流行性乙型脑炎中医证候分布特点及病因病机的研究

目的探讨流行性乙型脑炎（简称乙脑）中医证候分布特点，并分析其证候与病因病机的关系。方法收集湖北省中医院、武汉医疗救治中心、重庆医科大学附属儿童医院医院、贵阳市第五人民医院、杭州市第六人民医院、成都市传染病医院2012年7—9月收治277例确诊为乙脑的临床资料，包括病史、体征、舌苔、脉象；按照轻型、普通型、重型、极重型统计的流行性乙型脑炎症状、体征出现的频率；总结中医证候分布情况，并分析其证候分布特点和病因病机之间的规律。结果经过聚类分析，乙脑中医证型依次可归纳为4类：毒蕴肺胃证、毒损脑络证、毒陷心包证、阴阳衰竭证；主要以毒损脑络证和毒陷心包证为主，共205例，所占比例为74．O％。277例患者中病因主要以暑邪、热邪及毒邪为主，所占比例分别为92．42％（256／277）、87．73％（243／277）、99．64％（276／277）。结论4类中医证型符合乙脑中医证候临床特点，其基本病机为湿热疫毒为患，致使毒蕴肺胃，毒损脑络，毒陷心包，久则耗伤阴血，出现气阴两伤，虚实夹杂，最后导致阴阳衰竭。

Research on Syndrome Distribution Features,Etiologies, and Pathogeneses of Japanese Enceph-alitis

Objective To explore Chinese medical syndrome distribution features of Japanese en- cephalitis （JE）, and to analyze its correlation between syndromes and features of etiologies and pathogen- eses. Methods Recruited were 277 patients with confirmative diagnosis of JE from Wuhan Medical Treat- ment Center, Children＇s Hospital Affiliated to Chongqing Medical University, Fifth People＇s Hospital of Guiy- ang City, Hangzhou Sixth People＇s Hospital, and Chengdu Hospital of Infectious Diseases between July to September 2012. Chinese medical syndrome distribution features were summarized from their general ma- terials and detailed records of clinical data, including medical history, symptoms and signs, tongue fur, and pulse figures. The frequency of symptoms and signs was calculated according to mild, ordinary, se- vere, extreme severe degrees. The distribution of Chinese medical syndromes was summarized. And itscorrelation between syndromes and features of etiologies and pathogeneses were analyzed. Results After clustering analysis, Chinese medical syndromes of JE could be categorized as four groups ： toxicity accu- mulation in Fei and Wei syndrome （TAFWS）, brain collateral impaired by poison syndrome （BCIPS）, de- pression of toxicity in the pericardium syndrome （DTPS）, exhaustion of yin and yang syndrome （EYYS）. BCIPS and DTPS were dominated, accounting for 74.0% （205 cases）. The main causes covered evil of summer heat [accounting for 92.42% （256/277 cases） ], heat [accounting for 87.73% （243/277 cases） ], and toxin [accounting for 99. 64% （276/277 cases）]. Conclusions The four Chinese medical syndrome types of JE met Chinese medical clinical features of encephalitis. It is induced by infestation of dampness- heat, resulting in toxicity accumulation in Fei and Wei, brain collateral impaired by poison, depression of toxicity in the pericardium. Yin fluid and blood is exhausted as time goes by. Qi and yin are impaired to form intermingled deficiency and excess, and finally causing exhaustion of yin and yang.