老年多器官功能不全综合征中医病证探讨

目的探讨老年多器官功能不全综合征（MODSE）的中医证候分布规律、中医病名及诊断标准，阐明其发病机理，为规范MODSE的中医药研究奠定理论基础。方法对患者176例的中医证候资料进行分析研究，并进行统计学处理。结果衰竭前期正虚为主及邪盛为主比例差别不大，而衰竭期则以正虚为主。正虚为主的证型以气阴两虚最多，其次为阳气衰竭。邪盛为主的具体证型中瘀毒内阻最多，其次为痰热壅盛。结论该综合征发病机理为内外因合而为之，遇有外邪侵袭，正气难以抵御，迅速出现脏腑功能失调，气血津液严重紊乱而致阴阳之气不相顺接，脏问乘侮而致几个脏腑相继出现脏气耗伤之极，发为脏器衰败的逆转危候。“正气虚”是发病的基础，贯穿于病程始终，衰竭期正虚尤为突出。扶正是干预治疗的重要环节。正虚为主有气阴两虚、阳气衰竭、阴阳两虚、阳脱阴竭四个证型；邪盛为主有痰湿内蕴、痰热壅盛、热毒内盛、瘀毒内阻四个证型。

Explore Syndromes in TCM of Multiple Organ Dysfunction Syndromes in the Elderly

Objective： To illustrate the pathogenesis and establish the theory and conception on the traditional Chinese Medical（TCM） research in multiple organ dysfunction syndrome in the elderly（MODSE）, the distribution of MODSE was observed, the symptoms in TCM and the diagnostic standards were discussed. Methods： Analyzed the TCM clinical data from 176 cases by the statistic method. Results： All the patients in TCM syndromes contained Deficiency in root and Excess in superficiality andthe syndromes could be separated into two periods-the dysfunction phase and the failure phase. There was no significant difference compared that in the dysfunction phase while of which give prority to Deficiency in root or Excess in superficiality. But in failure phase, it usually displayed Deficiency in root had significant difference. The coexistence Qi and Yin Deficiency syndrome was the most in the Deficiency in root syndrome patients. The second was the exhaustion of Yang - Qi syndrome, Compared in Excessive pathogenic Qi patients, blockage interior by toxin and blood stasis was the first and the excessive phlegm - heat was second. Conclusions： Pathogenesis in MODSE combined Internal with External Factors. Whtn External Evil attacked and vital Qi was hard to withstand, the Zang Fu - Organs function was rapidly been weakness, and Qi,blood and Body fluids were unbalanced badly that leaded to disharmony between Yang Qi and Yin Qi. Viscera Oi was destroyed terribly by over restriction or reverse restriction. So vital Qi was element in process of disease. Strength- ening anti - pathogenic Qi is the most important principles in guiding clinical dysfunction phase treatment. Syndrome in TCM classify： Syndromes in Deficiency in root were make up by coexistence Qi and Yin deficiency syndrome, Yang exhaustion syndrome, Deficiency of both Yin and Yang syndrome, Yin and Yang exhausted simultaneously. Syndromes in Excess Evil were make up by Blockage of interior by phlegm- dampness, excessive phlegm- heat, heat stagnation, blockage