固、气血两亏的证候演变规律。

Objective: To explore the distribution of syndrome in the course of the epidemic hemorrhagic fever. Methods: The CNKI, Wanfang and VIP databases of 1980-2019 were searched, and the five stages of EHF were analyzed. Results: 92 literatures about EHF were collected in this study. The five stages of the EHF disease are as follows: the fever phase is dominated by Syndrome of both Qifen and Yingfen (31.03%), Syndrome of both Weifen and Qifen (17.24%);the hypotension shock phase is caused by removing of Qi and Yin (15.15%), Qi and Yin depletion (12.12%);the oliguria phase is mainly due to heat stagnation and injury syndrome (40.91%), heat-evil attacking Yingfen and Xuefen (13.04%);the polyuria phase is mainly due to yin deficiency and heat depression (33.33%), syndrome of instability of kidney-qi (25.00%);the recovery phase was mainly Qi and Yin Injury Syndrome (66.67%), Shen-Yin Deficiency Syndrome (33.33%). Conclusion: During the prognosis of EHF, the pathogenesis is mainly warm and damp-heat, and the overall existence of the differentiation of Wei-Qi-Ying-Xue combined with viscera syndrome differentiation is the same as that of Syndrome of both Weifen and Qifen, Syndrome of both Qifen and Yingfen, and toxic heat flourishing, heat-evil attacking Yingfen and Xuefen, Qi and Yin depletion, healthy energy and Yang energy exhaustion, syndrome of instability of kidney-qi, and syndrome of deficiency of both Qi and blood.