本文選題：兒童 + 大葉性肺炎��； 參考：《河南中醫(yī)學院》2014年碩士論文

【摘要】：目的：通過對住院病例的回顧性調(diào)查，探討兒童大葉性肺炎中醫(yī)證素分布與組合規(guī)律，闡明中醫(yī)病機，指導中醫(yī)辨證及治療。 方法：通過對456例住院的兒童大葉性肺炎患兒的病歷調(diào)查，編制《兒童大葉性肺炎回顧分析調(diào)查表》，建立證素證侯研究數(shù)據(jù)庫，通過SPSS19.0統(tǒng)計分析軟件，進行統(tǒng)計描述。 結果：在本研究中共提取大葉性肺炎證素11個，其中病因/病性證素9個，病位證素2個。9個病因/病性證素中，熱出現(xiàn)頻率（占所有記錄的百分比，下同）最高，為40.90%，其次為風、痰（飲）、血瘀、毒、氣虛、陰虛等，頻率分別為19.74%、17.19%、8.04%、5.90%等；病位主要在于肺，其頻率為97.18%，其次為脾2.82%。大葉性肺炎證素的組合形式共有6種。其中，三證素組合的證型最多，其累積構成比為75.88%，其次為四證素組合，其累積構成比13.60%。兩證素構成中僅有肺熱壅盛證和氣陰兩虛證被診斷，前者為單一病性證素+靶點即熱+肺，共9例占總比例1.97%，后者為兩病性證素即氣虛+陰虛構成，共6例占總比例1.32%。三證素構成中在兩病性證素與單一靶點組合中，熱+風和熱+痰出現(xiàn)的頻率最高，前者構成比分別為54.04%，后者構成比為36.70%，其作用靶點為肺。四證素組合情況：在三病性證素與單一靶點組合中，痰+熱+血瘀，熱+毒+血瘀，這兩者出現(xiàn)頻率最高，所占構成比同為38.71%；其組成為余風+熱+血瘀，氣虛+陰虛，痰+濕+血瘀，所占構成比分別為9.68%、3.23%、1.61%，其靶點均在肺。兩病性證素與兩靶點組合中，分別是氣虛+陰虛，氣虛+血瘀，各自所占構成比為3.23%和6.45%，其病位在肺與脾。四病性證素的組成為氣虛+陰虛+血瘀+痰，無靶點，所占構成比1.61%。五證素組合情況：四病性證素與單一靶點組合中，分別為風+熱+氣虛+陰虛，熱+毒+氣虛+陰虛，痰+熱+氣虛+陰虛，毒+熱+陰虛+血瘀，痰+熱+濕+血瘀，毒+熱+濕+血瘀其靶點均為肺，所占構成比依次為5.00%、20.00%、10.00%、5.00%、5.00%、5.00%。三病性證素與兩靶點組合分別為氣虛+痰+濕，氣虛+痰+血瘀，氣虛+風+熱，其病位靶點均為肺與脾，所占構成比均為5.00%。五病性證素由氣虛+陰虛+痰+濕+血瘀構成，其所占構成比35.00%。六證素組合情況：本組共有5例，在四病性證素與兩靶點組合中，分別為氣虛+風+熱+血瘀，，痰+熱+氣虛+陰虛，兩者靶點均為肺與脾，所占構成比依次為40%和20%。五病性證素與單一靶點組合分別為熱+毒+氣虛+陰虛+懸飲，其病位靶點為肺，所占構成比均為40%。 結論：兒童大葉性肺炎的主要病理因素為熱、風、痰（飲）、血瘀、毒、氣虛、陰虛等，主要病位在肺。本病病機為外感風溫熱毒之邪，入里灼津成痰，痰熱互結壅堵肺絡，肺失宣降，氣血運行不暢，痰瘀互結，阻塞脈絡。
[Abstract]:Objective: to investigate the distribution and combination of TCM syndromes in children with lobar pneumonia by retrospective investigation, to clarify the pathogenesis of TCM, and to guide the differentiation and treatment of TCM syndromes. Methods: according to the medical records of 456 hospitalized children with lobar pneumonia, the questionnaire of retrospective analysis of children with lobar pneumonia was compiled, and the database of syndromes and syndromes was established, and the statistical description was carried out by SPSS19.0 statistical analysis software. Results: in this study, 11 major leaf pneumonia syndromes were extracted, including 9 etiology / disease syndromes, 2 disease site syndromes, and the highest frequency of heat (the percentage of all recorded factors, the same below) in 9 etiology / disease syndromes. It was 40.90, followed by wind, phlegm (drink, blood stasis, toxin, deficiency of qi, deficiency of yin, etc.) the frequency was 19.74 and 17.197.19 and 8.045.90%, respectively, the disease was mainly in the lung, its frequency was 97.18, followed by the spleen 2.82. There are 6 kinds of syndromes of lobar pneumonia syndrome. Among them, the combination of three syndromes is the most, its cumulative composition ratio is 75.88, followed by the combination of four syndromes, its cumulative composition ratio is 13.60. Of the two syndromes, only the syndrome of excess of lung heat and deficiency of qi and yin were diagnosed. The former was the target of single disease syndrome element, that is, heat lung, and the latter was composed of two syndromes, namely deficiency of qi and yin, which accounted for 1.32% of the total. The frequency of hot wind and hot phlegm were the highest in the combination of two syndromes and one target, the former was 54.04, the latter was 36.70, and the target was lung. Combination of four syndrome factors: in the combination of three syndrome factors and a single target, phlegm, heat and blood stasis, heat and toxin and blood stasis, both of which appear the highest frequency, account for the same composition ratio is 38.71; its composition is excess wind heat and blood stasis, deficiency of qi and yin deficiency, The proportion of phlegm dampness and blood stasis was 9.68 and 3.23 and 1.61.The targets were in lung. In the combination of two disease syndromes and two targets, qi deficiency and yin deficiency, qi deficiency and blood stasis were respectively in the proportion of 3.23% and 6.45%, respectively. The disease was located in the lung and spleen. The composition of Qi-deficiency Yin deficiency and blood stasis phlegm, without target, was 1.61%. Combination of five syndrome factors: in the combination of four syndrome factors and a single target, they are respectively wind and heat qi deficiency yin deficiency, heat toxin qi deficiency yin deficiency, phlegm and heat qi deficiency yin deficiency, toxin heat yin deficiency and blood stasis, phlegm and heat dampness and blood stasis, etc. The targets of toxic heat, dampness and blood stasis were lung, and the proportion of them was 5.00 and 20.00, 10.00 and 5.00, 5.00 and 5.00 respectively. The combination of qi deficiency and phlegm dampness, qi deficiency phlegm and blood stasis, qi deficiency and wind heat were the targets of three disease syndromes. Five-disease syndrome element is composed of qi deficiency yin deficiency phlegm dampness and blood stasis and its proportion is 35.00. Combination of six syndromes: there were 5 cases in this group. In the combination of four disease syndrome factors and two targets, they were qi deficiency, wind heat and blood stasis, phlegm and heat deficiency yin deficiency, both of which were lung and spleen, the proportion of which was 40% and 20% respectively. The combination of five disease syndromes and single target is heat toxin qi deficiency yin deficiency suspension drink, and its disease position target is lung, the constituent ratio is 40% respectively. Conclusion: the main pathological factors of children's lobular pneumonia are heat, wind, phlegm, blood stasis, toxin, deficiency of qi, deficiency of yin and so on. The pathogenesis of the disease is exogenous wind warming heat toxin evil, into the heat into phlegm, phlegm and heat to block the lung collaterals, lung loss, blood flow, phlegm and blood stasis, blocking the choroid.
【學位授予單位】：河南中醫(yī)學院
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R272

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