山东中医杂志2017，Vol.36Issue(7)：544-547,4.
支气管镜下望诊肺痨局部辨证规律探讨
Discussion on Differentiation Rules of Micro Inspection Diagnosis of Local Findings of Lung Tuberculosis under Bronchoscopy
摘要
Abstract
Objective:Through the bronchoscopic findings to explore the local morphological changes of tuber-culosis(TB) and to put forward a new local differentiation method of Traditional Chinese Medicine(TCM). Methods:Total of 93 patients diagnosed as pulmonary TB were differentiated into 4 types according to TCM four diagnostic methods:lung yin deficiency,yin deficiency and fire excess,consumption of qi and yin,im-pairment of both qi and yin. The experimenters observed the airway by electronic bronchoscope ,and com pared the findings(including the tonguecoating and pulse) in different syndrome types by holistic diagnosis. Results:The manifestation under bronchofiberscopy could be generalized as follows:yellow spot of mucosa,su-perficial ulceration,mucosal vascular varicose and other purulent lesions accounted for 74.19%;intra-luminal granuloma,widened carina,owl wink and other morphological changes accounted for 3.22%;pale mucosa,weak inter-cartilage ring muscle,cicatricial tissue and other malnutrition manifestation accounted for 22.58%. Syn drome differentiation,tongue coating and pulse were of statistical difference (P<0.05),but tongue quality was of no statistical difference ( P>0 . 05 ) . Conclusions:TCM clinical syndrome differentiation for TB focuses on"yin deficiency" and emphasizes "deficiency of healthy qi". TCM treatment for TB should be nourishing yin and strengthening healthy qi. Based on the electronic bronchoscopic findings ,in combination with the tongue coating and pulse,by local syndrome differentiation TB could be divided into types of accumulated toxic heat in the lungs with purulent blood rotten flesh,of qi stagnation,blood stasis,coagulation of phlegm and dampness block,of deficiency of qi, blood and yin,which could provide a new approach for diagnosis and treatment for TB.关键词
肺结核/肺痨/电子支气管镜/中医望诊/局部辨证分型Key words
pulmonary tuberculosis/Feilao/elec- tronic bronchoscope/inspection diagnosis of traditional Chinese medicine/local syndrome differentiation分类
医药卫生引用本文复制引用
张艺严,高冰,卢家泉,张小娜,袁希彦,肖体权,张江..支气管镜下望诊肺痨局部辨证规律探讨[J].山东中医杂志,2017,36(7):544-547,4.基金项目
四川省中医药管理局资助课题(编号:2010-51) （编号:2010-51）
四川省自贡市科技局资助课题(编号:2011S084) （编号:2011S084）
