【作者】 张玉辉；

【导师】 曹洪欣；

【作者基本信息】 中国中医科学院 ， 中医基础理论， 2008， 博士

【摘要】 本文在全面整理民国时期温病医案的基础上,对673则温病医案进行分析,建立民国时期温病医案数据库。以证候要素与应证组合为切入点,运用频数统计、Logistic回归法、因子分析、关联规则分析、典型相关分析等数据挖掘的方法,利用SAS9.1.3统计软件,对温病医案进行系统研究。探讨温病的发病原因、症状特点,挖掘温病证候要素及证候要素应证组合规律。研究结果证实:1.疠气与六淫是温病发生的决定性因素,体质与饮食影响着温病的发展变化。2.民国时期温病医案集中体现热、毒、湿、痰、气逆、瘀血、阴虚、气乱、风、燥结、气滞、阳虚、寒、积滞、燥、风阳、暑、气虚、血虚等19个证候要素,这些证候要素反映了民国时期温病证候的总体特征。3.温病的核心证候要素为热、毒、湿、虚,可能在温病证候要素辨证中具有重要意义。4.由于感受邪气性质及及程度的不同,加之患者体质的不同,证候要素作用的靶位具有一定规律性。邪气在表,可见短暂的卫分证或上焦证。感受温热病邪,化燥伤阴趋势明显,其证候要素靶位主要集中在肺、胃、气分、营分及阳明,若热毒内陷心包或引动肝风则证候要素靶位主要在心、肝。而湿邪偏重的温病,其主要证候要素靶位集中在脾、胃、大肠、中焦。5.以证候要素挖掘为切入点,掌握证候要素的应证组合规律,是提高中医药治疗温病临床疗效的关键。更多还原

【Abstract】 The 673 cases of Warm disease of the period of the Republic of China were analyzed and the database was established. Data were analyzed by frequency analysis, factor analysis, typical correlation analysis, Logistic regression, Correlation analysis with SAS software. The etiology and symptom features were probed and the syndrome elements were abstracted, so that the rule of interrelation between Warm disease and syndrome elements was researched. The conclusions were as followed: 1. Warm disease is caused by many factors. Epidemic pathogenic factors and six exogenous pathogenic factors belong to the external cause, which are decisive factors. Physique and diet belong to the internal cause,which affect the development and change of Warm disease.. 2 It is found that heat, toxicity, dampness, phlegm, reversed flow of qi, blood stasis, yin deficiency, disorder of qi, wind, dry stagnation, qi stagnation, yang deficiency, cold, dyspepsia, dryness, wind-yang, summer-heat, qi deficiency and blood deficiency are the major syndrome elements. They completely reflect the syndrome characteristics of Warm disease in the period of the Republic of China.3 The core syndrome elements of Warm disease are heal, toxicity, dampness and deficiency, which can be regarded as creeds of syndrome differentiation of warm disease.4 When suffered the evil of warm, the trend of becoming dryness and injuring yin would be more obvious, and the syndrome elements target mainly concentrated in the lung, stomach, qifen, yingfen and Yangming. If the heat and toxic invaded the pericardium or caused liver wind, the syndrome elements target will be on the heart and liver. On the wetness warm disease, the main syndrome elements target will be on the spleen, stomach, large intestine and the middle jiao.5 The syndrome differentiation of Warm disease doesn’t follow the rule of wei, qi, ying, and xue and triple warmer transmission. Searching the syndrome common features of the warm disease, namely syndrome elements, which act as the entry point, and the law of interrelation between Warm disease and syndrome elements was been as the focal point, in order that we can enrich the treatment system based on syndrome differentiation of warm disease in this study.更多还原