【作者】 范磊；

【导师】 欧阳兵；

【作者基本信息】 山东中医药大学 ， 中医医史文献， 2009， 博士

【摘要】 目的:探讨小儿病毒性心肌炎发病的根本机制,以及病程各个阶段的证候特点,揭示证候演变规律,阐释肾精、滋补肾精法的内涵。基于对“邪之所凑,其气必虚”和小儿稚阴稚阳之体的认识,提出小儿病毒性心肌炎的基本病机和基本治法,为临床实践提供更好的辨治思路,提高中医防、治本病的疗效。方法:中医传统文献学与现代统计学相结合,系统整理历代儿科文献中与小儿病毒性心肌炎相关的病证记载,建立现代临床文献证型数据库,分析证型规律,比较古今证治的异同。结果:基于流行病学研究结果、古今文献的比较分析、小儿生理病理特点、心肾关系以及小儿病毒性心肌炎的发病特点,发现古代医家认为元气不足是小儿病毒性心肌炎相关病证发病中的关键因素,调补元气是重要治法;现代临床存在对小儿稚阴稚阳认识不足、过用苦寒药、淡化辨证等问题。结论:肾精不足是发病的潜在病机,也是小儿病毒性心肌炎众多发病形式的基本病机。滋补肾精法是预防和治疗本病,特别是疾病恢复、迁延期的基本和重要治法,应重新倡导临床辨证论治。更多还原

【Abstract】 Objective: Discussing the basic mechanisms of Viral Myocarditis in children and the characteristic symptom of every stage of the disease.Revealing the regularity of the symptomatic variation. Because the evil factor affects health when the healthy energy is deficient, and both Yin and Yang are immature in children, this essay raise the basic mechanisms and treating method. All of these could provide better idea for clinical practice and raise curative effect of preventing and treating the VMC with the method of Chinese medcine. Methods: Using the both methods of TCM literature and statistics. Unscrambling the relative record of VMC in archaic literature systematically ,establishing database of symptom type in modern clinical literature to analyze the regularity. In the meanwhile, comparing the difference of ancient and modern symptom type. Result: Base on the archaic and morden literature, physiological and pathological feature in children, relationship between kidney and heart,and characteristic of the disease,the thesis discovers that the ancient specialist considered that the insufficiency of healthy energe is the key facor , so invigorating premordial energy is the main method to cure the disease. But the modern clinical doctors don’t realize it , they used to use bitter cold drug and ignore the differentiation of symptoms and signs. Conclusion:Deficiency of kidney-essence is the latent pathogenesis, and it is also the basic pathogensis of numerous morbidity forms of VMC. Consolidating the kidney and supplementing essence is the fundamental and important method to prevent and treat the disease. It’s necessary to advocate determination of treatment based in pathogenesis obtained through differentiation of symptoms and signs.更多还原