明清鼓胀病医案证候规律研究  

Study on syndrome principle of tympanites based on medical cases of the Ming and Qing dynasties

作　　者：熊焰[1] 董婷[1] 余东慧[1] 易法银[2] 卢胜家[1] 

机构地区：[1]湖南中医药大学第一附属医院,长沙410007 [2]湖南中医药大学,长沙410208

出　　处：《中华中医药杂志》2015年第7期2590-2593,共4页China Journal of Traditional Chinese Medicine and Pharmacy

摘　　要：目的:探索鼓胀病的证候规律,应用并验证证候要素应证组合理论。方法:搜集明清时期的鼓胀病医案,将医案信息规范化处理后,运用SPSS 17.0统计软件包对症状进行频数、因子、聚类统计分析。提取证候要素,分析应证组合。结果:鼓胀病是以腹膨隆、腹胀、下肢浮肿、小便短少等为主要临床表现,主要病机是以肝脾肾受损,气血水互结所致的未虚标实、虚实夹杂为特点;聚类分析得出7种证型。提取鼓胀病证候要素及分析其应证组合,得出21个证候要素和10个主要证候。结论:明清时期鼓胀病是虚实夹杂的复杂疾病,实邪中尤以内湿、水、内寒、气滞、湿、血瘀为多见,体虚则以阳虚及气虚为主;证候特点以两因素证及单因素证居多,其中单因素证中以脾阳虚、脾肾阳虚为主,两因素组合证中以肝郁脾虚、湿热蕴结、脾虚湿困、寒湿困脾最多。Objective： To explore pattern regularity, use and confirm the theory of syndrome factors of tympanites and combination of syndrome elements. Methods： Medical cases of tympanites from dynasties of Ming and Qing were collected, after standardizing the information were collected, symptoms were made statistic analysis such as frequencies, factor analysis, clustering analysis by using statistical software SPSS 17.0. Syndrome factors were extracted and combination of syndrome elements was analyzed. Results： The main clinical manifestation of tympanites was abdominal swell, abmlominal distension, edema of lower extremity and short of urine. Pathogenesis of tympanites was damage of liver, spleen and renal, combination of qi, blood and water. Through cluster analysis of symptoms there were seven types of tympanites. Through extracting syndrome factors and analyzing combination of syndrome elements, 21 syndrome factors and 10 mian syndrome were obtained. Conclusion： Tympanites during the Ming and qing dynasties are complex diseases with sintermingled deficiency and excess. In real evil, especially the wet, water, cold, qi stagnation, dampness, blood stasis are common to seen. Body deficiency is mainly with Yang deficiency and Qi deficiency. Syndrome characteristics within two factors card and single factor card are in the majority. The single factor syndromes are mainly in spleen yang deficiency, yang deficiency of spleen and kidney. In two factors combination syndromes, the syndromes of liver-depression and spleen-deficiency, warm-heat pathogen, spleen deficiency damp obstruction, cold-damp affecting spleen are the most common.

关 键 词：鼓胀 明清医案 证候要素 应证组合 证候规律 

分 类 号：R259[医药卫生—中西医结合]