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Composite etiology pathogenesis analysis

2015年11月26日

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Composite etiology pathogenesis analysis

Time: 2015-11-25

Source: China's traditional Chinese medicine

Author: on the

As is known to all, the cause of traditional Chinese medicine generally divided into two major categories of exogenous and internal injuries, diseases, including six evils and plague will hapen qi, within the wounded including modern, diet, overwork. These can cause pathogenic alone, but in the context of clinical practice, the more see more in the form of a combination of the pathogenic, such as rheumatism, the wind cold dampness, phlegm dampness, hot and humid, etc. The cause of the two and more combination is complex etiology. Because of this combination in a variety of disease process often takes the form of fixed, consistent for abuse, inseparable, therefore, further study of the pathogenic characteristics of compound cause, to analysis the, determine the treatment is of great significance.

【 compound cause 】 in the form of

The pathogenic causes of complex phenomenon, the traditional Chinese medicine has a clear understanding, such as "element asked • BiLun" "three miscellaneous to gas, the wind cold dampness and for bi." "Element asked, six yuan ji is old theory of" rheumatism muscle "and" heat), etc. The acknowledgement, the later generations for the understanding of the complex etiology pathogenesis has become increasingly rich and profound, such as "three for party" think: "wind chill, rheumatism, temperature, wind cold dampness, wet temperature, five for and; the wind cold dampness, rheumatism, both for us." "Element asked mystery original disease type" : "6 gas divide into disease, which is with the disease, phase and hot dry with wind, and also more; cold dampness sex with, and also more", clearly points out the six pathogenic and gas phase phenomenon and common type. The warm fabrics also said: "heat wet easily and disease, of the children of judah during cold, each phase and feeling." Put forward: the heavy book popular treatise on febrile diseases ", which "all Yang meridians table evil incoming lunar, often the spleen and stomach heat and wet."

We illustrate common compound cause pathogenic form:

Phase of winds and neijing call wind "of the beginning of everything" (" element asked, bone theoretical ") and "fit" (" element asked, wind theory ", it is because of cold, wet, dry, hot per attached to the wind, the vital qi is in a state of absolute or relative deficiency in violation of the human body. That is to say, the wind due to rise away, good sex, often act as a pioneer in pathogenic role.

Wind fever by fur or muzzle infringement of the human body, which will form the table card in two basic types. If the guard table card (evil cold, fever), and see the lung disease (cough, etc.), was diagnosed as a cold; The others can also lead to cough, asthma syndrome, headache, swelling (feng shui), etc.

Wind and dry close, see more at the autumn, each in the lung injury, lung XuanRun loss, on the inverse and cough, clinical less visible dry cough phlegm, recited a choking, dry throat pain, lip nasal dryness, beginning or see table card. If the wind temperature, dry, still can send for hemoptysis.

Wind the origin, can make the head, body, deter QingYang or meridians, clinical visible headache as wrapped, heavy body trapped, defecate or pond, white greasy moss, etc.

If the wind and dampness, or in hot and humid, resistance meridians closed, affect blood running, cause the limb bones and muscles, joints, muscles, the place such as pain, heavy, sour, numbness, or adverse joint flexion and extension, stiffness, swelling, deformation, wait for a symptom, this is a certification certificate.

Phase of sputum and Phlegm is the body the water is not reformed, tianjin, the pathology of products, and pathogenesis of pathological factors. It is generally believed that phlegm is the result of wet, wet, was born in the spleen, and therefore the source of "the spleen for ShengTan". Of sputum, both can be wet phlegm, sputum, dry, cold wind phlegm, phlegm heat and other forms with jet fluctuation is less than, the such as "class card for cutting" said: "drink stop accumulation of intestines and stomach, phlegm is the gas lift, is that all that in the lungs are cough, the stomach is ou, heart is nervous, on the head is dizzy... change the end, yesterday what strange disease much sputum, diseased belong to fire more also." Because of its pathogenesis has universality, it is "everything is all in the sputum work".

The sign of wet phlegm, lung resistance of most easily, can send to cough and gasp the clinical, and often made by phlegm, phlegm out cough asthma reduction flat; If the resistance in the chest, can send to obstruction; If block the brain, or obsessed with the blind brain, can be sent as a headache or dizziness; If with qi depression, blinded by understanding, can send for epilepsy; If the local wet phlegm flows, visible, item, mandible neck or limbs, shoulders and subcutaneous emphysema up like nuclear agglomerate, how much is differ, not red not swollen, not hard pain, touch the movable, this is phlegm nucleus, and so on.

Visible sign of heat phlegm, phlegm thick sticky or yellow thick hard cough up, companion see chest side bulge, or surface hot naked. If YuZu in lungs, can lead to cough, asthma, If lurk in the lungs, meet the sense of touch, can send to xiao disease; Interference in in the heart, and can cause heart palpitations, insomnia; Phlegm fire disturbance and obsessed with the brain, or trigger a wild card.

Character of wind phlegm, generally considered to be outside by wind or endogenous wind touches of phlegm in the body. Outside caused by wind, make the lungs is common cough spit PaoMoTan stripping, accompanied by a card table; Into the complex can be single hair eye 㖞 oblique mouth, tongue language Jian, spat salivate, or with skin goes, extremities numbness, joint pain, etc. Caused by endogenous wind, can deceive qing qiao, escaping channels and collaterals, hair, chronic disease or stroke.

Internal injuries in the miscellaneous diseases, the etiology and pathogenesis of phenomenon is more common, more factors such as a variety of modern miscellaneous knead, a variety of diet not festival and see, causes in the cause of the injury, illness, disease are difficult to determine, complex pathological changes.

In addition, there is a kind of inside and outside because of disease, such as the onset of pulmonary abscess, by with phlegm, exogenous wind hot; Out of card tables in the cold lung heat syndrome (namely "cold pack fire"), is known as the heat, after feeling cold outside.

【 compound the cause of the relationship between 】

By the above example, you can see that the cause of combinations are diverse, complex, but also to have certain rules to follow, such as the six exogenous pathogenic each to the guideline of the wind, phlegm, very cold, the change of thermalization, etc. Composite causes many for parallel relationship between, namely phase and superposition, common for the disease, but in the evolution of disease, or to show the causal relationship between several kinds of pathogenic factors, such as wet to phlegm, and to blood stasis, Yang deficiency is to drink, in blood deficiency of qi deficiency, suffered or Yin deficiency of liver Yang syndrone. Some diseases, but both parallel relationship between pathological factors, also can present a causal relationship, such as hysteresis of pixu (spleen deficient) or stomach in liver depression, both neither can exist at the same time, also can be the latter, is the fruit of the diseases by spleen and stomach.

Can cause combination, geometric phase and with no obvious tendency, but there are also common primary and secondary points, form a deviation, such as "element asked • BiLun" in put forward: "the ethos winners for migratory arthralgia, chill the pain of the bi, the moisture winner for polioplus partners also"; Treatise on febrile disease caused by the sun in the disease felt cold, zhang zhongjing according to feel the weight of the wind and the cold into a stroke with typhoid. Again, such as Yang huang, also there is a hot focus on wet heat and wet weight of two cases.

This causes combination although has close relationship with the composition itself, but it is not a simple superposition, in a sense, it has become a new cause, for the occurrence of a disease appears as the existence of fixed and independent, such as xiao of cold phlegm, heat phlegm, chronic disease of wind phlegm, bi certificate to the wind and dampness, rheumatic fever, and so on.

Cause after combination, on the one hand, in the course of illness that acted plays a pathogenic role of the respective, and influence each other on the other hand, mutual cooperation, change their role position and evolution trend, form new pathogenic process. Such as the injury in the wind, on the first; the injury in the wet, the first by the "(" element asked, too theory of Yin and Yang Ming"), "yue inflammation on fire" (" history, hung fan "), can be on the head and wet with the wind, the fire (heat) and wet can be arrived in medicine. Such as wet and heat sealing, such as oil into the face, neck, block qi activity, lingering painless; Wind and fire, the flames wind, fire, changfeng, wind fire fan and heat jue. Therefore, for complex etiology should be the overall view, and fully consider the cause between the causal relationship between the weight, or primary and secondary.

The complex etiology evidence cure 】

Composite etiology often result in composite card type. Cause of composite processing, therefore, should be the result of the disease on the basis of overall understanding, combined with the relationship between the complex causes, establish the corresponding treatment. Should grasp the general principle is: parallel relationship to divide and rule, both causal relations.

According to the phase of the wind and cold, hot, dry, wet, clinical respectively adopt breeze breeze clear heat, cold, wind run dry, the wind to wet method; At the same time, should also consider the characteristics of disease, such as cough, cough, headache, pain, edema, water, etc. If the wind and dampness or hot and humid and, the remedy to drain clearing damp, cold wind or breeze heat clearing damp, and should be according to the part made by the t2dm, the so-called "for first blood, blood enhancement self-quenching" (Li Zhongzi). In this kind of disease, because of the evil by the wind, so the treatment should focus on "breeze", to express "solution evil", this is traditional Chinese medicine treatment of "give evil way out.

Such as composite disease because causality, should make clear causal specimens, and to do both. Such as lung, cough due to phlegm wet aggregates the onset process goes through five stages, namely the congenital deficiency or diet not festival, spleen deficiency, loss of wet - together and stop for phlegm, phlegm in lung, lung inverse gas, is the basic requirement of the treatment of "phlegm cough", is the basic requirement of the treatment of "spleen dry wet", while the demand in the whole process of the treatment is to restore the spleen, cut not born of phlegm, clearing has born of phlegm.

In addition, because the cause of the combination of different composition, establishment should also try to distinguish between primary and secondary treatment, such as cold outside of the sun, cold (real) with ephedra soup, wind (virtual) with guizhi soup; Again such as Yang yellow treatment, heat over wet person to cure "clear heat relieving, lishi retreat yellow", wet over fever treated with "dehumidification spleen, heat retreat yellow".