咳嗽病“肺胃相关”理论研究
摘要
目的：肺、胃均是人体重要的脏器,且肺与胃关系密切；本研究旨在通过对文献整理,总结“肺胃相关”理论。通过对2009年1月至2009年12月湖南中医药大学第一附属医院,呼吸内科门诊咳嗽病患者病例收集,目的在于探讨咳嗽病肺系症状与胃系症状的相关性,进一步认识咳嗽病“肺胃相关”病机,为咳嗽病临床治疗提供理论指导和数据支持。
方法：1.理论研究：通过古今文献整理“肺胃相关”理论,从生理、病理角度使理论系统化。
2.临床研究：临床收集符合纳入标准和排除标准的咳嗽病病例资料200份,分为病例组1(有胃系症状)、病例组2(无胃系症状)各100例。运用spss15.0统计处理,采用X2检验、t检验分析两组患者之间的基本情况、个人史、患病时间之间的差别。对照两组诱发因素和证型,比较两组间差异。通过直线相关分析和logistics回归分析咳嗽病肺系与胃系症状相关性分析。
结果：病例1组与病例2组性别比较无统计学意义(p>0.05),两组年龄比较有显著差异(p<0.01),病例组1患者年龄较病例2组年龄大。比较两组患者个人史(吸烟、喜食生冷)有统计学意义(p<0.05),认为吸烟与喜食生冷对咳嗽病胃系症状出现有影响作用。病例组1患病时间较病例组2患病时间长,有明显统计学意义(p<0.01)。病例组1饮食不调位列诱发因素第一位,受凉感冒位列病例组2第一位。经直线相关分析,肺系症状与胃系症状呈正相关(r=0.60)。logistics回归分析显示,咳嗽(p<0.01)、咽庠(p<0.05)、咽干(p<0.01)、咳痰(p<0.01)是胃系症状出现的危险因素。
结论：1.肺系症状与胃系症状呈正相关,肺系症状越重,胃系症状越重。说明咳嗽病与胃系关系密切。
2.饮食失调与受凉感冒分列咳嗽病诱因第一、二位,且两组患者个人史(吸烟、喜食生冷)比较有统计学意义。说明“形寒饮冷”与“内外”合邪在咳嗽病病机中有重要作用。
3.通过养“胃气”可以预防咳嗽病的复发。
Objective:lung and stomach are both of the important organs of the human body, and the correlation of these two organs is very close.This study was designed to sum up the Lung-Stomach Correlation Theory through literature review. Cases study was made on the patients with cough disease diagnosed at the clinic of Department of Respiratory, Hunan University of Chinese Medicine First Affiliated Hospital from January 2009 to December 2009,to explore the correlation of pulmonary symptoms and gastric symptoms of cough disease, and to further understand the pathogenic mechanism of Lung-Stomach Correlation a to provide theoretical guidance and data to support for the clinical treatment for the cough disease.
Methods:1.Theoretical study:The literature review on the ancient and modern documents was made to sort out the Lung-Stomach Correlation theory and systemized it from the physiological and pathological perspective.
2.Clinical Research:collected clinical 200 cases with cough disease which are in line with the inclusion and exclusion criteria. The cases were divided into 2 groups in line with whether it had gastric symptoms.Each groups had 100 cases.The software of Spss15.0 was used for statistical processing.The basic information, personal history of illness and differential of disease dates between the two groups were analyzed by using Chi-Square Tests and t-test. We compared the differentials of the predisposing factors and figures of the two groups,and analyzed the correlation of pulmonary and gastric symptoms by linear regression analysis and logistic regression analysis.
Result:there was no significant difference in gender between the two groups (p> 0.05),but there was a significant difference in age (p<0.01), the patients of groups 1 were older than those of group 2.Comparing personal history of the two groups (smoking and eating cold foods), we found statistical significance (p<0.05) that smoking and eating cold foods has influences on the gastric symptoms of cough disease.Group 1 had longer disease dates than group 2 which had statistical significance (p <0.01).Diet-induced factors ranked number one of the predisposing factors in group 1,and taking cold was the first predisposing factor of group 2.Pulmonary symptoms and gastric symptoms were positively correlated (r=0.60) by linear correlation analysis Logistic regression analysis showed that symptoms,such as cough (p<0.01),pharyngeal itching (p<0.05),dry pharynx (p<0.01),expectoration (p<0.01),were the risk factors of gastric symptoms.
Conclusion:1.The pulmonary symptoms and gastric symptoms were positively correlated, the more severe pulmonary symptoms o, the more severe gastric symptoms,which showed close relations between cough disease and gastric system.
2.Eating disorders and taking cold are the first two predisposing factors of cough disease, and the comparison of personal history (smoking and eating cold foods) of the two groups had statistical significance,which showed that Exogenous Cold and Cold Eating and Joint Evil Inside and Outside had great importance in the pathogenic mechanism of cough disease.
3.By raising stomach qi,we can prevent the recurrence of cough disease.
方法：1.理论研究：通过古今文献整理“肺胃相关”理论,从生理、病理角度使理论系统化。
2.临床研究：临床收集符合纳入标准和排除标准的咳嗽病病例资料200份,分为病例组1(有胃系症状)、病例组2(无胃系症状)各100例。运用spss15.0统计处理,采用X2检验、t检验分析两组患者之间的基本情况、个人史、患病时间之间的差别。对照两组诱发因素和证型,比较两组间差异。通过直线相关分析和logistics回归分析咳嗽病肺系与胃系症状相关性分析。
结果：病例1组与病例2组性别比较无统计学意义(p>0.05),两组年龄比较有显著差异(p<0.01),病例组1患者年龄较病例2组年龄大。比较两组患者个人史(吸烟、喜食生冷)有统计学意义(p<0.05),认为吸烟与喜食生冷对咳嗽病胃系症状出现有影响作用。病例组1患病时间较病例组2患病时间长,有明显统计学意义(p<0.01)。病例组1饮食不调位列诱发因素第一位,受凉感冒位列病例组2第一位。经直线相关分析,肺系症状与胃系症状呈正相关(r=0.60)。logistics回归分析显示,咳嗽(p<0.01)、咽庠(p<0.05)、咽干(p<0.01)、咳痰(p<0.01)是胃系症状出现的危险因素。
结论：1.肺系症状与胃系症状呈正相关,肺系症状越重,胃系症状越重。说明咳嗽病与胃系关系密切。
2.饮食失调与受凉感冒分列咳嗽病诱因第一、二位,且两组患者个人史(吸烟、喜食生冷)比较有统计学意义。说明“形寒饮冷”与“内外”合邪在咳嗽病病机中有重要作用。
3.通过养“胃气”可以预防咳嗽病的复发。
Objective:lung and stomach are both of the important organs of the human body, and the correlation of these two organs is very close.This study was designed to sum up the Lung-Stomach Correlation Theory through literature review. Cases study was made on the patients with cough disease diagnosed at the clinic of Department of Respiratory, Hunan University of Chinese Medicine First Affiliated Hospital from January 2009 to December 2009,to explore the correlation of pulmonary symptoms and gastric symptoms of cough disease, and to further understand the pathogenic mechanism of Lung-Stomach Correlation a to provide theoretical guidance and data to support for the clinical treatment for the cough disease.
Methods:1.Theoretical study:The literature review on the ancient and modern documents was made to sort out the Lung-Stomach Correlation theory and systemized it from the physiological and pathological perspective.
2.Clinical Research:collected clinical 200 cases with cough disease which are in line with the inclusion and exclusion criteria. The cases were divided into 2 groups in line with whether it had gastric symptoms.Each groups had 100 cases.The software of Spss15.0 was used for statistical processing.The basic information, personal history of illness and differential of disease dates between the two groups were analyzed by using Chi-Square Tests and t-test. We compared the differentials of the predisposing factors and figures of the two groups,and analyzed the correlation of pulmonary and gastric symptoms by linear regression analysis and logistic regression analysis.
Result:there was no significant difference in gender between the two groups (p> 0.05),but there was a significant difference in age (p<0.01), the patients of groups 1 were older than those of group 2.Comparing personal history of the two groups (smoking and eating cold foods), we found statistical significance (p<0.05) that smoking and eating cold foods has influences on the gastric symptoms of cough disease.Group 1 had longer disease dates than group 2 which had statistical significance (p <0.01).Diet-induced factors ranked number one of the predisposing factors in group 1,and taking cold was the first predisposing factor of group 2.Pulmonary symptoms and gastric symptoms were positively correlated (r=0.60) by linear correlation analysis Logistic regression analysis showed that symptoms,such as cough (p<0.01),pharyngeal itching (p<0.05),dry pharynx (p<0.01),expectoration (p<0.01),were the risk factors of gastric symptoms.
Conclusion:1.The pulmonary symptoms and gastric symptoms were positively correlated, the more severe pulmonary symptoms o, the more severe gastric symptoms,which showed close relations between cough disease and gastric system.
2.Eating disorders and taking cold are the first two predisposing factors of cough disease, and the comparison of personal history (smoking and eating cold foods) of the two groups had statistical significance,which showed that Exogenous Cold and Cold Eating and Joint Evil Inside and Outside had great importance in the pathogenic mechanism of cough disease.
3.By raising stomach qi,we can prevent the recurrence of cough disease.
引文
[1]王洪图.内经讲义[M].北京：人民卫生出版社,2002：67-230.
[2]沈雪勇.“肺系”、“胃系”与“咽”、“喉”[J].天津中医,1997,14(6)：277.
[3]张安玲.关于肺胃生理相关性的探讨[J].中医药学报,2004,32(3)：3.
[4]张介兵.类经图翼[M].北京：学苑出版社,2005：9.
[5]汪丹.肺胃相关理论对慢性阻塞性肺病病因病机研究的指导意义.广州中医药大学博士论文[D].
[6]孙广仁.中医基础理论[M].北京：中国中医药出版社,2006：22-124.
[7]叶霖.难经正义[M].上海科技出版社,1981：12.
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[9]汪丹.肺胃相关性研究浅析[J].陕西中医.2008,29(7)：930.
[10]管桦桦,黄心洁,李赛美.肺胃相关性发挥[J].中医药学报.2008,3(38)：38.
[11]章恪.论肺胃相关[J].辽宁中医杂志.2006,33(7)：808.
[12]胡永军,孟静岩.《黄帝内经》脾胃理论析要[J].中华中医药学刊.2007,4(25)：31.
[13]唐容川.血证论[M].北京：中国中医药出版社,1996：132.
[14]戴自英.实用内科学[M].北京：人民卫生出版社,1993：1303.
[15]张仲景.伤寒论[M].北京：中国中医药出版社,2006：10.
[16]吴塘.温病条辨[M].南京：南京中医药大学温病学教研室.2005：8.
[17]柯琴.伤寒来苏集[M].北京：学苑出版社,2009：56-84.
[18]汤泰秦.胃食管反流性疾病与呼吸系统疾病(综述)[J].暨南大学学报医学报,2001,22(4)：51.
[19]陶志达.从溃疡病肺功能变化探脏腑关系[J].新中医,1985,17(6)：8.
[20]张媛,刘贵颖.中医药治疗咳嗽的临床研究进展[J].云南中医中药杂志,2007,10(28)：50.
[21]刘春涛,孙翊道.呼吸系统疾病的回顾及展望[J].四川医学,2004,25(12)：1358.
[22]薛汉荣.慢性咳嗽治疗之我见[J].江西中医药,1999,30(1)：20.
[23]白文元,穆华.胃食管反流病与呼吸系统疾病[J].中国全科医学,2006,9(23)：1934.
[24]张关生,阎继勤,张力军.辨证治疗胃食管返流性咳嗽42例[J].中国民间疗法,2000,8(8)：41-42.
[25]刘学俭.吴鞠通治疗咳嗽特色探析[J].辽宁中医,2001,3(4)：3.
[26]赵继红.从“聚于胃,关于肺”论咳嗽[J].浙江中医杂志,2002,4(40)：62.
[27]徐艳玲.运用《内经》肺胃相关理论指导肺系疾病的辨证论治[J].辽宁中医杂志,2008,35(2)：207.
[28]邓月娥.叶天士《临证指南医案》脾胃辨治规律探析[J].福建中医学院学报,2007,17(6)：78.
[29]潘星宇.运用“培土生金”法治疗久咳[J].甘肃中医,2002,15(4)：45.
[30]李东垣,张年顺.脾胃论[M].北京：中国中医药出版社.2007：130-152.
[31]师董芳,张念志.外感咳嗽的中医药研究进展[J].临床肺科杂志,2009,14(1)：81.
[32]粱松健.中医辨治慢性咳嗽[J].河北中医,2006,28(5)：28.
[33]吴子明,李肇夷.宋元明清医案[M].长沙：湖南科技出版社,2005：45-610.
[34]中华医学会.中医内科常见病诊疗指南中医病证部分[J].中国中医药出版社,2008：1.
[35]田华.咳嗽[J].河北中医,2009,1(2)：320.
[36]谭邦华.从咳嗽的诊断与治疗探析中医辨治疾病思路[J].光明中医,2007,22(6)：17.
[37]郑筱萸.中药新药临床研究指导原则[M]北京：中国医药科技出版社,2002：134-139.
[38]张介宾.景岳全书[M].北京：人民卫生出版社,2007：9.
[39]蓝立业,徐成贺.《内经》对咳证治的思想探讨[J].光明中医,2002,17(100)：23.
[40]刘完素.素问玄机原病式[M].北京：人民卫生出版社,2005：8.
[41]余韵星.略论“肺胃不和”[J].北京中医杂志,2004,1(1)：20.
[42]朱晋龙.也谈咳皆聚于胃关于肺[J].辽宁中医学院学报,2003,5(3)：218.
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[2]沈雪勇.“肺系”、“胃系”与“咽”、“喉”[J].天津中医,1997,14(6)：277.
[3]张安玲.关于肺胃生理相关性的探讨[J].中医药学报,2004,32(3)：3.
[4]张介兵.类经图翼[M].北京：学苑出版社,2005：9.
[5]汪丹.肺胃相关理论对慢性阻塞性肺病病因病机研究的指导意义.广州中医药大学博士论文[D].
[6]孙广仁.中医基础理论[M].北京：中国中医药出版社,2006：22-124.
[7]叶霖.难经正义[M].上海科技出版社,1981：12.
[8]罗仁,杨运高,陈达理.肺系病证妙谛[M].北京：人民军医出版社,2008：10-24.
[9]汪丹.肺胃相关性研究浅析[J].陕西中医.2008,29(7)：930.
[10]管桦桦,黄心洁,李赛美.肺胃相关性发挥[J].中医药学报.2008,3(38)：38.
[11]章恪.论肺胃相关[J].辽宁中医杂志.2006,33(7)：808.
[12]胡永军,孟静岩.《黄帝内经》脾胃理论析要[J].中华中医药学刊.2007,4(25)：31.
[13]唐容川.血证论[M].北京：中国中医药出版社,1996：132.
[14]戴自英.实用内科学[M].北京：人民卫生出版社,1993：1303.
[15]张仲景.伤寒论[M].北京：中国中医药出版社,2006：10.
[16]吴塘.温病条辨[M].南京：南京中医药大学温病学教研室.2005：8.
[17]柯琴.伤寒来苏集[M].北京：学苑出版社,2009：56-84.
[18]汤泰秦.胃食管反流性疾病与呼吸系统疾病(综述)[J].暨南大学学报医学报,2001,22(4)：51.
[19]陶志达.从溃疡病肺功能变化探脏腑关系[J].新中医,1985,17(6)：8.
[20]张媛,刘贵颖.中医药治疗咳嗽的临床研究进展[J].云南中医中药杂志,2007,10(28)：50.
[21]刘春涛,孙翊道.呼吸系统疾病的回顾及展望[J].四川医学,2004,25(12)：1358.
[22]薛汉荣.慢性咳嗽治疗之我见[J].江西中医药,1999,30(1)：20.
[23]白文元,穆华.胃食管反流病与呼吸系统疾病[J].中国全科医学,2006,9(23)：1934.
[24]张关生,阎继勤,张力军.辨证治疗胃食管返流性咳嗽42例[J].中国民间疗法,2000,8(8)：41-42.
[25]刘学俭.吴鞠通治疗咳嗽特色探析[J].辽宁中医,2001,3(4)：3.
[26]赵继红.从“聚于胃,关于肺”论咳嗽[J].浙江中医杂志,2002,4(40)：62.
[27]徐艳玲.运用《内经》肺胃相关理论指导肺系疾病的辨证论治[J].辽宁中医杂志,2008,35(2)：207.
[28]邓月娥.叶天士《临证指南医案》脾胃辨治规律探析[J].福建中医学院学报,2007,17(6)：78.
[29]潘星宇.运用“培土生金”法治疗久咳[J].甘肃中医,2002,15(4)：45.
[30]李东垣,张年顺.脾胃论[M].北京：中国中医药出版社.2007：130-152.
[31]师董芳,张念志.外感咳嗽的中医药研究进展[J].临床肺科杂志,2009,14(1)：81.
[32]粱松健.中医辨治慢性咳嗽[J].河北中医,2006,28(5)：28.
[33]吴子明,李肇夷.宋元明清医案[M].长沙：湖南科技出版社,2005：45-610.
[34]中华医学会.中医内科常见病诊疗指南中医病证部分[J].中国中医药出版社,2008：1.
[35]田华.咳嗽[J].河北中医,2009,1(2)：320.
[36]谭邦华.从咳嗽的诊断与治疗探析中医辨治疾病思路[J].光明中医,2007,22(6)：17.
[37]郑筱萸.中药新药临床研究指导原则[M]北京：中国医药科技出版社,2002：134-139.
[38]张介宾.景岳全书[M].北京：人民卫生出版社,2007：9.
[39]蓝立业,徐成贺.《内经》对咳证治的思想探讨[J].光明中医,2002,17(100)：23.
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