基于核心症状群对中医疫病学病症研究的思考  

Thinking on the study of traditional Chinese medicine epidemic disease based on core symptom clusters

作　　者：董斐[1] 周雪忠[2] 谷晓红[1,3] DONG Fei;ZHOU Xuezhong;GU Xiaohong(Institute of Chinese Medicine Epidemic Disease,Beijing University of Chinese Medicine,Beijing 100029,China;School of Computer and Information Technology,Beijing Jiaotong University,Beijing 100044,China;School of Traditional Chinese Medicine,Beijing University of Chinese Medicine,Beijing 100029,China)

机构地区：[1]北京中医药大学中医疫病研究院,北京100029 [2]北京交通大学计算机与信息技术学院,北京100044 [3]北京中医药大学中医学院,北京100029

出　　处：《中华中医药杂志》2023年第9期4030-4035,共6页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：科技基础资源调查专项(No.2022FY102000,No.2022FY102005);国家中医药管理局中医药创新团队及人才支持计划项目(No.ZYYCXTD-C-202006);中央高校基本科研业务费专项资金资助(No.2022-JYB-XJSJJ010)

摘　　要：古籍记载中的疫病缺乏明确的病原微生物诊断,只能通过症状表现相似性、方药应用等推测古代与现代疫病的对应关系。现代疫病的症状表现复杂多样,归纳描述异质性大,限制了中医疫病理论的传承与推广。中医疫病的疾病分类尚待明确。以“症状群”开展的症状科学研究为中医疫病学核心理论研究提供了新思路,文章“症状群”研究的关键问题,结合中医疫病辨治特点,提出疫病核心病症研究的环形框架:通过定义疫病症状群的特征,筛选核心症状群,推测其潜在机制,确定其测量方法,并开展对其有针对性的干预,实现对临床干预的评价与证据转化。通过准确定位疫病核心症状群,能更好地审定疫病中医病因,把握疫病核心病机,辨准证型提出最佳的治疗方案,以期发挥中医药防治疫病的特色与优势。In ancient literature,a clear diagnosis of the pathogen responsible for the epidemic disease was lacking.The correspondence between ancient and modern epidemic disease can only be inferred through similarities in symptoms and the use of traditional herbal medicine.The diverse symptoms of epidemic diseases have limited the inheritance and promotion of traditional Chinese medicine(TCM)theories on the epidemic disease.Meanwhile,disease classification in TCM for epidemic disease still needs to be clarified.Symptom studies based on‘symptom clusters’provide a new approach to systematic study of disease symptoms in TCM.By referring to key issues in‘symptom clusters’research and combining them with the characteristics of TCM,we propose a circular framework for the study of core symptoms of epidemic disease consisting of five steps:defining the characteristics of epidemic symptom clusters,selecting core symptom clusters and potential mechanisms,determining measurement methods for symptom clusters,conducting targeted interventions for symptom clusters,and evaluating clinical intervention and evidence translation based on symptom clusters.By accurately locating the core symptom cluster of epidemic disease,it can better examine the etiology of TCM,grasp the core pathogenesis of the disease,identify the syndrome type and put forward the best treatment plan,in order to give full play to the characteristics and advantages of TCM prevention and treatment of the epidemic disease.

关 键 词：中医疫病学 疫病 症状 病机 证型 新型冠状病毒感染 疾病分类 核心症状群 

分 类 号：R254.3[医药卫生—中医内科学]