严重腹腔感染所致多脏器功能障碍综合征中医辨证规律研究

目的：研究严重腹腔感染所致多脏器功能障碍综合征中医证型分布规律及变化特点，方法：采用八纲辨证方法连续观察外科重症监护病房46例严重腹腔感染所致MODS患者，在采取病因及对症治疗同时按不同证型进行中医辨证论治观察记录中医证型变化。结果：第1d以里实热证和虚实夹杂证为主，第3d和第7d以虚实夹杂证为主，其次为里实热证和里虚热证，里虚寒证及亡阴／亡阳证少见，未见里实寒证。结论：随病情加重里实热证逐渐减少，里虚热症有增加趋势。

TCM Syndrome Differentiation of Patients with MODS Induced by Severe Intra-abdominal Infection

Objective To explore the distribution rule of the traditional Chinese medicine （TCM） pattern of syndrome and the changing characteristics of patients with multiple organ dysfunction syndrome（MODS） induced by severe intra - abdominal infections. Methods The eight principal syndrome differentiation of TCM was applied to observe 46 patients with MODS induced by severe intra - abdominal infections and treatment based on was given according to different patterns of syndrome. Results On the 1st day, all patients were characterized by interior - sthenia - heat syn- drome and asthenia mingled with sthenia syndrome. And on the 3rd and 7th days, they had major asthenia and sthenia syndrome, and then the interior- sthenia- heat syndrome and the interior- asthenia- heat syndrome. The cold syn- drome with internal asthenia and the Yin exhaustion/Yang exhaustion and interior- sthenia- cold syndrome were rarely seen; On the 3rd day, 39.13% of sthenia syndrome transformed to asthenia syndrome and 34.78% of sthenia syndrome transformed to asthenia mingled with sthenia syndrome, 15.79% asthenia mixed with sthenia syndrome transformed to asthenia syndrome. On the 7th day., 28.57% of asthenia syndrome transformed to asthenia mingled with sthenia syndrome. Conclusion The interior- stheniaheat syndromes decreased gradually following the aggravation of the pathogenic conditions, and the interior - asthenia - heat syndrome had a tendency of increasing. It is clinically significant to predict the developing tendency and the prognosis of the septic MODS induced by severe intra- abdominal infections.