伏邪致病论及小儿急乳蛾伏火上攻证方证分析-discussion on pathogenic factors of epidemic febrile diseases and analysis of prescription and syndrome of epidemic febrile attack of infantile urgent moth.docx

中文摘要目的：论伏邪致病为宗旨并以小儿急乳蛾为例探讨伏邪致病的临床现象及 治则治法方药，从而证实本理论的正确性及其在临床的指导意义。方法：总结古代医家关于伏邪的论述，参考现代文献研究，归纳出伏邪致 病的病因病机、证候表现、治疗及预后。通过小儿急乳蛾（伏火上攻证）的方 证研究证实本理论的临床指导意义。并收集导师门诊病例 60 例，以服用清透消 蛾汤煎液为治疗组进行治疗前后自身疗效对照，同时与口服清热解毒软胶囊对 照组做组间疗效对照，对其临床疗效进行评价。结果：（1）小儿急乳蛾（伏火上攻证）多为素体正虚，感邪伏藏, 或“伏 邪自发”，或“新感引发”而为病。其证候表现起病无明显外感病因，亦无明显 的表卫证候，凡发病以里热见证为主，且易反复发作；治宜清热泻火，凉血透 邪，通腑泻热，解毒利咽；方选导师经验方清透消蛾汤。（2）本临床观察中， 治疗组在治疗前后疗效比较具有统计学意义，且在总疗效方面优于对照组，说 明清透消蛾汤治疗小儿急乳蛾（伏火上攻证）疗效确切。结论：历代医家经过长期的临床实践，伏邪学说在理论上趋于完善，有效 的指导着临床实践。清透消蛾汤对小儿急乳蛾（伏火上攻证）有确切疗效，说 明伏邪致病论对小儿急乳蛾（伏火上攻证）的临床指导作用。关键词：伏邪清透消蛾汤小儿急乳蛾伏火上攻证ABSTRACTObjective: This article aimed for discussing the theory of disease due to latent pathogen and take acute infantile tonsillitis for example to explore clinical phenomenon and therapeutic principle of the theory, then confirm correctness of the theory and its guiding significance for clinic.Methods: We summary the review of latent pathogen of ancient doctors, reference for modern research of documents, then we conclude pathogenic factors and pathogenesis, syndrome manifestations, treatment and prognosis of the theory of disease due to latent pathogen. Then confirm the theory by research of syndrome differentiation and treatment of acute infantile tonsillitis(the latent fire attacking up syndrome). We gathered 60 cases in outpatient department, set treatment-group which patients took QingtouXiaoe Tang and take efficacy control in pretherapy and post-treatment. Meaningwhile, set control-group which patients took Qingrejiedu ruan jiao nang, which be used for inter-group control. Then evaluate their clinical efficacy.Results: (1)Acute infantile tonsillitis(the latent fire attacking up syndrome) generally is due to insufficiency of constitution, evil be latent, “the disease induced by the latent pathogen spontaneousely”or “the disease induced by the newly pathogen”. And at the beginning, its syndrome menifestation has no obviousely pathogeny, or has no exterior syndrome clearly. All of the diseases onset is mainly interior-heat s