中医古代脓毒症医案的疾病分布研究  

Study on the Distribution of Sepsis Cases in Ancient Chinese Medicine

作　　者：陈腾飞[1] 陈剑明[1] 徐霄龙[2] 连博 刘清泉[1] Chen Tengfei;Chen Jianming;Xu Xiaolong;Lian Bo;Liu Qingquan(Beijing Hospital of Traditional Chinese Medicine,Capital Medical Universi-ty,Beijing 100010,China)

机构地区：[1]首都医科大学附属北京中医医院,北京100010 [2]北京市中医研究所,北京100000

出　　处：《中国中医急症》2021年第8期1321-1323,1369,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：国家自然科学基金项目(81973608);中国博士后面上基金(2019M650774);北京市属医院科研培育计划项目(PZ2018018);首都医科大学校级自然科学基金(PYZ19170)。

摘　　要：通过对1167则中医古代脓毒症医案中涉及的病名诊断进行归纳研究,共得出15类疾病诊断,分别为:风温类、春温类、温病/热类、温毒类、湿温/热类、暑温/湿类、秋温/邪、伏暑/邪类、冬温类、伤寒类、疫病类、痧疹类、痈疽疔疮类、产后类、其他类。针对医案数量最多的前4类疾病进行病名诊断的二次分类,研究得出5种疾病类型:1)疾病“自然进展”导致病情加重而成为脓毒症;2)病邪“逆传或内陷”而成为脓毒症;3)疾病存在“兼证及夹证”而成为脓毒症;4)疾病因“误治及坏证”而加重成为脓毒症;5)“特殊人群”感邪而成为脓毒症。并结合目前脓毒症中医治疗现状,探讨了脓毒症中医诊断的改良方法及其积极意义。Through the inductive research on the diagnosis of disease names involved in 1167 ancient Chinese medicine records of sepsis,a total of 15 types of disease diagnosis were obtained,i.e.,wind-warm disease,spring-warm disease,warm disease/heat disease,warm-toxin disease,damp-warm disease/heat disease,summer-warm disease/damp disease,autumn-warm disease/pathogen,latent summer heat disease/pathogen,winter-warm disease,typhoid fever,epidemic disease,rash,ulcer and deep-rooted boil,postpartum disease,and other types of disease.For the top four types of diseases with the largest number of medical records,a secondary classification study of disease name diagnosis resulted in the following five types of diseases:1)“natural progression”of the disease leading to aggravation of the disease and then sepsis;2)“reverse transmission or inward sinking”of the pathogen leading to sepsis;3)the disease had“combined syndromes and complicated syndromes”and then leading to sepsis;4)the disease was aggravated by“mistreatment and bad syndromes”and then leading to sepsis;5)“special population”who were invaded by pathogen leading to sepsis.Combined with the current status of TCM treatment of sepsis,this paper tried to discuss the improved method of TCM diagnosis of sepsis and its positive significance.

关 键 词：脓毒症 古代医案 中医病名 危重症 

分 类 号：R632[医药卫生—外科学]