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目的:探讨手足口病的病因病机、传变规律和辨证模式。方法:采用比较医学的方法,对中医药研究手足口病的文献进行梳理和理论分析。结果:认为手足口病的疾病归属宜“疫疹”为妥,病邪性质为温热夹湿,感邪门户虽然符合口鼻而入,但不排除皮毛外感(强调邪袭卫表的临床表现,而口鼻而入强调的是上呼吸道的临床表现)。根据证候学调查,基本符合“肌表-经脉-脏腑”传变假说(“温邪外感,首犯太阴,顺传脾肺,逆传心肝”),并提出“不传、顺传、逆传”等三种传变模式,建议根据病程分为表证期、里证期、恢复期/坏证期,各期通过证素分析提炼出主要病机、次要病机,以便确立基本证候和兼夹证候,再根据“理法方药”原则采取相应的“主方加减”论治策略。结论:手足口病应该结合临床实际和传染病学的进展,丰富、发展和总结符合中医特色的证治规律,为诊疗进步提供理论支持。
Objective: To explore the etiopathogenisis and pathogenesis of hand-foot-mouth disease, the law of change and the pattern of syndrome differentiation. Methods: Using comparative medical methods, combing and theoretical analysis of literature on the study of hand-foot-mouth disease in traditional Chinese medicine. Results: The disease of hand, foot and mouth disease should be attributed to the “epidemic rash” is appropriate, the pathogenic nature of the warm folder wet, although the portal line of mouth, but does not rule out exogenous fur (stress evil defensive watch Clinical manifestations, while oral and nasal emphasis is on the clinical manifestations of the upper respiratory tract). According to the investigation of syndromes, it basically conformed to the hypothesis of “mass-meridian-meridian-viscera” (“Wen Xie extrinsic flu, first criminal perineum, Shun Chuan, retrograde ”and other three kinds of transmission mode, it is recommended according to the course of the disease is divided into table period, the card period, the recovery period / bad card period, each period through the analysis of factors extracted from the main pathogenesis, secondary pathogenesis , In order to establish the basic syndromes and the concurrent syndromes, and then according to “law prescriptions ” principle to take the corresponding “master addition and subtraction ” theory of treatment strategy. Conclusion: HFMD should be combined with the clinical practice and epidemiological progress, enrich, develop and summarize the syndrome differentiation and treatment rules that conform to the characteristics of TCM, and provide theoretical support for the progress of diagnosis and treatment.