慢性咳嗽证候特征与“温润辛金培本”法应用研究
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摘要
研究目的
1.通过文献研究得到近十年文献中慢性咳嗽证候类型、症状的分布情况,为制定临床信息采集表、开展临床研究奠定基础；应用循证医学方法客观评价随机对照研究中中药治疗慢性咳嗽的疗效,以期这些研究结果能为后续慢性咳嗽的方-证研究提供循证医学证据。
2.通过临床研究得到慢性咳嗽的症状、证候分布特点,并应用不同的数据挖掘方法探讨证候特点,同时探讨导致慢性咳嗽的不同疾病与证候的相关性。
3.通过临床研究,从不同角度论证了“温润辛金培本”法治疗慢性咳嗽的临床疗效；通过“温润辛金培本”法治疗慢性咳嗽不同证候间疗效差异的比较,得到该法治疗效果较好的证候,为慢性咳嗽的证候规范化研究及临床治疗提供依据。
研究方法
1.文献研究
采用循证医学系统综述文献研究方法,系统检索现代文献数据库,收集整理有关慢性咳嗽中医证候、症状的全部文献；用Epidata建立数据库,对症状、证候名称进行规范化,应用SPSS17.0软件统计分析其证候及症状分布特点。
采用循证医学系统综述文献研究方法,系统检索现代文献数据库,收集整理有关中药治疗慢性咳嗽的随机对照研究文献；设计资料提取表,由2名以上人员进行相关信息提取,遇有疑问与第三者协商解决；分别对文献的质量(包括方法、对象、干预措施、结局测量等)进行评价,应用Revman5.1对中药治疗的疗效进行分析。
2.临床研究
遵循临床流行病学和循证医学的原理与方法,采用前瞻、多中心、开放式、有监督无监督相结合的观察性研究方法,全面采集慢性咳嗽患者基本信息、四诊信息及证候诊断相关资料。共收集临床病例539例,其中中医病例458例,西医病例81例。采用构成比分析、因子分析、聚类分析和logistic回归分析,对所得数据进行挖掘,多方位揭示慢性咳嗽的症状及证候特征并探讨病-证的相关性。
选取西医病例81例,“温润辛金培本”法治疗的中医病例97例,进行疗效比较；另选取72例其它中药疗法治疗的病例及80例“温润辛金培本”法治疗的病例,进行疗效比较。采用卡方检验、秩和检验和t检验及方差分析等统计学方法进行疗效分析。
共选取114例“温润辛金培本”法治疗的中医病例进行证候间的疗效比较。其中气郁伤肺证17例,肺肾气虚证40例,卫气不固证27例,肺脾两虚证30例。采用卡方检验、秩和检验、t检验和方差分析等统计学方法进行疗效分析。
研究结果
1.文献研究结果
1.1证候研究结果
1.1.1慢性咳嗽证候分布特点
共得到慢性咳嗽中医证候128个,单个证候114个,复合证候14个。
按照证候出现的频次进行排列,位列前十位的证候分别是：气阴两虚证、肺气亏虚证、痰热蕴肺证、肝火犯肺证、气滞血瘀证、肺阴亏虚证、气虚痰湿证、阴虚肺燥证、痰湿蕴肺证、肺脾气虚证。
1.1.2不同病因导致慢性咳嗽的证候分布特点
上气道咳嗽综合征,排列在前四位的证型分别是风痰恋肺证、风痰郁肺证、阴虚肺燥证和脾胃虚弱证；咳嗽变异性哮喘,以肺气亏虚、肝火犯肺、寒邪伏肺及风热犯肺为主要证型；胃食管反流性咳嗽以肝胃郁热为主要证型,其次为肝胃不和、胆热犯胃和痰气郁阻；变应性咳嗽主要证型依次为风寒犯肺、肺气亏虚、风热犯肺和燥邪伤肺；肺癌主要证型为气阴两虚、肺气亏虚、气虚痰热、肺脾气虚等；慢性支气管炎以肺肾气虚、脾肾阳虚、痰热郁肺、肺肾阴虚等证型为主；支气管扩张主要证型为痰热郁肺、肝火犯肺和肺脾气虚证；肺结核主要证型为气阴两虚、阴虚火旺、肺气亏虚、肺脾气虚等。
1.1.3慢性咳嗽症状分布特点
(1)主症分布特点：常见主症共有17种,包括：咳声阵发、夜间咳嗽加重、痰少及胸痛,气急,胸闷,痰粘等症状。(2)伴随症状分布特点：共有19个伴随症状,分别是：咽痒,乏力,口干,咽干,失眠,痰难咳出,出汗等症状。(3)舌象脉象分布特点：舌色以舌红、舌淡及舌淡红、淡暗为主；舌体多为胖大有齿痕；舌苔质地以薄苔及腻苔、少苔为主；舌苔以黄苔、白苔占大多数。脉象以细脉最多,其次为弦脉、滑脉及细数脉、细弱脉和弦滑脉、数脉。
1.2中药治疗慢性咳嗽随机对照研究Meta分析结果
就目前纳入的文献来说,中药治疗慢性咳嗽有一定优势,明显优于西药治疗(P<0.01)。具体可表现在治疗咳嗽变异性哮喘(P=0.001)、支气管扩张(P<0.0001)的疗效显著,明显优于西药；中药治疗慢性支气管炎疗效均明显优于西药(P<0.01)。
目前还不能认为中药治疗上气道咳嗽综合征(P=0.06),肺癌(P=0.17)效果优于西药化疗,也不能认为中药治疗变应性咳嗽(P=0.32)、嗜酸粒细胞性支气管炎(P=0.86)及胃食管反流性咳嗽(P=0.05)疗效优于西药。
2.临床研究结果
2.1慢性咳嗽证候、症状分布特点
2.1.1证候分布特点
将收集的证候规范后,共得到24个证候,其中常见的证候有：气郁伤肺证,肺肾气虚证,肺阴虚证,卫气不固证,肺脾两虚证,凉燥袭肺证和肺燥郁热证。
2.1.2症状分布特点
共收集到慢性咳嗽主症及伴随症状141种,舌象26种,脉象12种,其中,常见的症状及舌脉共计52种；慢性咳嗽常见的主症共计11个,分别是咳声阵发,声低无力,冷风诱发,冷风、油烟及异味诱发,咳痰等；慢性咳嗽常见的伴随症状共计28个,分别是咽部异物感,怕冷,乏力,易感冒,咽痒,失眠多梦,口干,怕风,气短,大便稀溏等。
2.1.3舌脉分布情况
舌象中,以薄白苔为主；其次为黄苔、厚苔、腻苔；舌质少津、舌色淡暗、舌暗红、舌色鲜红、舌紫黯/瘀斑亦为常见舌象。脉象中,以沉脉和虚脉为主；其次为滑脉和弦脉。
2.2因子分析
共得到15个公因子及其方程,提示可归纳为以下15个证候：肺气虚证、肺阳虚证、气郁伤肺证、气阴两虚证、肺脾两虚证、肺肾气虚证、肺卫气虚证、肺肾阳虚证、肺燥郁热证、凉燥袭肺证、心肺实热证、痰热闭肺证、肺阴亏虚证和肺燥津亏证、痰凝咽喉证。
2.3聚类分析
共可聚为7大类,结果提示慢性咳嗽中医证型可归纳为：肺气虚证、肺阳虚证、气郁伤肺证、气阴两虚证、肺脾两虚证、肺肾气虚证、肺卫气虚证、肺肾阳虚证、肺燥、痰热闭肺证、心肺气虚证和痰凝咽喉证。
2.4logistic回归分析
2.4.1症状与证候logistic回归分析
气郁伤肺证相关的症状、体征分别是：咳黄痰,痰稀薄,咽部异物感,痰少,便干,失眠多梦,黄苔,舌暗红。
肺肾气虚证相关的症状分别是：痰稀薄,动则气喘,腹泻,怕风。
肺阴虚证相关的症状、体征分别是：咳黄痰,冷风诱发咳嗽,痰少,便干,失眠多梦,黄苔,白苔。
卫气不固证相关的症状、体征分别是：咳痰,动则气喘,胸闷,平素易感冒,微脉。
肺脾两虚证相关的症状、体征分别是：声低无力,咳痰,咳白痰,动则气喘,便干,口干,腹泻,白苔。
凉燥袭肺证相关的症状、舌象是：痰少,平素易感冒和白苔。
肺燥郁热证相关的症状、舌象是：口干,动则气喘,皮肤过敏,黄苔,便于
2.4.2病因与证候logistic回归分析
上气道咳嗽综合征的证候特点是肺燥郁热证；感冒后咳嗽的常见证候为肺肾气虚证和卫气不固证；咳嗽变异性哮喘的证候特点是气郁伤肺证、卫气不固证和肺脾两虚证；慢支的证候特点为气郁伤肺证、肺肾气虚证和肺阴虚证；COPD的证候特点可包括气郁伤肺证、肺肾气虚证、卫气不固证；支气管扩张的证候特点是肺阴虚证、肺肾气虚证。
2.5“温润辛金培本”法疗效初探
2.5.1“温润辛金培本”法与西药治疗的疗效比较
(1)总体疗效：“温润辛金培本”法治疗的有效率可达97.94%,显效率可达74.23%；西药组有效率为81.48%,显效率为45.68%；“温润辛金培本”法的疗效明显优于西药,P<0.01。(2)咳嗽症状：“温润辛金培本”法在改善咳嗽症状方面疗效明显优于西药,P<0.01。(3)LCQ：“温润辛金培本”法疗效明显优于西药,P<0.01。
2.5.2“温润辛金培本”法与其它中药疗法的疗效比较
(1)总体疗效：“温润辛金培本”法治疗的有效率可达95%,其它中药疗法有效率为91.67%；“温润辛金培本”法治疗的显效率可达73.20%,其它中药疗法为70.37%；不能认为该法的疗效优于其它中药疗法,P>0.05。(2)咳嗽症状：“温润辛金培本”法在改善患者的夜间咳方面疗效优于其它中药疗法,P<0.01。(3)LCQ：“温润辛金培本”法疗效优于其它中药疗法,P<0.01。
2.5.3不同证候间的疗效比较
(1)总体疗效：“温润辛金培本”法治疗四组证候,气郁伤肺证显效率为58.82%,肺肾气虚证显效率为80%,卫气不固证显效率为74.08%,肺脾两虚证显效率为80%,经统计学检验该显效率结果无统计学差异,P>0.05。
治疗气郁伤肺证有效率76.47%,肺肾气虚证有效率95%,卫气不固证有效率100%,肺脾两虚证有效率93.33%,四组证候间的有效率存在统计学差异,P<0.05。
(2)咳嗽症状
在改善咳嗽症状方面,其证候间存在明显差异,以肺脾两虚证、卫气不固证和肺肾气虚证咳嗽症状改善最为显著,P<0.01。
(3) LCQ
“温润辛金培本”法均可在不同程度上改善四种证候的生命质量。从总分来说,疗效可依次排列为：肺脾两虚证>卫气不固证>肺肾气虚证>气郁伤肺证,P<0.01。从心理维度得分来说,以气郁肺证疗效最佳,其次为肺肾气虚证,P<0.05。
研究结论
通过文献研究及临床研究,可得出如下结论：
1.慢性咳嗽的证候与五脏相关,虚实寒热错杂。以肺脾肾虚为主,虚中夹实。文献研究结果与临床研究结果基本相符。
2.在不同病因导致的慢性咳嗽证候特征方面,不同疾病证候表现不同。上气道咳嗽综合征,虚证不显,但以“燥”和“热”较为明显,而过敏性鼻炎的证候以虚证为主；咳嗽>8周的感冒后咳嗽,已无表证可言,以虚证为主,主要表现为气虚和卫气不固；咳嗽变异性哮喘、慢支、COPD和支气管扩张的证候基本反映了疾病特点,病情复杂,其证候特征亦是虚实夹杂,既有实证也有虚证。病-证结合的证候特点研究符合临床实际及疾病特点,可为临床辨证及治疗提供依据。
3.通过规范的临床研究,进一步证实了“温润辛金培本”法的临床疗效。该法在慢性咳嗽的治疗中,疗效优于西药；在改善夜间咳及生活质量方面疗效优于其它中药疗法；研究提示：温润辛金培本法治疗慢性咳嗽气郁伤肺证、肺脾两虚证、卫气不固证和肺肾气虚证均有较好的临床疗效,但不同证候间疗效亦存在差异,主要体现在症状改善和生活质量提高两个方面。症状改善方面,气郁伤肺证疗效不如肺脾两虚证、卫气不固证和肺肾气虚证,而在LCQ心理维度则以气郁伤肺证疗效最佳。这从不同方面说明了方-证的相关性,提示该法适宜于这四种证型,可在不同层面改善症状,提高临床疗效。
Objective:
1. Getting distributated situation of TCM syndromes and symptoms in chronic cough by ten years' literatures research so as to lay the foundation of making clinical report form and carrying out clinic research; Evaluating objectively curative effect of herbs in randomized controlled trial of chronic cough by using methods of evidenced-based medicine so that these results can offer evidences for subsequent research of prescriptions corresponding to syndromes in chronic cough.
2. Getting distributated situation of TCM syndromes and symptoms in chronic cough by clinical research and discussing different syndromes characteristics by using multiple methods of data mining. Meanwhile,exploring relevance between different diseases of chronic cough and TCM syndromes.
3. Proving curative effect that method of WenRunXinJinPeiBen treats chronic cough from multiple sides by clinical research. Getting better effect syndroms of chronic cough, which may supply evidences for syndrome standardized research and clinical treatment in chronic cough.
Medthods:
1. Literature Research
Retrieve systematicly modern literature data base, colleet and organize all literatures about TCM syndromes and symptoms of chronic cough; Build database with Epidata3.0,standardize name of TCM syndromes and symptoms and analyze distributated situation of TCM syndromes and symptoms with SPSS17.0.
Firstly,Retrieve modern literature database systematicly,collect and organize all literatures about RCT of curative effect of herbs in chronic cough. Secondly,design data extraction table and withdraw useful informations by two researchers. when they have quest ions, they must consult the third researcher and resolve it by negotiation. Thirdly,evalua tequalities of included studies(including method, object, intervention measure and outcome,etc) and analyze curative effect of chinese herbs with Revman5.1.
2.Clinical Research
According to theories and methods of clinic epidemiology and evidence-based medicine, prospective observational study was launched by ways of supervision with combination of non-supervision methods in multiple study centers.Chronic cough patients' informationswere collected comprehensively, including patients' basic informations, informations of four diagnostic methods and diagnosis of syndromes informations. At last539reports were finished, among which there are458TCM reports and81west medical reports. Analyze these repots with proportion ratio analysis, factor analysis, clustering analysis and logistic regression analysis. Accordingly, it may be revealed that specialties of syndromes, symptoms and the relevance between different diseases with syndromes in chronic cough.
81patients of western medicine and97TCM patients were chosed, which was used to compare the effect of WenRunXinJinPeiBen with western medicine by ways of statistical methods, such as chi-square test,rank sum test, t-test, and analysis of variance.
114TCM reports that were treated with medthod of WenRunXinJinPeiBen were chosed, among which there are17reports of Qi depression and lung injury,40reports of qi deficiency of lung and kidney,27reports of defensive Qi instability and30reports of lung and spleen deficiency. Curative effect variance were compared among four different syndromes by ways of statistical methods, such as chi-square test,rank sum test,t-test,and analysis of variance.
Results:
1.Results Of Literature Research
1.1Results Of Syndromes Study
1.1.1Distributed Characteristics Of Syndromes
128TCM Syndromes were obstained in this study.There are114single syndromes and14compounded syndromes among these.Ten syndromes are ranked in sequence according to their frequencies and they respectively are syndromes of Qi and Yin deficiency, lung Qi deficiency, phlegm-heat storing in lung, liver fire invading lung, Qi-stagnation and blood stasis, lung Yin deficiency, Blood deficiency and phlegm wet, Yin deficiency and lung dryness, phlegm-wet storing in lung, Qi deficiency in lung and spleen.
1.1.2Distributed Characteristics Of Syndromes In Different Diseases
Up Airway Cough Syndromes:wind-phlegm staying in lung, wind-phlegm stagnated in lung, Yin deficiency and lung dryness and weakness of the spleen and stomach.Cough Variant Asthma:main TCM syndromes are syndromes of lung qi deficiency,liver fire invading lung, Cold evil storing in lung and wind-heat affecting lung.Gastroesophageal Reflux Cough:main syndrome is heat stagnated in liver and stamoch. Others are syndromes of liver-stomach disharmony, Gallbladder heat invading stomach and Qi-phlegm stagnation and stasis. Atopic Cough:main TCM Syndromes are Syndromes of wind-cold affecting lung, weakness of lung qi, wind-heat affecting lung and dryness injuring lung. Lung Carcinoma:main TCM Syndromes are Syndromes of Qi and Yin deficiency,weakness of lung qi,Qi deficiency and phlegm heat, lung Qi deficiency and spleen, etc. Chronic Bronchi tis: main TCM Syndromes are Syndromes of Qi deficiency in lung and kidney, insufficiency of both the spleen and the kidney, phlegm-heat stagnated in lung, Yin deficiency in lung and kidney, etc. Bronchiactasis:Syndrome of phlegm-heat stagnated in lung, Syndrome of liver fire invading lung, Syndrome of Qi deficiency in lung and spleen. Tuberculosis:insufficiency of both Qi and Yin, fire excess from yin deficiency, lung Qi deficiency and Qi deficiency in lung and spleen.
1.1.3Distributed Characteristics Of symptoms in chronic cough
(1) Distributed Characteristics Of Main Symptoms:there are17common types of main symptoms, including paroxysmal cough, worsening of cough at night, little sputum, chest pain, dyspnea, oppress ion in chest,Viscous sputum,etc.
(2) Distributed Characteristics Of associated symptoms:There are19types of associated symptoms and they respectively are Pharyngeal iten ing,fatigue, dry mouth, dry Pharyngeal, insomnia,sweat ing,etc.
(3) Distributed Characteristics Of Tongue Picture And Pulse Condition:tongue color based on red, light, light red and light dark tongue. Tongue body are mostly fat,big and indented. The thin,greasy and short coating are main coating on the tongue. The coat ing colors are mostly yellow and white. Thready pulse is the most of pulse condition, the others are string-like pulse, slippery pulse, thin and count ing pulse, thin and weak pulse, string-like and slippery pulse and count ing pulse.
1.2Systematic Review Results That Chinese Herbs Treat Chronic Cough In RCT
Chinese herbs treating chronic cough has regular superiority according to included literatures at present.It may be definitely manifested by curative effect that Chinese herbs treats CVA,Bronchiactasis and Chronic Bronchitis.The results showed that Chinese herbs was superior to west medicine, P=0.001, P<0.01, P<0.01.
At present it can't be proved that Chinese herbs is superior to western medicine in Atopic cough (P=0.32), eosinophilic bronchitis (P=0.86) and gastroesophageal reflux cough (P=0.05).
2. Results Of Clinical Research
2.1Distributed Characteristics Of Syndromes And Symptoms
2.1.1Distributed Characteristics Of Syndromes
24kinds of TCM Syndromes were obstained after collected syndroms were standardized, in which common syndromes are syndromes of lung injured by Qi stagnation, qi deficiency of lung and kidney,deficiency of lung Yin, defensive Qi instability, deficiency of both lung and spleen,cool dry invading lung and dry-heat stagnation in lung.
2.1.2Distributed Characteristics Of Symptoms
141kinds of main Symptoms and associated symptoms of chronic cough were collected. There are26types of tongue pictures and twelve kinds of pulse conditions in this clinical study.Common Symptoms and tongue and pulse presentations are summed to52types.11types of symptoms are common, which are paroxysmal cough, low voice, cold wind triggering cough, sputum, etc. There are28kinds of common associated symptoms of chronic cough, which are foreign body sensation in oropharyngeal area,sensation of chill, fatigue,Easy cold, pharyngeal itching, insomnia and dreaminess,dry mouth,fear of wind,short of breath and loose stool,etc.
2.1.3Distributed Characteristics Of Tongue and Pulse Presentations
Thin white tongue coating is main in tongue pictures, the others are yellow,thick and greasy tongue coating. Tongue less Jin,light dark color of the tongue,dull-red tongue, scarlet tongue and dark purple tongue with ecchymosis are also common tongue picture. Pulse conditions are based on deep pulse and feeble pulse, slippery pulse and string-like pulse are next.
2.2Results Of Factor Analysis
Fifteen common factors and Equat ions are obstained. It may be concluded that fifteen common factors represent fifteen syndromes,which are lung qi deficiency syndrome, lung Yang deficiency syndrome,Qi depression and lung injury syndrome, deficiency of both qi and yin syndrome,deficiency of both lung and spleen syndrome,qi deficiency of lung and kidney syndrome, defensive Qi instability syndrome, lung and kidney Yang deficiency syndrome,dry-heat stagnation in lung syndrome, Cool-dry invading lung syndrome, Intense Heat of Heart and Lung syndrome, Phlegm-heat storing in lung syndrome,lung yin deficiency syndrome,dry lung and jin deficiency syndrome and syndrome of qi stagnation and coagulated phlegm in throat.
2.3Results Of Cluster Analysis
Fifty-two symptoms were grouped seven clusters. The results may be concluded that twelve syndromes were inferred:lung qi deficiency syndrome,lung Yang deficiency syndrome, Qi depression lung injury syndrome, deficiency of both qi and yin syndrome, deficiency of both lung and spleen syndrome, qi deficiency of lung and kidney syndrome, defensive Qi instability syndrome,lung and kidney Yang deficiency syndrome, dry lung syndrome, Phlegm-heat storing in lung syndrome, syndrome of Qi deficiency in heart and lung and syndrome of qi stagnation and coagulated phlegm in throat.
2.4Results Of Logistic Regression Analysis
2.4.1Symptoms And Syndromes Of Logistic Regression Analysis
Symptoms related to Qi depression lung injury syndrome are yellow sputum, thin sputum,foreign body sensation in oropharyngeal area,short of sputum, dry stools, insomnia and dreaminess, yellow tongue coating and dark red tongue.
Symptoms related to qi deficiency of lung and kidney syndrome are thin sputum,asthma when moving, diarrhea,fear of wind.
Symptoms related to lung yin deficiency syndrome are yellow sputum, Cold wind induced cough, short of sputum, dry stools, insomnia and dreaminess, yellow and white tongue coating.
Symptoms related to defensive Qi instability syndrome are sputum, asthma when moving, choking sensation in chest,easy cold,faint pulse.
Symptoms related to deficiency of both lung and spleen syndrome are low voice, sputum, asthma when moving, dry stools,dry mouth,diarrhea,white tongue coating.
Symptoms related to Cool-dry invading lung syndrome are short of sputum,easy cold,white tongue coating.
Symptoms related to dry-heat stagnation in lung syndrome are dry mouth, asthma when moving, skin allergy,yellow tongue coating,dry stools.
2.4.2Diseases And Syndromes Of Logistic Regression Analysis
Syndrome char act erist ic of Up Airway Cough Syndromes is dry-heat stagnation in lung syndrome.Syndrome of qi deficiency in lung and kidney and defensive Qi instability syndrome are common syndromes of Post infectious Cough. Syndrome characteristics of Cough Variant Asthma are Qi depression lung injury syndrome, defensive Qi instability syndrome and deficiency of both lung and spleen syndrome. Syndrome characteristics of Chronic Bronchitis are Qi depression lung injury syndrome,qi deficiency in lung and kidney syndrome and lung yin deficiency syndrome. Syndrome characteristics of Chronic Obstructive Pulmonary Disease are Qi depression lung injury syndrome,qi deficiency in lung and kidney syndrome and defensive Qi instability syndrome. Syndrome characteristics of Bronchiectasis are lung yin deficiency syndrome and qi deficiency in lung and kidney syndrome.
2.5Results Of Curative Effect Of WenRunXinJinPeiBen Priscription
2.5.1Results Of curative Effect Compared With Western Medicine
(1)The total effect:effect rate of WenRunXinJinPeiBen reached97.94%, Significant efficiency was74.23%. Effect rate of western medicine group was81.48%, and significant efficiency was45.68%.Curative effect of WenRunXinJinPeiBen is superior to western medicine, P<0.01.(2)The cough improvement:the cough improvement of is better than western medicine, P<0.01.(3)LCQ:The method of WenRunXinJinPeiBen can arise patients' quality of life,and its effect is superior to western medicine, P<0.01.
2.5.2Results Of curative Effect Compared With Other Chinese Therapies
(1)The total effect:effect rate of WenRunXinJinPeiBen reached95%, Significant efficiency was73.20%.Effect rate of other chinese therapies was91.67%, and s ignificant efficiency was70.37%. So we can't think curative effect of WenRunXinJinPeiBen is superior to other chinese therapies, P>0.05.(2)The cough improvement:the cough improvement at night of WenRunXinJ inPeiBen is better than other chinese therapies, P<0.01.(3) LCQ:The method of WenRunXinJinPeiBen can arise patients'quality of life,and its effect is superior to other chinese therapies, P<0.01.
2.5.3Results Of Curative Effect In Different Syndromes
(1)The total effect:It was effective that mothod of WenRunXinJinPeiBen treated four TCM Syndromes. Significant efficiency of Qi depression lung injury syndrome was58.82%, qi deficiency in lung and kidney syndrome was80%, defensive Qi instability syndrome was74.08%, deficiency of both lung and spleen syndrome was80%. The results are no statistical difference by the statistical tests, P>0.05.
Effect rate of Qi depression lung injury syndrome reached76.47%; Effect rate of qi deficiency in lung and kidney syndrome was95%, defensive Qi instability syndrome was100%, and deficiency of both lung and spleen syndrome was93.33%. The curative effect of four syndromes exists statistical difference, P<0.05.
(2)The cough improvement:the cough improvement of four syndromes exists notable statistical difference,and the cough improvement of Qi deficiency in lung and kidney syndrome, defensive Qi instability syndrome and deficiency of both lung and spleen syndrome is the most significant among these, P<0.01.
(3) LCQ:The method of WenRunXinJinPeiBen can arise four syndromes'qual i ty of life in different degrees. As far as total scores, its curative effect can be ranked as follows:deficiency of both lung and spleen syndrome> defensive Qi instability syndrome>qi deficiency in lung and kidney syndrome>Qi depression lung injury syndrome, P<0.01. For psychological scores, the best curative effect is Qi depression lung injury syndrome and qi deficiency in lung and kidney syndrome is next, P<0.01.
Conclusions:
By literature research and cinical study, the conclusions can be made as follows:
1.The syndromes of chronic cough are relative to the five internal organs and they are intermingled deficiency and excess, mixed coldness and heat.The characteristics of syndromes are based on deficiency of lung, spleen and kidney. The results of literature research are mainly coincided with results of clinical s tudy.
2.As far as characteristics of syndromes in different diseases of chronic cough, if diseases are different, accordingly, their syndromes will be not same. For example, Up Airway Cough Syndromes, its deficiency syndromes are not significant, but "dry" and "heat" are moresignificant. Allergic Rhinitis is one disease of UACS, but its Syndromes are based on deficiency syndromes. There haven' t been exterior syndrome in Post infectious Cough, and its syndromes are main of Qi deficiency syndromes and defensive Qi instability syndrome. Syndromes characteristics of cough variant asthma, chronic bronchitis, COPD and bronchiectasis basically reflect features of these disease, whose conditions are complex and syndromes are intermingled deficiency and excess too. The study that combined disease and syndromes accords with clinical practice and disease characteristics.It can provide the basis evidences for clinical syndrome differentiation and treatment.
3. Through clinical research, further confirmed the clinical curative effect of "WenRunXinJinPeiBen". Curative effect of this method is superior to western medicine in the treatment of chronic cough; In the same way, its curative effect is better than other Chinese therapies in improving the nighttime cough and quality of life.
Study suggests:curative effect of WenRunXinJinPeiBen is better in the treatment of chronic cough. It can be used to treat qi depression lung injury syndrome, deficiency of both lung and spleen syndrome, defensive Qi instability syndrome and qi deficiency in lung and kidney syndrome. But curative effect also exists differences between different four syndromes, mainly reflected in two aspects improvement:symptoms and quality of life.In aspect of symptoms improvement,curative effect of qi depression lung injury syndrome is not better than deficiency of both lung and spleen syndrome,defensive Qi instability syndrome and qi deficiency in lung and kidney syndrome, while in aspect of LCQ psychological dimension,curative effect of qi depression lung injury syndrome is best.The results are illuminated from various aspects that the priscription and syndrome are relative. At the same time, study indicates the method of WenRunXinJinPeiBen is suitable for the four types, can improve the symptoms in different levels and enhance the clinical curative effect.
1.通过文献研究得到近十年文献中慢性咳嗽证候类型、症状的分布情况,为制定临床信息采集表、开展临床研究奠定基础；应用循证医学方法客观评价随机对照研究中中药治疗慢性咳嗽的疗效,以期这些研究结果能为后续慢性咳嗽的方-证研究提供循证医学证据。
2.通过临床研究得到慢性咳嗽的症状、证候分布特点,并应用不同的数据挖掘方法探讨证候特点,同时探讨导致慢性咳嗽的不同疾病与证候的相关性。
3.通过临床研究,从不同角度论证了“温润辛金培本”法治疗慢性咳嗽的临床疗效；通过“温润辛金培本”法治疗慢性咳嗽不同证候间疗效差异的比较,得到该法治疗效果较好的证候,为慢性咳嗽的证候规范化研究及临床治疗提供依据。
研究方法
1.文献研究
采用循证医学系统综述文献研究方法,系统检索现代文献数据库,收集整理有关慢性咳嗽中医证候、症状的全部文献；用Epidata建立数据库,对症状、证候名称进行规范化,应用SPSS17.0软件统计分析其证候及症状分布特点。
采用循证医学系统综述文献研究方法,系统检索现代文献数据库,收集整理有关中药治疗慢性咳嗽的随机对照研究文献；设计资料提取表,由2名以上人员进行相关信息提取,遇有疑问与第三者协商解决；分别对文献的质量(包括方法、对象、干预措施、结局测量等)进行评价,应用Revman5.1对中药治疗的疗效进行分析。
2.临床研究
遵循临床流行病学和循证医学的原理与方法,采用前瞻、多中心、开放式、有监督无监督相结合的观察性研究方法,全面采集慢性咳嗽患者基本信息、四诊信息及证候诊断相关资料。共收集临床病例539例,其中中医病例458例,西医病例81例。采用构成比分析、因子分析、聚类分析和logistic回归分析,对所得数据进行挖掘,多方位揭示慢性咳嗽的症状及证候特征并探讨病-证的相关性。
选取西医病例81例,“温润辛金培本”法治疗的中医病例97例,进行疗效比较；另选取72例其它中药疗法治疗的病例及80例“温润辛金培本”法治疗的病例,进行疗效比较。采用卡方检验、秩和检验和t检验及方差分析等统计学方法进行疗效分析。
共选取114例“温润辛金培本”法治疗的中医病例进行证候间的疗效比较。其中气郁伤肺证17例,肺肾气虚证40例,卫气不固证27例,肺脾两虚证30例。采用卡方检验、秩和检验、t检验和方差分析等统计学方法进行疗效分析。
研究结果
1.文献研究结果
1.1证候研究结果
1.1.1慢性咳嗽证候分布特点
共得到慢性咳嗽中医证候128个,单个证候114个,复合证候14个。
按照证候出现的频次进行排列,位列前十位的证候分别是：气阴两虚证、肺气亏虚证、痰热蕴肺证、肝火犯肺证、气滞血瘀证、肺阴亏虚证、气虚痰湿证、阴虚肺燥证、痰湿蕴肺证、肺脾气虚证。
1.1.2不同病因导致慢性咳嗽的证候分布特点
上气道咳嗽综合征,排列在前四位的证型分别是风痰恋肺证、风痰郁肺证、阴虚肺燥证和脾胃虚弱证；咳嗽变异性哮喘,以肺气亏虚、肝火犯肺、寒邪伏肺及风热犯肺为主要证型；胃食管反流性咳嗽以肝胃郁热为主要证型,其次为肝胃不和、胆热犯胃和痰气郁阻；变应性咳嗽主要证型依次为风寒犯肺、肺气亏虚、风热犯肺和燥邪伤肺；肺癌主要证型为气阴两虚、肺气亏虚、气虚痰热、肺脾气虚等；慢性支气管炎以肺肾气虚、脾肾阳虚、痰热郁肺、肺肾阴虚等证型为主；支气管扩张主要证型为痰热郁肺、肝火犯肺和肺脾气虚证；肺结核主要证型为气阴两虚、阴虚火旺、肺气亏虚、肺脾气虚等。
1.1.3慢性咳嗽症状分布特点
(1)主症分布特点：常见主症共有17种,包括：咳声阵发、夜间咳嗽加重、痰少及胸痛,气急,胸闷,痰粘等症状。(2)伴随症状分布特点：共有19个伴随症状,分别是：咽痒,乏力,口干,咽干,失眠,痰难咳出,出汗等症状。(3)舌象脉象分布特点：舌色以舌红、舌淡及舌淡红、淡暗为主；舌体多为胖大有齿痕；舌苔质地以薄苔及腻苔、少苔为主；舌苔以黄苔、白苔占大多数。脉象以细脉最多,其次为弦脉、滑脉及细数脉、细弱脉和弦滑脉、数脉。
1.2中药治疗慢性咳嗽随机对照研究Meta分析结果
就目前纳入的文献来说,中药治疗慢性咳嗽有一定优势,明显优于西药治疗(P<0.01)。具体可表现在治疗咳嗽变异性哮喘(P=0.001)、支气管扩张(P<0.0001)的疗效显著,明显优于西药；中药治疗慢性支气管炎疗效均明显优于西药(P<0.01)。
目前还不能认为中药治疗上气道咳嗽综合征(P=0.06),肺癌(P=0.17)效果优于西药化疗,也不能认为中药治疗变应性咳嗽(P=0.32)、嗜酸粒细胞性支气管炎(P=0.86)及胃食管反流性咳嗽(P=0.05)疗效优于西药。
2.临床研究结果
2.1慢性咳嗽证候、症状分布特点
2.1.1证候分布特点
将收集的证候规范后,共得到24个证候,其中常见的证候有：气郁伤肺证,肺肾气虚证,肺阴虚证,卫气不固证,肺脾两虚证,凉燥袭肺证和肺燥郁热证。
2.1.2症状分布特点
共收集到慢性咳嗽主症及伴随症状141种,舌象26种,脉象12种,其中,常见的症状及舌脉共计52种；慢性咳嗽常见的主症共计11个,分别是咳声阵发,声低无力,冷风诱发,冷风、油烟及异味诱发,咳痰等；慢性咳嗽常见的伴随症状共计28个,分别是咽部异物感,怕冷,乏力,易感冒,咽痒,失眠多梦,口干,怕风,气短,大便稀溏等。
2.1.3舌脉分布情况
舌象中,以薄白苔为主；其次为黄苔、厚苔、腻苔；舌质少津、舌色淡暗、舌暗红、舌色鲜红、舌紫黯/瘀斑亦为常见舌象。脉象中,以沉脉和虚脉为主；其次为滑脉和弦脉。
2.2因子分析
共得到15个公因子及其方程,提示可归纳为以下15个证候：肺气虚证、肺阳虚证、气郁伤肺证、气阴两虚证、肺脾两虚证、肺肾气虚证、肺卫气虚证、肺肾阳虚证、肺燥郁热证、凉燥袭肺证、心肺实热证、痰热闭肺证、肺阴亏虚证和肺燥津亏证、痰凝咽喉证。
2.3聚类分析
共可聚为7大类,结果提示慢性咳嗽中医证型可归纳为：肺气虚证、肺阳虚证、气郁伤肺证、气阴两虚证、肺脾两虚证、肺肾气虚证、肺卫气虚证、肺肾阳虚证、肺燥、痰热闭肺证、心肺气虚证和痰凝咽喉证。
2.4logistic回归分析
2.4.1症状与证候logistic回归分析
气郁伤肺证相关的症状、体征分别是：咳黄痰,痰稀薄,咽部异物感,痰少,便干,失眠多梦,黄苔,舌暗红。
肺肾气虚证相关的症状分别是：痰稀薄,动则气喘,腹泻,怕风。
肺阴虚证相关的症状、体征分别是：咳黄痰,冷风诱发咳嗽,痰少,便干,失眠多梦,黄苔,白苔。
卫气不固证相关的症状、体征分别是：咳痰,动则气喘,胸闷,平素易感冒,微脉。
肺脾两虚证相关的症状、体征分别是：声低无力,咳痰,咳白痰,动则气喘,便干,口干,腹泻,白苔。
凉燥袭肺证相关的症状、舌象是：痰少,平素易感冒和白苔。
肺燥郁热证相关的症状、舌象是：口干,动则气喘,皮肤过敏,黄苔,便于
2.4.2病因与证候logistic回归分析
上气道咳嗽综合征的证候特点是肺燥郁热证；感冒后咳嗽的常见证候为肺肾气虚证和卫气不固证；咳嗽变异性哮喘的证候特点是气郁伤肺证、卫气不固证和肺脾两虚证；慢支的证候特点为气郁伤肺证、肺肾气虚证和肺阴虚证；COPD的证候特点可包括气郁伤肺证、肺肾气虚证、卫气不固证；支气管扩张的证候特点是肺阴虚证、肺肾气虚证。
2.5“温润辛金培本”法疗效初探
2.5.1“温润辛金培本”法与西药治疗的疗效比较
(1)总体疗效：“温润辛金培本”法治疗的有效率可达97.94%,显效率可达74.23%；西药组有效率为81.48%,显效率为45.68%；“温润辛金培本”法的疗效明显优于西药,P<0.01。(2)咳嗽症状：“温润辛金培本”法在改善咳嗽症状方面疗效明显优于西药,P<0.01。(3)LCQ：“温润辛金培本”法疗效明显优于西药,P<0.01。
2.5.2“温润辛金培本”法与其它中药疗法的疗效比较
(1)总体疗效：“温润辛金培本”法治疗的有效率可达95%,其它中药疗法有效率为91.67%；“温润辛金培本”法治疗的显效率可达73.20%,其它中药疗法为70.37%；不能认为该法的疗效优于其它中药疗法,P>0.05。(2)咳嗽症状：“温润辛金培本”法在改善患者的夜间咳方面疗效优于其它中药疗法,P<0.01。(3)LCQ：“温润辛金培本”法疗效优于其它中药疗法,P<0.01。
2.5.3不同证候间的疗效比较
(1)总体疗效：“温润辛金培本”法治疗四组证候,气郁伤肺证显效率为58.82%,肺肾气虚证显效率为80%,卫气不固证显效率为74.08%,肺脾两虚证显效率为80%,经统计学检验该显效率结果无统计学差异,P>0.05。
治疗气郁伤肺证有效率76.47%,肺肾气虚证有效率95%,卫气不固证有效率100%,肺脾两虚证有效率93.33%,四组证候间的有效率存在统计学差异,P<0.05。
(2)咳嗽症状
在改善咳嗽症状方面,其证候间存在明显差异,以肺脾两虚证、卫气不固证和肺肾气虚证咳嗽症状改善最为显著,P<0.01。
(3) LCQ
“温润辛金培本”法均可在不同程度上改善四种证候的生命质量。从总分来说,疗效可依次排列为：肺脾两虚证>卫气不固证>肺肾气虚证>气郁伤肺证,P<0.01。从心理维度得分来说,以气郁肺证疗效最佳,其次为肺肾气虚证,P<0.05。
研究结论
通过文献研究及临床研究,可得出如下结论：
1.慢性咳嗽的证候与五脏相关,虚实寒热错杂。以肺脾肾虚为主,虚中夹实。文献研究结果与临床研究结果基本相符。
2.在不同病因导致的慢性咳嗽证候特征方面,不同疾病证候表现不同。上气道咳嗽综合征,虚证不显,但以“燥”和“热”较为明显,而过敏性鼻炎的证候以虚证为主；咳嗽>8周的感冒后咳嗽,已无表证可言,以虚证为主,主要表现为气虚和卫气不固；咳嗽变异性哮喘、慢支、COPD和支气管扩张的证候基本反映了疾病特点,病情复杂,其证候特征亦是虚实夹杂,既有实证也有虚证。病-证结合的证候特点研究符合临床实际及疾病特点,可为临床辨证及治疗提供依据。
3.通过规范的临床研究,进一步证实了“温润辛金培本”法的临床疗效。该法在慢性咳嗽的治疗中,疗效优于西药；在改善夜间咳及生活质量方面疗效优于其它中药疗法；研究提示：温润辛金培本法治疗慢性咳嗽气郁伤肺证、肺脾两虚证、卫气不固证和肺肾气虚证均有较好的临床疗效,但不同证候间疗效亦存在差异,主要体现在症状改善和生活质量提高两个方面。症状改善方面,气郁伤肺证疗效不如肺脾两虚证、卫气不固证和肺肾气虚证,而在LCQ心理维度则以气郁伤肺证疗效最佳。这从不同方面说明了方-证的相关性,提示该法适宜于这四种证型,可在不同层面改善症状,提高临床疗效。
Objective:
1. Getting distributated situation of TCM syndromes and symptoms in chronic cough by ten years' literatures research so as to lay the foundation of making clinical report form and carrying out clinic research; Evaluating objectively curative effect of herbs in randomized controlled trial of chronic cough by using methods of evidenced-based medicine so that these results can offer evidences for subsequent research of prescriptions corresponding to syndromes in chronic cough.
2. Getting distributated situation of TCM syndromes and symptoms in chronic cough by clinical research and discussing different syndromes characteristics by using multiple methods of data mining. Meanwhile,exploring relevance between different diseases of chronic cough and TCM syndromes.
3. Proving curative effect that method of WenRunXinJinPeiBen treats chronic cough from multiple sides by clinical research. Getting better effect syndroms of chronic cough, which may supply evidences for syndrome standardized research and clinical treatment in chronic cough.
Medthods:
1. Literature Research
Retrieve systematicly modern literature data base, colleet and organize all literatures about TCM syndromes and symptoms of chronic cough; Build database with Epidata3.0,standardize name of TCM syndromes and symptoms and analyze distributated situation of TCM syndromes and symptoms with SPSS17.0.
Firstly,Retrieve modern literature database systematicly,collect and organize all literatures about RCT of curative effect of herbs in chronic cough. Secondly,design data extraction table and withdraw useful informations by two researchers. when they have quest ions, they must consult the third researcher and resolve it by negotiation. Thirdly,evalua tequalities of included studies(including method, object, intervention measure and outcome,etc) and analyze curative effect of chinese herbs with Revman5.1.
2.Clinical Research
According to theories and methods of clinic epidemiology and evidence-based medicine, prospective observational study was launched by ways of supervision with combination of non-supervision methods in multiple study centers.Chronic cough patients' informationswere collected comprehensively, including patients' basic informations, informations of four diagnostic methods and diagnosis of syndromes informations. At last539reports were finished, among which there are458TCM reports and81west medical reports. Analyze these repots with proportion ratio analysis, factor analysis, clustering analysis and logistic regression analysis. Accordingly, it may be revealed that specialties of syndromes, symptoms and the relevance between different diseases with syndromes in chronic cough.
81patients of western medicine and97TCM patients were chosed, which was used to compare the effect of WenRunXinJinPeiBen with western medicine by ways of statistical methods, such as chi-square test,rank sum test, t-test, and analysis of variance.
114TCM reports that were treated with medthod of WenRunXinJinPeiBen were chosed, among which there are17reports of Qi depression and lung injury,40reports of qi deficiency of lung and kidney,27reports of defensive Qi instability and30reports of lung and spleen deficiency. Curative effect variance were compared among four different syndromes by ways of statistical methods, such as chi-square test,rank sum test,t-test,and analysis of variance.
Results:
1.Results Of Literature Research
1.1Results Of Syndromes Study
1.1.1Distributed Characteristics Of Syndromes
128TCM Syndromes were obstained in this study.There are114single syndromes and14compounded syndromes among these.Ten syndromes are ranked in sequence according to their frequencies and they respectively are syndromes of Qi and Yin deficiency, lung Qi deficiency, phlegm-heat storing in lung, liver fire invading lung, Qi-stagnation and blood stasis, lung Yin deficiency, Blood deficiency and phlegm wet, Yin deficiency and lung dryness, phlegm-wet storing in lung, Qi deficiency in lung and spleen.
1.1.2Distributed Characteristics Of Syndromes In Different Diseases
Up Airway Cough Syndromes:wind-phlegm staying in lung, wind-phlegm stagnated in lung, Yin deficiency and lung dryness and weakness of the spleen and stomach.Cough Variant Asthma:main TCM syndromes are syndromes of lung qi deficiency,liver fire invading lung, Cold evil storing in lung and wind-heat affecting lung.Gastroesophageal Reflux Cough:main syndrome is heat stagnated in liver and stamoch. Others are syndromes of liver-stomach disharmony, Gallbladder heat invading stomach and Qi-phlegm stagnation and stasis. Atopic Cough:main TCM Syndromes are Syndromes of wind-cold affecting lung, weakness of lung qi, wind-heat affecting lung and dryness injuring lung. Lung Carcinoma:main TCM Syndromes are Syndromes of Qi and Yin deficiency,weakness of lung qi,Qi deficiency and phlegm heat, lung Qi deficiency and spleen, etc. Chronic Bronchi tis: main TCM Syndromes are Syndromes of Qi deficiency in lung and kidney, insufficiency of both the spleen and the kidney, phlegm-heat stagnated in lung, Yin deficiency in lung and kidney, etc. Bronchiactasis:Syndrome of phlegm-heat stagnated in lung, Syndrome of liver fire invading lung, Syndrome of Qi deficiency in lung and spleen. Tuberculosis:insufficiency of both Qi and Yin, fire excess from yin deficiency, lung Qi deficiency and Qi deficiency in lung and spleen.
1.1.3Distributed Characteristics Of symptoms in chronic cough
(1) Distributed Characteristics Of Main Symptoms:there are17common types of main symptoms, including paroxysmal cough, worsening of cough at night, little sputum, chest pain, dyspnea, oppress ion in chest,Viscous sputum,etc.
(2) Distributed Characteristics Of associated symptoms:There are19types of associated symptoms and they respectively are Pharyngeal iten ing,fatigue, dry mouth, dry Pharyngeal, insomnia,sweat ing,etc.
(3) Distributed Characteristics Of Tongue Picture And Pulse Condition:tongue color based on red, light, light red and light dark tongue. Tongue body are mostly fat,big and indented. The thin,greasy and short coating are main coating on the tongue. The coat ing colors are mostly yellow and white. Thready pulse is the most of pulse condition, the others are string-like pulse, slippery pulse, thin and count ing pulse, thin and weak pulse, string-like and slippery pulse and count ing pulse.
1.2Systematic Review Results That Chinese Herbs Treat Chronic Cough In RCT
Chinese herbs treating chronic cough has regular superiority according to included literatures at present.It may be definitely manifested by curative effect that Chinese herbs treats CVA,Bronchiactasis and Chronic Bronchitis.The results showed that Chinese herbs was superior to west medicine, P=0.001, P<0.01, P<0.01.
At present it can't be proved that Chinese herbs is superior to western medicine in Atopic cough (P=0.32), eosinophilic bronchitis (P=0.86) and gastroesophageal reflux cough (P=0.05).
2. Results Of Clinical Research
2.1Distributed Characteristics Of Syndromes And Symptoms
2.1.1Distributed Characteristics Of Syndromes
24kinds of TCM Syndromes were obstained after collected syndroms were standardized, in which common syndromes are syndromes of lung injured by Qi stagnation, qi deficiency of lung and kidney,deficiency of lung Yin, defensive Qi instability, deficiency of both lung and spleen,cool dry invading lung and dry-heat stagnation in lung.
2.1.2Distributed Characteristics Of Symptoms
141kinds of main Symptoms and associated symptoms of chronic cough were collected. There are26types of tongue pictures and twelve kinds of pulse conditions in this clinical study.Common Symptoms and tongue and pulse presentations are summed to52types.11types of symptoms are common, which are paroxysmal cough, low voice, cold wind triggering cough, sputum, etc. There are28kinds of common associated symptoms of chronic cough, which are foreign body sensation in oropharyngeal area,sensation of chill, fatigue,Easy cold, pharyngeal itching, insomnia and dreaminess,dry mouth,fear of wind,short of breath and loose stool,etc.
2.1.3Distributed Characteristics Of Tongue and Pulse Presentations
Thin white tongue coating is main in tongue pictures, the others are yellow,thick and greasy tongue coating. Tongue less Jin,light dark color of the tongue,dull-red tongue, scarlet tongue and dark purple tongue with ecchymosis are also common tongue picture. Pulse conditions are based on deep pulse and feeble pulse, slippery pulse and string-like pulse are next.
2.2Results Of Factor Analysis
Fifteen common factors and Equat ions are obstained. It may be concluded that fifteen common factors represent fifteen syndromes,which are lung qi deficiency syndrome, lung Yang deficiency syndrome,Qi depression and lung injury syndrome, deficiency of both qi and yin syndrome,deficiency of both lung and spleen syndrome,qi deficiency of lung and kidney syndrome, defensive Qi instability syndrome, lung and kidney Yang deficiency syndrome,dry-heat stagnation in lung syndrome, Cool-dry invading lung syndrome, Intense Heat of Heart and Lung syndrome, Phlegm-heat storing in lung syndrome,lung yin deficiency syndrome,dry lung and jin deficiency syndrome and syndrome of qi stagnation and coagulated phlegm in throat.
2.3Results Of Cluster Analysis
Fifty-two symptoms were grouped seven clusters. The results may be concluded that twelve syndromes were inferred:lung qi deficiency syndrome,lung Yang deficiency syndrome, Qi depression lung injury syndrome, deficiency of both qi and yin syndrome, deficiency of both lung and spleen syndrome, qi deficiency of lung and kidney syndrome, defensive Qi instability syndrome,lung and kidney Yang deficiency syndrome, dry lung syndrome, Phlegm-heat storing in lung syndrome, syndrome of Qi deficiency in heart and lung and syndrome of qi stagnation and coagulated phlegm in throat.
2.4Results Of Logistic Regression Analysis
2.4.1Symptoms And Syndromes Of Logistic Regression Analysis
Symptoms related to Qi depression lung injury syndrome are yellow sputum, thin sputum,foreign body sensation in oropharyngeal area,short of sputum, dry stools, insomnia and dreaminess, yellow tongue coating and dark red tongue.
Symptoms related to qi deficiency of lung and kidney syndrome are thin sputum,asthma when moving, diarrhea,fear of wind.
Symptoms related to lung yin deficiency syndrome are yellow sputum, Cold wind induced cough, short of sputum, dry stools, insomnia and dreaminess, yellow and white tongue coating.
Symptoms related to defensive Qi instability syndrome are sputum, asthma when moving, choking sensation in chest,easy cold,faint pulse.
Symptoms related to deficiency of both lung and spleen syndrome are low voice, sputum, asthma when moving, dry stools,dry mouth,diarrhea,white tongue coating.
Symptoms related to Cool-dry invading lung syndrome are short of sputum,easy cold,white tongue coating.
Symptoms related to dry-heat stagnation in lung syndrome are dry mouth, asthma when moving, skin allergy,yellow tongue coating,dry stools.
2.4.2Diseases And Syndromes Of Logistic Regression Analysis
Syndrome char act erist ic of Up Airway Cough Syndromes is dry-heat stagnation in lung syndrome.Syndrome of qi deficiency in lung and kidney and defensive Qi instability syndrome are common syndromes of Post infectious Cough. Syndrome characteristics of Cough Variant Asthma are Qi depression lung injury syndrome, defensive Qi instability syndrome and deficiency of both lung and spleen syndrome. Syndrome characteristics of Chronic Bronchitis are Qi depression lung injury syndrome,qi deficiency in lung and kidney syndrome and lung yin deficiency syndrome. Syndrome characteristics of Chronic Obstructive Pulmonary Disease are Qi depression lung injury syndrome,qi deficiency in lung and kidney syndrome and defensive Qi instability syndrome. Syndrome characteristics of Bronchiectasis are lung yin deficiency syndrome and qi deficiency in lung and kidney syndrome.
2.5Results Of Curative Effect Of WenRunXinJinPeiBen Priscription
2.5.1Results Of curative Effect Compared With Western Medicine
(1)The total effect:effect rate of WenRunXinJinPeiBen reached97.94%, Significant efficiency was74.23%. Effect rate of western medicine group was81.48%, and significant efficiency was45.68%.Curative effect of WenRunXinJinPeiBen is superior to western medicine, P<0.01.(2)The cough improvement:the cough improvement of is better than western medicine, P<0.01.(3)LCQ:The method of WenRunXinJinPeiBen can arise patients' quality of life,and its effect is superior to western medicine, P<0.01.
2.5.2Results Of curative Effect Compared With Other Chinese Therapies
(1)The total effect:effect rate of WenRunXinJinPeiBen reached95%, Significant efficiency was73.20%.Effect rate of other chinese therapies was91.67%, and s ignificant efficiency was70.37%. So we can't think curative effect of WenRunXinJinPeiBen is superior to other chinese therapies, P>0.05.(2)The cough improvement:the cough improvement at night of WenRunXinJ inPeiBen is better than other chinese therapies, P<0.01.(3) LCQ:The method of WenRunXinJinPeiBen can arise patients'quality of life,and its effect is superior to other chinese therapies, P<0.01.
2.5.3Results Of Curative Effect In Different Syndromes
(1)The total effect:It was effective that mothod of WenRunXinJinPeiBen treated four TCM Syndromes. Significant efficiency of Qi depression lung injury syndrome was58.82%, qi deficiency in lung and kidney syndrome was80%, defensive Qi instability syndrome was74.08%, deficiency of both lung and spleen syndrome was80%. The results are no statistical difference by the statistical tests, P>0.05.
Effect rate of Qi depression lung injury syndrome reached76.47%; Effect rate of qi deficiency in lung and kidney syndrome was95%, defensive Qi instability syndrome was100%, and deficiency of both lung and spleen syndrome was93.33%. The curative effect of four syndromes exists statistical difference, P<0.05.
(2)The cough improvement:the cough improvement of four syndromes exists notable statistical difference,and the cough improvement of Qi deficiency in lung and kidney syndrome, defensive Qi instability syndrome and deficiency of both lung and spleen syndrome is the most significant among these, P<0.01.
(3) LCQ:The method of WenRunXinJinPeiBen can arise four syndromes'qual i ty of life in different degrees. As far as total scores, its curative effect can be ranked as follows:deficiency of both lung and spleen syndrome> defensive Qi instability syndrome>qi deficiency in lung and kidney syndrome>Qi depression lung injury syndrome, P<0.01. For psychological scores, the best curative effect is Qi depression lung injury syndrome and qi deficiency in lung and kidney syndrome is next, P<0.01.
Conclusions:
By literature research and cinical study, the conclusions can be made as follows:
1.The syndromes of chronic cough are relative to the five internal organs and they are intermingled deficiency and excess, mixed coldness and heat.The characteristics of syndromes are based on deficiency of lung, spleen and kidney. The results of literature research are mainly coincided with results of clinical s tudy.
2.As far as characteristics of syndromes in different diseases of chronic cough, if diseases are different, accordingly, their syndromes will be not same. For example, Up Airway Cough Syndromes, its deficiency syndromes are not significant, but "dry" and "heat" are moresignificant. Allergic Rhinitis is one disease of UACS, but its Syndromes are based on deficiency syndromes. There haven' t been exterior syndrome in Post infectious Cough, and its syndromes are main of Qi deficiency syndromes and defensive Qi instability syndrome. Syndromes characteristics of cough variant asthma, chronic bronchitis, COPD and bronchiectasis basically reflect features of these disease, whose conditions are complex and syndromes are intermingled deficiency and excess too. The study that combined disease and syndromes accords with clinical practice and disease characteristics.It can provide the basis evidences for clinical syndrome differentiation and treatment.
3. Through clinical research, further confirmed the clinical curative effect of "WenRunXinJinPeiBen". Curative effect of this method is superior to western medicine in the treatment of chronic cough; In the same way, its curative effect is better than other Chinese therapies in improving the nighttime cough and quality of life.
Study suggests:curative effect of WenRunXinJinPeiBen is better in the treatment of chronic cough. It can be used to treat qi depression lung injury syndrome, deficiency of both lung and spleen syndrome, defensive Qi instability syndrome and qi deficiency in lung and kidney syndrome. But curative effect also exists differences between different four syndromes, mainly reflected in two aspects improvement:symptoms and quality of life.In aspect of symptoms improvement,curative effect of qi depression lung injury syndrome is not better than deficiency of both lung and spleen syndrome,defensive Qi instability syndrome and qi deficiency in lung and kidney syndrome, while in aspect of LCQ psychological dimension,curative effect of qi depression lung injury syndrome is best.The results are illuminated from various aspects that the priscription and syndrome are relative. At the same time, study indicates the method of WenRunXinJinPeiBen is suitable for the four types, can improve the symptoms in different levels and enhance the clinical curative effect.
引文
[1]邓伟吾.慢性咳嗽诊断新概念.中国实用内科杂志.2006,26(1)：3-4.
[2]陈如冲,赖克方,刘春丽,等.广州地区1087名大学生咳嗽的流行病学调查.中华流行病学杂志.2006,27(2)：123-126.
[3]中华医学会呼吸病学分会哮喘学组.咳嗽的诊断与治疗指南(2009版).全科医学临床与教育,2009,7(5)：453-456.
[4]晁恩祥.关于咳嗽的中医证治及对风咳的讨论意见.会议论文：1-6.
[5]史锁芳.慢性咳嗽证治思路概要.江苏中医药,2008，40(7)：11.
[6]苏强,史锁芳,朴振璟.夹湿咳嗽的临证特点及中医治疗.亚太传统医药,2009,5(3)：116-117.
[7]李丹.从痰论治慢性咳嗽浅识.实用中医内科杂志.2010,24(5)：40-41.
[8]贾桂娈.慢性咳嗽从痰论治的体会.浙江中医杂志.2005,11：486-487.
[9]湿热咳嗽证治探讨.魏鹏草,苗青,樊茂荣.会议论文：
[10]韩峰,张竞之,刘美英.慢咳饮治疗慢性咳嗽35例.中医研究.2008,21(8)：22-24.
[11]蒋吉林,李承珍.中医辨证治疗顽固性咳嗽165例.河北中医.2002,24(3)：177.
[12]张元兵.慢性咳嗽的辨证论治简析中医药学刊.2003,21(7)：11 98-1199.
[13]赵东凯,宫晓燕.慢性咳嗽从肺阳虚证辨治.长春中医药大学学报,2008,24(16)：680-681.
[14]张传名.中医辨治慢性咳嗽体会.云南中医中药杂志,2012,33(2)：84.
[15]周文涛,王家平,宋国宏.浅析慢性咳嗽重视从肝辨治.新中医2012,44(4)：136.
[16]王洪.从肝论治慢性咳嗽肝咳证临床观察.北京中医药,2012,31(7)：531-532.
[17]弋巧玲.从肝论治慢性咳嗽.中医研究,2012,25(9)：44-45.
[18]薛丽姣,崔云,苗青.半夏泻心汤治疗慢性咳嗽机理探析.北京中医药2012,31(9)：684-685.
[19]闫保瑞,陈丽娜,侯莉芬.侯江红教授治疗小儿慢性咳嗽亚健康状态的经验.光明中医,2010,25(12)：2172-2173.
[20]许丽梅,刘小虹.从五脏相关探讨慢性咳嗽之病机.新中医.2012,44(4)：7-8.
[21]朱兴国.从五脏论治慢性咳嗽.实用中医内科杂志,2012,26(4)：66-67,69.
[22]瞿金鸿,林小劲.慢性咳嗽的中西医证治.浙江中西医结合杂志2010,20(9)：542-543.
[23]林色奇,薛汉荣.慢性咳嗽中医证治研究进展.江西中医药,2004,35(262)：61-63.
[24]吴银根.慢性咳嗽的中医治疗思路和经验.江苏中医药,2008,40(7)：7-8.
[25]周贺芙.慢性咳嗽从虚寒论.长春中医药大学硕士学位论文2007.
[26]肖立成.慢性咳嗽诊治探微.辽宁中医药大学学报,2008,10(11)：92-93.
[27]杨珺超,夏永良,宋康.宋康辨治慢性咳嗽经验[J].浙江中医杂志,2009,44(2)：79-81.
[28]柯新桥.咳嗽变异型哮喘中医辨治思路与方法[J].湖北中医杂志,2005,27(2)：3-5.
[29]史锁芳.上气道咳嗽综合征中医证治探讨.南京中医药大学学报,2009,25(3)：164-166.
[30]王德钧,谈欧.慢性咳嗽的中医治疗.江西中医药.2007,38(296)：8-9.
[31]张振千.从肺胃论治慢性咳嗽.山西中医,2007,23(6)：74.
[32]袁玉,魏文周,杨会双.中西医结合治疗咳嗽变异性哮喘疗效观察.河北中医,2007,29(7)：620.
[33]蓝洁.慢性咳嗽辨治体会.中国中医急症,2009,18(12)：2067-2068. 朱奉民,陈宪海.脏腑咳嗽临证探讨.河南中医,2012,32(5)：593-594.
[34]杨珊超,陈素珍,夏永良.宋康教授辨治慢性咳嗽验案.浙江省中西医结合呼吸病诊治进展暨第六次学术年会论文汇编2008：168-171.
[35]陆青.桂技汤合玉屏风散加减治疗过敏性咳嗽50例[J].广西中医药,2007,3(3)：53.
[36]罗海丽.补肾养阴、祛风和中法治疗过敏性咳嗽[J].北京中医药,2009,28(10)：774-776
[37]夏以琳.邵长荣治咳经验介绍.中医杂志,1996,37(4)：210-211.
[38]陈连起.健脾法在咳证治疗中的运用.中国会议论文电子版,1987,9：25-26.
[39]彭蔚平.慢性咳嗽审因论治心得.福建中医药,2007,38(6)：47-48.
[40]朱佳.治疗慢性咳嗽尤当注意辨证与辨病相合.江苏中医药,2008,40(7)：12-13.
[41]郑忻.叶天士《临证指南医案》论治慢性咳嗽经验探析.辽宁中医药大学学报,2012,14(5)：91-93.
[42]魏鹏草,苗青,张文江.叶天士治疗慢性咳嗽的学术思想探讨.江苏中医药,2010,42(4)：12-13.
[43]王宝玉.运用治肺十三法诊治慢性咳嗽的体会.中国会议论文(电子版)1994-2012：146-150.
[44]马瑞智.寇辉论治慢性咳嗽经验.河南中医,2012,32(5)：639-640.
[45]王洪.从肝论治慢性咳嗽肝咳证临床观察.北京中医药2012,31(7)：531-532.
[46]韩峰,张竞之,刘美英.慢咳饮治疗慢性咳嗽35例.中医研究,2008,21(8)：22-24.
[47]史苗颜,毕小利,张炜.平金方治疗慢性咳嗽的临床研究.上海中医药杂志,2010,44(11)：54-56.
[48]常宗焕.自拟宁嗽汤治疗小儿慢性咳嗽160例.陕西中医学院学报,2009,32(4)：47.
[49]魏葆琳.辨证治疗慢性咳嗽200例.长春中医药大学学报.2010,26(6)：877-878.
[50]农志新.麻黄附子细辛汤加减治疗慢性咳嗽50例.福建中医药,2007,38(3)：24.
[51]杨志强.麦门冬汤加减治疗慢性咳嗽40例.实用中医内科杂志,2011,25(12)：23-25.
[52]任文辉.益气化痰汤治疗慢性咳嗽68例.河南中医,2006,26(7)：40-41.
[53]吴如飞.五磨饮子加减治疗心因性慢性咳嗽20例.浙江中医杂志,2011,46(12)：881.
[54]李福厚.自拟补肺消咳饮治疗慢性咳嗽虚证48例.现代中医药,2010,30(3)：22.
[55]曹祥.止咳定嗽汤治疗顽固性咳嗽60例疗效观察.中国卫生产业,2011,8(2-3)：93.
[56]余中成.中西医结合治疗慢性咳嗽84例.实用中医药杂志,2012,28(1)：29.
[57]周建新.中西医结合治疗气道高反应性慢性咳嗽的临床研究.中国民族民间医药会议论文,2011：97.
[58]左明晏,李高兵,范世友.中西医结合治疗慢性咳嗽30例.光明中医,2011,26(12)：2514-2515.
[59]蔡彬.中西医结合治疗慢性咳嗽疗效分析.中医当代医药,2012,19(10)：126.
[60]谭远光.《黄帝内经》慢性咳嗽的证治规律.中国医药导刊,2011,13(12)：2017-2108.
[61]陈先菊.药物配合电动起立床训练缓解慢性咳嗽的效果分析.现代医院,2010,10(9)：46-47.
[62]付强,苏传明,杨永明.中医推拿在治疗慢性咳嗽中的应用.第十一次全国中西医结合防治呼吸系统疾病学术研讨会论文集,2010：365-368.
[63]屈娅婷.脾肾阳虚慢性咳嗽大鼠模型的研制.湖南中医药大学硕士学位论文2012.
[64]谢梦洲,何军锋,屈娅婷.脾肾阳虚慢性咳嗽大鼠模型的研制.湖南中医药大学学报,2010,30(9)：30-33.
[65]刘春芳,朱生梁,曹会杰.通降和胃方及其拆方对胃食管反流性咳嗽豚鼠模型气道炎症及肺通透性影响的实验研究.中国会议论文电子版,2010：96-99.
[66]于树夔.胃蛋白酶检测对喉咽反流的诊断及疗效判定.第四军医大学硕士学位论文,2010.
[67]徐亚军,宋新平,曾勋枝.支气管肺泡灌洗液嗜酸细胞检测在嗜酸细胞性支气管炎诊断中的作用.海南医学,2010,21(21)：53-54.
[1]吕爱平,朱良春.再论证候研究思路与方法.中国中医基础医学杂志.2004,10(8)1-2,7.
[2]郭振球.微观辨证学的研究现状与发展趋势[J].中医药学刊,2003,(5)：646.
[3]王俊,徐丽华,闵捷.慢性支气管炎中医证型与理化指标的关系探要.中医药学刊,2004,22(4)：605,615.
[4]魏春华,温明春,等.COPD患者急性加重期细菌感染状况与肺功能的关系[J].山东医药,2002,42(19)：45
[5]霍建民,杨光,等.COPD患者急性加重期细菌学与肺功能关系的初步研究[J].中国急救医学,2002,22(1)：35
[6]高永翔,龚立,李群英.虚证慢性支气管炎不同中医证型支气管肺泡灌洗液中免疫相关指标的比较研究.成都中医药大学学报,2006,29(1)：5-7.
[7]杨瑶瑶.非小细胞肺癌患者中医证候与免疫等指标的相关性研究.中国中医科学院硕士学位论文,2010.
[8]郭蕾,王永炎,张志斌.关于证候概念的诠释.北京中医药大学,2003,26(2)：5.
[9]李梢.从维度与阶度探讨中医证候的特征及标准化方法.北京中医药大学学报2003,26(3)：1-4.
[10]张文风,林宇春,赵宏杰,等.证候数据多维界面细分与同界面数据分类及证候研究中的逻辑问题探讨.中国会议论文：331-334.
[11]李泽庚,彭波,张念芳,等.证候研究的层次论和阶段论.天津中医药,2007,24(3)：228-229.
[12]郭蕾,王永炎,张志斌,等.证候动态时空特征的复杂性及相应的研究思路.中医研究,2006,19(3)：1-3.
[13]王泓午,王玉来,金章安,等.中风发病前7d-30d内先兆症状的1：2配对病例对照研究[J].中国中医基础医学杂志,2002,8(9)：56.
[14]秦金霞.中晚期非小细胞肺癌中医证候分布规律的研究.现代中医药,2010,30(4)：64-65.
[15]黎敬波,李科威,张征.非小细胞肺癌化疗前后证候变化的临床研究.新中医,2009,41(1)：18-20.
[16]黎敬波,张征,林丽珠非小细胞肺癌手术前后证候变化的对照研究.新中医,2008,40(9)：24-26.
[17]左明焕,王芬,孙韬.晚期肺癌的中医证候研究.北京中医药大学学报(中医临床版)2003,10(4)：7-9.
[18]胡小梅,张培彤,杨宗艳,等.非小细胞肺癌不同病理分类与中医证候分布规律关系探讨.中国中医药信息杂志,2006,13(12)：19-21.
[19]程平荣,晋献春,陈勇鹏.原发性支气管肺癌末次化疗后中医证候演变规律研究.中国中医药信息杂志.2011,18(7)：21-22.
[20]杨丹,田国庆,王景,等.原发性支气管肺癌中医证型分布特点的研究.中国实践2010,13(11B)：3607-3611.
[21]申维玺,孙燕.医学模式和病证的统一性原理[J].中国中医基础医学杂志,2004,(3)：13-15.
[23]林坚.试论中医学方证的相应观[J].中国中医基础医学杂志,2000,(7)：9.
[22]刘艳骄,黄璐琦,杨洪军.中医学关于证候疾病方剂关系的理论研究.中国中医基础医学杂志2006,12(8)：562-563.
[24]李凛.亚急性、慢性咳嗽病因与中医证型相关性研究.北京中医药大学硕士学位论文,2012.
[25]阎碉.感冒后咳嗽证候类型与方证效相关性研究.北京中医药大学博士学位论文,2012.
[26]周伟生,严英,莫伟,等.浅论中医模糊思维阴.中国中西医结合影像学杂志,2003,1(2)：114-116
[27]余兴龙,谭耀麟,竺子民,等.中医舌诊自动识别方法的研究[J].中国生物医学工程学报,1994,13(4)：336—343.
[28]陈荣山,陈东汉,等.模糊数学在中医脉象模式识别中应用[J].医学信息,1998,11(3)：20—21.
[29]马斌荣.中医专家系统与中医知识库—中医领域计算机软件的开发与应用[M].北京：北京出版社,1997.
[30]魏威,魏欣甫,等.模糊数学与中医辨证论治[J].中医教育,1999,18(4)：54·55.
[31]钟铮.300例慢性咳嗽患者中医临床证候规范研究.成都中医药大学硕士学位论文,2008.
[32]洪敏俐,郑伟彬,洪春霖,等.慢性咳嗽的病因调查及其中医证型分布规律探讨.福建中医学院学报2010,20(1)：41-42.
[33]黄敏玲.亚急性及慢性咳嗽证候规律探讨.广州中医药大学硕士学位论文,2008.
[34]张蕊.50例老年慢性咳嗽患者的中医证候特点探讨.中国自然医学杂志,2010,12(1)：47-48.
[35]史利卿,周小娟.慢性咳嗽中医证候学特点观察.中国会议论文：140-143.
[36]何德平,林琳,吴蕾.慢性咳嗽中医证候分布规律探讨.广州中医药大学学报,2008,25(6)：560-562
[37]喻清和,王鹏,黄婉怡,等.难治性慢性咳嗽临床证型研究.新中医,2012,44(2)：27-29.
[38]李鹤鸣.慢性咳嗽中医证候分布规律初探.北京中医药大学硕士学位论文,2009.
[39]张天嵩,唐斌擎,张素,等.基于因子分析的不明原因慢性咳嗽证素研究.中国中医药信息杂志,2010,17(9)：21-22.
[40]刘国华.辨证分型治疗慢性咳嗽刍议[J].实用中医内科杂志,2007,(8)：26.
[41]孙晓春.论老年慢性咳嗽的病机特点与临证辨治[J].北京师范大学学报(自然科学版),1999,(04)：532-535.
[42]王鹏.咳嗽变异性哮喘的病因证治[J].湖北中医杂志,2006,(05)：28-29.
[43]刘朝辉.慢性咳嗽的证素特征及其与常见病因的关联研究[D].福建中医药大学,2012.
[44]万文蓉.干祖望辨治喉源性咳嗽经验探要[J].北京中医,2000,(05)：6-7.
[45]潘文超,赵蓓.上气道咳嗽综合征200例中医证型观察.中国中医药信息杂志,2010,17(6)：22-23
[46]史锁芳.上气道咳嗽综合征中医证治探讨[J].南京中医药大学学报,2009,(03)：164-166.
[47]朱生梁,马淑颖,程艳梅,孙吉,孙永顺,李黎,王晓素,方盛泉.胃食管反流病中医证型与反流类型的临床研究[A].中华中医药学会脾胃病分会.中华中医药学会脾胃病分会第十九次全国脾胃病学术交流会论文汇编[C].中华中医药学会脾胃病分会,2007：3.
[48]水正,乐毅,樊舟,郭志峰.中医辨证分型治疗胃食管反流病52例的临床研究[J].浙江中西医结合杂志,2003,(07)：40-41
[49]谢胜,颜春艳,朱初良,等.66例酸碱混合反流型胃食管反流病中医证型分析[J].北京中医,2004,(03)：147-148.
[50]刘汶,王仲霞,韩偎偎,夏志伟.中西医结合治疗胃食管反流病(下)胃食管反流病中医证候流行病学研究[J].北京中医药,2008,(04)：243-244,251.
[51]戴昕.胃食管反流病中医辨证分型研究概况[J].现代中西医结合杂志,2009,(09)：1073-1075.
[52]叶文彬.50例嗜酸细胞性支气管炎辨证分型治疗[J].福建中医药,2007,(01)：35.
[53]张天锡,李霞,索钢.青果止咳汤治疗过敏性咳嗽300例[J].四川中医,2007,(01)：62.
[54]陆青.桂枝汤合玉屏风散加减治疗过敏性咳嗽50例[J].广西中医药,2007,(03)：53.
[55]张天嵩.不明原因慢性咳嗽从燥论治探析[J].上海中医药杂志,2011,(11)：44-47.
[56]朱晓丹.变应性咳嗽中医证候初步研究[D].北京中医药大学,2012.
[57]唐锐.辨证治疗慢性支气管炎的体会[J].光明中医,2002,(02)：31-32.
[58]金建立,付存穰.中医辨证治疗慢性支气管炎急性发作100例[J].中国民间疗法,2010,5：35.
[59]姜良铎,唐光华.60例内伤基础上外感咳嗽病例观察[A].中华中医药学会、中华中医药杂志社.全国中医药科研与教学改革研讨会论文集[C].中华中医药学会、中华中医药杂志社：,2000：3.
[60]汪海飚,徐卫方,王平,高振.慢性支气管炎的中医证-治相应关系研究[J].中国实验方剂学杂志,2010,(12)：193-196.
[61]李欣,吴银根,张惠勇,邵长荣.支气管扩张症辨证模式初探[J].中西医结合学报,2004,(04)：255-257.
[62]唐雪春,陈小燕.150例支气管扩张住院患者中医证候分布规律的回顾性研究[J].辽宁中医杂志,2008,(08)：1157-1158.
[63]张惠勇,李欣,倪伟,等.支气管扩张证中医辨证分型规律的研究[J].上海中医药杂志,2005,(01)：16-18.
[64]李丛煌,花宝金.283例中晚期非小细胞肺癌患者证候分布及证候要素组合特点分析[J].北京中医药大学学报,2009,(10)：712-715.
[65]谢长生,王东建,潘磊,等.561例肺癌中医证型与TNM分期及病理类型的相关性探索[J].浙江中医杂志,2010,(06)：398-399.
[66]张月,张培彤,赵冰,等.基于聚类分析的肺癌中医证候分类及诊断的研究[J].北京中医药大学学报,2009,(02)：132-135.
[67]赵琳,尤辉,任郭侠,等.肺结核中医证候规律的临床研究[J].陕西中医,2011,(02)：173-1 74.
[68]王胜圣,田洋,刘嵋松,等.基于中医文献检索的肺结核病中医证候规律分析[J].中华中医药杂志,2011,(11)：2491-2493.
[69]郭晓燕,张惠勇,耿佩华,等.基于现代文献的肺结核中医证候及证候要素分布规律研究[J].辽宁中医杂志,2012,(01)：68-70.
[1]刘丽梅,陈琳,王瑞海,等.病证结合方证相应基础研究的现状[J].中国中医基础医学杂志,2009,5：334-336.
[2]中华医学会呼吸病学分会哮喘学组.咳嗽的诊断与治疗指南(2009版)[J].全科医学临床与教育,2009,7(5)：453-456.
[3]Moher D, Schulz KF, Altman DG. The CONSORT statement:revised recommendations for improving the quality of reports of parallel-group randomized trials [J]. Lancet 2001,357:1191-1194.
[4]王波,詹思延.如何撰写高质量的流行病学研究论文第一讲观察性流行病学研究报告规范——STROBE介绍[J].中华流行病学杂志,2006,27(6)：547-549.
[5]全国科学技术名词审定委员会.《中医药学名词》[M].北京：科学出版社,2004.
[6]朱文峰,袁肇凯主编.《中医诊断学》[M].北京：人民卫生出版社,2011.
[7]姚乃礼主编.《中医证候鉴别诊断学》[M].北京：人民卫生出版社,2005.
[8]游海.加减咳血方治疗嗜酸粒细胞性支气管炎肝火犯肺证的临床观察[D].湖南中医药大学,2010.
[9]陈海涛.上气道咳嗽综合征中医证治规律研究[D].南京中医药大学,2010.
[10]何伟平,邱宝珊,王士贞.慢性咽炎中医证型与相关因素分析[A].中华中医药学会、中华中医药学会耳鼻喉科分会、“世中联”耳鼻喉口腔科专业委员会.中华中医药学会耳鼻喉科分会第15届学术交流会论文集[c].2009：5.
[11]潘文超,赵蓓.上气道咳嗽综合征200例中医证型观察[J].中国中医药信息、杂志,2010,(6)：22-23.
[12]徐青菁.咳嗽变异性哮喘的中医证候学特点研究[D].北京中医药大学,2009.
[13]张小梅.小儿咳嗽变异性哮喘中医证候量化分析初步研究[D].南京中医药学,2010.
[14]罗社文,李友林,晁恩祥.咳嗽变异性哮喘的中医证候学研究[J].北京中医药大学学报(中医临床版),2007,(3)：11-14.
[15]朱生梁,马淑颖,程艳梅,等.胃食管反流病中医证型与反流类型的临床研究[A].中华中医药学会脾胃病分会.中华中医药学会脾胃病分会第十九次全国脾胃病学术交流会论文汇编[c].中华中医药学会脾胃病分会,2007：3.
[16]刘静.和胃降逆法治疗肝胃不和型胃食管反流病的临床研究及作用机制探讨[D].广州中医药大学,2009.
[17]朱晓丹.变应性咳嗽中医证候初步研究[D].北京中医药大学,2012
[18]谢长生,王东建,潘磊,等.561例肺癌中医证型与TNM分期及病理类型的相关性探索[J].浙江中医杂志,2010,(6)：398-399.
[19]瞿彬,张培彤.肺癌并发胸水患者中医证型分布规律研究[J].中医杂志,2011,(6)：483-485.
[20]朱婴,李萍萍,黄立中.肺癌初诊患者的中医证候分布规律研究[J].湖南中医药大学学报,2009,(6)：71-72.
[21]李际强,徐凯,罗翌,等.肺癌患者中医证候分型与T淋巴细胞亚群及NK细胞的相关性研究[A].中国中西医结合学会.第三届世界中西医结合大会论文摘要集[C].中国中西医结合学会,2007：2.
[22]沈敏鹤,阮善明,舒琦瑾.肺癌中医实证证候要素与临床相关因素的单因素分析[J].世界中医药,2008,(4)：209-212.
[23]张月,张培彤,赵冰,等.基于聚类分析的肺癌中医证候分类及诊断的研究[J].北京中医药大学学报,2009,(2)：132-135.
[24]苏婉,徐振晔,王中奇,等.肺癌中医证候与代谢酶基因CYPlA1、CYP2E1多态性的关联研究[J].上海中医药大学学报,2010,(5)：29-32.
[25]张月.中晚期肺癌患者中医证候的聚类分析研究[D].北京中医药大学,2008.
[26]左明焕,王芬,孙韬.晚期肺癌的中医证候研究[J].北京中医药大学学报(中医临床版),2003,(4)：7-9.
[27]胡凯文,王芬,左明焕,等.中晚期肺癌患者合并肺部细菌感染的中医证候危险因素分析[J].中国中医基础医学杂志,2004,(8)：45-46.
[28]王芬,周而复,陈文强,等.中晚期肺癌中医证候与患者生存质量关系的分析[J].中国中医药信息杂志,2007,(2)：21-22,108.
[29]李丛煌,花宝金.283例中晚期非小细胞肺癌患者证候分布及证候要素组合特点分析[J].北京中医药大学学报,2009,(10)：712-715.
[30]黎敬波,李科威,张征,等.非小细胞肺癌化疗前后证候变化的临床研究[J].新中医,2009,(1)：18-20.
[31]胡小梅,张培彤,杨宗艳,等.非小细胞肺癌不同病理分类与中医证候分布规律关系探讨[J].中国中医药信息杂志,2006,(12)：19-21.
[32]黎敬波,张征,林丽珠,等.非小细胞肺癌417例证候分布的临床研究[J].广州中医药大学学报,2009,(1)：73-77.
[33]黄立中,邹彩亮,何欣,等.非小细胞肺癌术后Ⅲ、Ⅳ期患者的中医证候分布规律初探[J].湖南中医药大学学报,2010,(11)：48-50.
[34]叶磊,欧阳学农,戴西湖,等.非小细胞肺癌中医证候分析[J].中医杂志,2011,(16)：1393-1395.
[35]张淑香.晚期非小细胞肺癌(NSCLC)的证候研究[J].中医药学刊,2006,(4)：678-679.
[36]曹洋.晚期非小细胞肺癌的中医证候规律研究[J].中华中医药学刊,2011,(04)：754-757.
[37]侯丽,姜苗,陈信义,等.晚期非小细胞肺癌中医证候特征回顾性临床研究[J].中国中医药信息杂志,2007,(04)：19-21.
[38]王芬,胡凯文,陈文强,等.晚期非小细胞肺癌中医证候与生存质量的关系[J].中国中医药信息杂志,2005,(06)：16-17.
[39]秦金霞,黎敬波.中晚期非小细胞肺癌中医证候分布规律的研究[J].现代中医药,2010,(04)：64-65.
[42]李国勤,边永君,李光熙,等.冬病夏治消喘膏治疗慢性肺系疾病的回顾性研究.北京中医药,2008,27(11)：835-837.
[43]闫平,张庆祥,燕欣鹏.慢性支气管炎中医辨证的流行病学调查研究[J].辽宁中医药大学学报,2008,(04)：107-108.
[44]徐丽华,王俊,陈启光,等.慢性支气管炎中医四诊信息调查及EFA分析[J].浙江中西医结合杂志,2003,(11)：12-13.
[45]王俊,徐丽华,闵捷.慢性支气管炎中医证型与理化指标的关系探要[J].中医药学刊,2004,(04)：605-615.
[46]高永翔,龚立,李群英,等.虚证慢性支气管炎不同中医证型支气管肺泡灌洗液中免疫相关指标的比较研究[J].成都中医药大学学报,2006,(01)：5-7.
[47]牛锐,郑运松.中医咳证分型与影像分析[J].陕西中医学院学报,2008,(05)：17-18.
[48]唐雪春,陈小燕.150例支气管扩张住院患者中医证候分布规律的回顾性研究[J].辽宁中医杂志,2008,(08)：1157-1158.
[49]陈小燕.支气管扩张中医证候规律研究[D].广州中医药大学,2007.
[50]张惠勇,李欣,倪伟,等.支气管扩张证中医辨证分型规律的研究[J].上海中医药杂志,2005,(01)：16-18.
[51]陈沁.支气管扩张中医证型的聚类分析探讨[J].中国中医急症,2010,(9)：1537-1539.
[52]刘贤会,罗威.120例初治继发性肺结核患者中医证候规律总结[J].中国临床研究,2011,(21)：3-5.
[53]赵琳,尤辉,任郭侠,等.肺结核中医证候规律的临床研究[J].陕西中医,2011,(2)：173-174.
[54]王胜圣,周杰,董芳,等.肺结核中医证候规律及其与客观指标相关性的研究[J].中医临床研究,2011,(15)：13-14.
[55]郭晓燕,张惠勇,鹿振辉,等.耐多药肺结核中医证候分布规律研究[J].中华中医药杂志,2011,(11)：2494-2497.
[56]温绍惠,席宁,史利卿.72例慢性咳嗽患者中医相关病理因素及生活质量调查分析[J].北京中医药大学学报(中医临床版),2011,(2)：11-14.
[57]洪敏俐,郑伟彬,洪春霖,等.慢性咳嗽的病因调查及其中医证型分布规律探讨[J].福建中医学院学报,2010,(1)：41-43.
[58]杨溯,刘渊.慢性咳嗽证型与时辰规律的研究[J].云南中医中药杂志,2012,(3)：7-8.
[59]何德平,林琳,吴蕾,等.慢性咳嗽中医证候分布规律探讨[J].广州中医药大学学报,2008,(6)：560-562.
[60]周小娟.慢性咳嗽中医证候学特点观察[D].北京中医药大学,2010.
[61]唐彦,何平,王艳芬,等.昆明地区小儿慢性咳嗽中医证型与体质关系探讨[J].中国中医药信息杂志,2011,(9)：21-22.
[62]张蕊.50例老年慢性咳嗽患者的中医证候特点探讨[J].中国自然医学杂志,2010,(1)：47-48.
[63]喻清和,王鹏,黄婉怡,等.难治性慢性咳嗽临床证型研究[J].新中医,2012,(2)：27-29.
[1]姜桂峰.辨证治疗慢性支气管炎合并感染[J].湖北中医杂志,2000,(01)：22.
[2]苏玲,徐磊.分型穴位贴敷法治疗慢性支气管炎、支气管哮喘研究[J].江苏中医,1999,(07)：36-37.
[3]王端权.大青龙汤治疗52例慢性支气管炎合并肺部感染[J].河南中医,2000,(05)：37.
[4]吴小华,杨文庆,宋郁河.从哮论治咳嗽变异性哮喘58例[J].福建中医药,2004,(06)：26-27.
[5]刘松山,何成诗,杨仁旭,等.复方薤白胶囊治疗慢性支气管炎急性发作期Ⅲ期临床研究[J].中国新药杂志,2010,(15)：1333-1336+1354.
[6]曹红洲.固本止咳汤治疗慢性支气管炎45例[J].河南中医,2000,(04)：45.
[7]尹英杰,张洪春,晁恩祥.固本止咳胶囊治疗慢性支气管炎迁延期的临床研究[J].北京中医药大学学报,2001,(02)：58-61.
[8]陈泉.化瘀宣肺汤治疗慢性支气管炎63例[J].时珍国医国药,1999,(04)：50-51.
[9]毛兵,张瑞明,李廷谦,等.咳速宁颗粒剂治疗慢性支气管炎急性发作的临床观察[J].中国中西医结合杂志,2002,(08)：597-598.
[10]张芬兰.理气和胃止咳方治疗胃食管反流性咳嗽临床研究[J].长春中医药大学学报,2010,(05)：667-668.
[11]冯尔和.麻龙黄芩汤治疗慢性支气管炎(痰热证)102例[J].新中医,2008,(07)：76.
[12]王洪.从肝论治慢性咳嗽肝咳证临床观察[J].北京中医药,2012,(07)：531-532.
[13]史苗颜,毕小利,张炜.平金方治疗慢性咳嗽的临床研究[J].上海中医药杂志,2010,(11)：54-56.
[14]韩峰,张竞之,刘美英.慢咳饮治疗慢性咳嗽35例[J].中医研究,2008,(08)：22-24.
[15]陈红,姜成,丁念,等.清肺止咳方加炎琥宁治疗慢性咳嗽疗效观察[J].湖北中医药大学学报,2012,(03)：47-48.
[16]游柏稳,游海,杜海燕.清肝宁肺方治疗嗜酸粒细胞性支气管炎肝火犯肺证的临床观察[J].湖南中医药大学学报,2011,(09)：61-63+67.
[17]潘文超,赵蓓,史锁芳.上气道咳嗽综合征风痰恋肺证中医药临床治疗观察[J].中医临床研究,2012,(08)：11-12.
[18]胡崇静.加味止嗽颗粒治疗风邪恋肺型慢性咳嗽的临床疗效观察[D].广州中医药大学,2011.
[19]游海.加减咳血方治疗嗜酸粒细胞性支气管炎肝火犯肺证的临床观察[D].湖南中医药大学,2010.
[20]黄纯美.加味三叶汤治疗鼻后滴流综合征慢性咳嗽临床疗效观察[D].广州中医药大学,2008.
[21]郁晓维,王明明.加味玉屏风散治疗小儿慢性咳嗽肺脾两虚证疗效评价[J].中医儿科杂志,2010,(01)：23-27.
[22]徐宁.苍屏散加减治疗小儿UACS所致慢性咳嗽的临床疗效观察[D].成都中医药大学,2010.
[23]王富春.抗支糖浆对小儿咳嗽变异性哮喘肺功能和血清中IgE的影响和临床研究[D].黑龙江中医药大学,2010.
[24]黄叶.祛风止咳方治疗变应性咳嗽的临床研究[D].南京中医药大学,2011.
[25]毛薇薇.参附注射液联合TP/GP方案治疗晚期非小细胞肺癌32例临床观察[J].中国现代医生,2011,(15)：61+65.
[26]贾学科,胡立新,刘建国,等.慈桃软坚胶囊对非小细胞肺癌抑瘤作用的临床研究[J].中国实验方剂学杂志,2011,(16)：265-266.
[27]刘红健,秦鉴,吴国珍.健脾益气补肾法辅助化疗治疗非小细胞肺癌临床观察[J].中国中医急症,2009,(12)：1959-1960+2016.
[28]张长花.加味止嗽散治疗小儿风邪犯肺型咳嗽变异性哮喘30例疗效观察[J].北京中医药,2009,(08)：619-621.
[29]王艳.宣肺止咳方治疗小儿咳嗽变异性哮喘的临床疗效学研究[D].南京中医药大学,2010.
[30]甄润平.中西医结合治疗小儿咳嗽变异性哮喘58例[J].中国中医急症,2011,(08)：1311-1312.
[31]陈昌华.“慢咳宁方”治疗慢性咳嗽32例临床观察[J].江苏中医药,2011,(10)：43-44.
[32]伍德军.小柴胡汤加味治疗咳嗽变异性哮喘36例[J].甘肃中医,2009,(09)：20-21.
[33]杨树升,林丽,向艳丽.小青龙汤治疗咳嗽变异性哮喘的临床疗效分析[J].现代医药卫生,2012,(06)：901-903.
[34]程珍.小青龙汤加减治疗成人咳嗽变异型哮喘34例[J].医药导报,2012,(06)：749-751.
[35]魏鹏草.分型辨证论治咳嗽变异性哮喘临床研究[D].北京中医药大学,2011.
[36]祁海燕.润肺止咳法治疗咳嗽变异性哮喘的临床和实验研究[D].中国中医科学院,2009.
[37]夏露.止咳定喘汤治疗咳嗽变异性哮喘60例临床分析[D].湖北中医学院,2009.
[38张金举,向希雄.通鼻止咳方颗粒治疗儿童上气道咳嗽综合征40例[J].湖北中医杂志,2012,(02)：32-33.
[39]徐昕.中西医结合治疗鼻后滴漏综合征所致慢性咳嗽疗效观察[J].河北中医,2010,(03)：378-380.
[40]张芬兰.理气和胃止咳方治疗胃食管反流性咳嗽临床研究[J].长春中医药大学学报,2010,(05)：667-668.
[41]陈茹琴,梁兆球.泻白散合清燥救肺汤加味治疗支气管扩张症35例临床观察[J].中医药导报,2006,(07)：22-24.
[42]赵杜鹃,陈秀妹.通支饮对稳定期支气管扩张痰热壅肺证生活质量的影响[J].辽宁中医杂志,2012,(04)：669-671.
[43]王玉明.泻白散合清燥救肺汤在支气管扩张症治疗中的临床应用[J].内蒙古中医药,2012,(10)：25-26.
[44]黄海茵,秦鸿,杨佩兰,等.支扩稳定方治疗稳定期支气管扩张症临床研究[J].上海中医药杂志,2011,(01)：33-36.
[45]张剑辉.加味清金化痰汤治疗痰热蕴肺型支气管扩张症的临床疗效观察[D].广州中医药大学,2011.
[46]邱婧.麻杏石甘汤加味治疗慢性支气管炎急性发作期(痰热郁肺证)临床观察[D].长春中医药大学,2010.
[47]闫国友,张立民,王兴.参百止咳合剂治疗慢性支气管炎急性发作30例临床观察[J].河北中医,2011,(1 0)：1468-1470.
[48]李广诚,曾江正,曾望远.参麦注射液对慢性支气管炎气虚证患者T细胞亚群的影响[J].湖南中医学院学报,2004,(03)：35-36+41.
[49]高宏,魏素丽,杨建宇,等.川贝养亲口服液治疗慢性支气管炎215例临床观察[J].山东中医杂志,2003,(10)：592-593.
[50]孙淑荣,莫霄云.当归六黄汤加味治疗慢性支气管炎迁延期临床研究[J].辽宁中医药大学学报,2007,(02)：104-105.
[51]杨仁旭,胡勇刚,景瑞,等.复方薤白胶囊治疗慢性支气管炎急性发作期的Ⅱ期临床研究[J].中药新药与临床药理,2008,(02)149-152.
[52]李红.加减清气化痰丸治疗痰热壅肺型慢支咳嗽的疗效观察[J].中医临床研究,2011,(11)：1-2.
[53]周建伟.金水六君煎治疗慢性支气管炎迁延期肺肾阴虚证45例[J].中国中医药现代远程教育,2011,(03)：23-24.
[54]熊四毛,葛正清.清热化痰祛湿法治疗慢性支气管炎急性发作60例[J].实用中西医结合临床,2010,(06)：48-49.
[55]黄孝锦.慢性支气管炎肺气肿中医辨证治疗效果观察[J].中医临床研究,2012,(04)：89-90.
[56]董玉华.清化宣肺汤治疗痰热郁肺型慢性支气管炎疗效观察[J].山西中医,2009,(01)：9-10.
[57]李崇红,廖莎.清气化痰汤治疗慢性支气管炎急性发作期的临床观察[J].中医药导报,2009,(11)：14-15.
[58]杨宏志,田正鉴.痰热清注射液治疗急性发作期慢性支气管炎(痰热郁肺证)疗效观察[J].吉林中医药,2005,(10)：15-16.
[59]肖庆龄,黄雅菊,朱启勇,等.三子咳喘胶囊治疗慢性支气管炎痰湿阻肺证疗效观察[J].河南中医,2007,(07)：20-22.
[60]张明利.痰热清注射液治疗慢性支气管炎急性发作60例[J].河南中医,2005,(09)：75-76.
[61]简永英.西医常规疗法加中医辨证治疗慢性支气管炎急性发作疗效观察[J].广西中医学院学报,2006,(03)：32-34.
[62]刘淦新.小青龙汤治疗慢性支气管炎急性发作56例疗效观察[J].国际医药卫生导报,2006,(04)：83.
[63]谭文秀,呼翠萍,乔牡玲.中西医结合治疗慢性喘息型支气管炎急性发作疗效观察[J].内蒙古中医药,2012,(02)：26-27.
[64]张军.中西医结合治疗慢性支气管炎52例疗效观察[J].山西中医学院学报,2009,(04)：47-48.
[65]李淼.中西医结合治疗慢性支气管炎100例[J].中国医药指南,2011,(26)：322-323.
[66]徐桐柏,邵娜,杨力宁.中西医结合治疗慢性支气管炎急性发作临床观察[J].实用中医药杂志,2008,(02)：100.
[67]张儒斌,葛润明.中医辨证分型治疗慢性支气管炎的临床疗效分析[J].内蒙古中医药,2012,(08)：10+31.
[68]彭淑芳.中医辨证治疗80例慢性支气管炎的临床研究[J].亚太传统医药,2012,(03)：73-74.
[69]李雄.中医辨证治疗慢性支气管炎肺气肿效果分析[J].中医临床研究,2012,(07)：42-43.
[70]吕俊芳.中医辨证治疗慢性支气管炎临床分析[J].中国实用医药,2011,(21)：241-242.
[71]孙海霞.中医辩证治疗慢性支气管炎肺气肿126例临床疗效观察[J].医学信息、(中旬刊),2010,(05)：1306-1307.
[1]吕爱平,朱良春.再论证候研究思路与方法.中国中医基础医学杂志,2004,10(8)：1-2，7.
[2]邓铁涛,郑洪.中医五脏相关学说研究-从五行到五脏相关[J].中国工程科学,2008,10(2)：7-12.
[1]吕爱平,朱良春.再论证候研究思路与方法.中国中医基础医学杂志,2004,10(8)1-2，7.
[1]中华医学会呼吸病学分会哮喘学组.咳嗽的诊断与治疗指南(2009版).全科医学临床与教育,2009,7(5)：453-456.
[2]国家技术监督管理局.《中华人民共和国国家标准-中医临床诊疗术语》[S].北京：中国标准出版社,1997.
[3]中华人民共和国卫生部.《中药新药临床研究指导原则》[S].北京：中国医药科技出版社,2002.
[1]胡立胜,周强.中医临床研究设计与SAS编程统计分析[M].学苑出版社,2004(5)：2.
[1]史周华,张雪飞.中医药统计学[M].北京：科学出版社.
[2]李建生,王至婉,余学庆.基于慢性阻塞性肺病COPD急性加重期文献的多元统计方法在证候研究的应用探讨[J].河南中医学院学报,2007,22(133)：8-10.
[3]薛富波,张文彤,田晓燕.SAS8.2统计应用教程[M].北京：北京希望电子出版社,2004.
[1]曹昧,马伯艳.多元统计分析方法在中医证候研究中的应用.中医药信息2008,25(3)：76-78.
[2]史周华,张雪飞.中医药统计学[M].北京：科学出版社.
[3]杜彩凤,王天芳,辛意.绝经后期更年期综合征常见证候要素的Logistic回归分析.北京中医药大学学报,2009,32(4)：238-242.
[1]中华人民共和国卫生部.《中药新药临床研究指导原则》[S].北京：中国医药科技出版社,2002.
[2]陈如冲,赖克方,刘春丽,等.广州地区1087名大学生咳嗽的流行病学调查.中华流行病学杂志.2006,27(2)：123-126.
[3]中华医学会呼吸病学分会哮喘学组.咳嗽的诊断与治疗指南(2009版).全科医学临床与教育,2009,7(5)：453-456.
[4]晁恩祥.关于咳嗽的中医证治及对风咳的讨论意见.会议论文：1-6.
[5]史锁芳.慢性咳嗽证治思路概要.江苏中医药,2008，40(7)：11.
[6]苏强,史锁芳,朴振璟.夹湿咳嗽的临证特点及中医治疗.亚太传统医药,2009,5(3)：116-117.
[7]李丹.从痰论治慢性咳嗽浅识.实用中医内科杂志.2010,24(5)：40-41.
[8]贾桂娈.慢性咳嗽从痰论治的体会.浙江中医杂志.2005,11：486-487.
[9]湿热咳嗽证治探讨.魏鹏草,苗青,樊茂荣.会议论文：
[10]韩峰,张竞之,刘美英.慢咳饮治疗慢性咳嗽35例.中医研究.2008,21(8)：22-24.
[11]蒋吉林,李承珍.中医辨证治疗顽固性咳嗽165例.河北中医.2002,24(3)：177.
[12]张元兵.慢性咳嗽的辨证论治简析中医药学刊.2003,21(7)：11 98-1199.
[13]赵东凯,宫晓燕.慢性咳嗽从肺阳虚证辨治.长春中医药大学学报,2008,24(16)：680-681.
[14]张传名.中医辨治慢性咳嗽体会.云南中医中药杂志,2012,33(2)：84.
[15]周文涛,王家平,宋国宏.浅析慢性咳嗽重视从肝辨治.新中医2012,44(4)：136.
[16]王洪.从肝论治慢性咳嗽肝咳证临床观察.北京中医药,2012,31(7)：531-532.
[17]弋巧玲.从肝论治慢性咳嗽.中医研究,2012,25(9)：44-45.
[18]薛丽姣,崔云,苗青.半夏泻心汤治疗慢性咳嗽机理探析.北京中医药2012,31(9)：684-685.
[19]闫保瑞,陈丽娜,侯莉芬.侯江红教授治疗小儿慢性咳嗽亚健康状态的经验.光明中医,2010,25(12)：2172-2173.
[20]许丽梅,刘小虹.从五脏相关探讨慢性咳嗽之病机.新中医.2012,44(4)：7-8.
[21]朱兴国.从五脏论治慢性咳嗽.实用中医内科杂志,2012,26(4)：66-67,69.
[22]瞿金鸿,林小劲.慢性咳嗽的中西医证治.浙江中西医结合杂志2010,20(9)：542-543.
[23]林色奇,薛汉荣.慢性咳嗽中医证治研究进展.江西中医药,2004,35(262)：61-63.
[24]吴银根.慢性咳嗽的中医治疗思路和经验.江苏中医药,2008,40(7)：7-8.
[25]周贺芙.慢性咳嗽从虚寒论.长春中医药大学硕士学位论文2007.
[26]肖立成.慢性咳嗽诊治探微.辽宁中医药大学学报,2008,10(11)：92-93.
[27]杨珺超,夏永良,宋康.宋康辨治慢性咳嗽经验[J].浙江中医杂志,2009,44(2)：79-81.
[28]柯新桥.咳嗽变异型哮喘中医辨治思路与方法[J].湖北中医杂志,2005,27(2)：3-5.
[29]史锁芳.上气道咳嗽综合征中医证治探讨.南京中医药大学学报,2009,25(3)：164-166.
[30]王德钧,谈欧.慢性咳嗽的中医治疗.江西中医药.2007,38(296)：8-9.
[31]张振千.从肺胃论治慢性咳嗽.山西中医,2007,23(6)：74.
[32]袁玉,魏文周,杨会双.中西医结合治疗咳嗽变异性哮喘疗效观察.河北中医,2007,29(7)：620.
[33]蓝洁.慢性咳嗽辨治体会.中国中医急症,2009,18(12)：2067-2068. 朱奉民,陈宪海.脏腑咳嗽临证探讨.河南中医,2012,32(5)：593-594.
[34]杨珊超,陈素珍,夏永良.宋康教授辨治慢性咳嗽验案.浙江省中西医结合呼吸病诊治进展暨第六次学术年会论文汇编2008：168-171.
[35]陆青.桂技汤合玉屏风散加减治疗过敏性咳嗽50例[J].广西中医药,2007,3(3)：53.
[36]罗海丽.补肾养阴、祛风和中法治疗过敏性咳嗽[J].北京中医药,2009,28(10)：774-776
[37]夏以琳.邵长荣治咳经验介绍.中医杂志,1996,37(4)：210-211.
[38]陈连起.健脾法在咳证治疗中的运用.中国会议论文电子版,1987,9：25-26.
[39]彭蔚平.慢性咳嗽审因论治心得.福建中医药,2007,38(6)：47-48.
[40]朱佳.治疗慢性咳嗽尤当注意辨证与辨病相合.江苏中医药,2008,40(7)：12-13.
[41]郑忻.叶天士《临证指南医案》论治慢性咳嗽经验探析.辽宁中医药大学学报,2012,14(5)：91-93.
[42]魏鹏草,苗青,张文江.叶天士治疗慢性咳嗽的学术思想探讨.江苏中医药,2010,42(4)：12-13.
[43]王宝玉.运用治肺十三法诊治慢性咳嗽的体会.中国会议论文(电子版)1994-2012：146-150.
[44]马瑞智.寇辉论治慢性咳嗽经验.河南中医,2012,32(5)：639-640.
[45]王洪.从肝论治慢性咳嗽肝咳证临床观察.北京中医药2012,31(7)：531-532.
[46]韩峰,张竞之,刘美英.慢咳饮治疗慢性咳嗽35例.中医研究,2008,21(8)：22-24.
[47]史苗颜,毕小利,张炜.平金方治疗慢性咳嗽的临床研究.上海中医药杂志,2010,44(11)：54-56.
[48]常宗焕.自拟宁嗽汤治疗小儿慢性咳嗽160例.陕西中医学院学报,2009,32(4)：47.
[49]魏葆琳.辨证治疗慢性咳嗽200例.长春中医药大学学报.2010,26(6)：877-878.
[50]农志新.麻黄附子细辛汤加减治疗慢性咳嗽50例.福建中医药,2007,38(3)：24.
[51]杨志强.麦门冬汤加减治疗慢性咳嗽40例.实用中医内科杂志,2011,25(12)：23-25.
[52]任文辉.益气化痰汤治疗慢性咳嗽68例.河南中医,2006,26(7)：40-41.
[53]吴如飞.五磨饮子加减治疗心因性慢性咳嗽20例.浙江中医杂志,2011,46(12)：881.
[54]李福厚.自拟补肺消咳饮治疗慢性咳嗽虚证48例.现代中医药,2010,30(3)：22.
[55]曹祥.止咳定嗽汤治疗顽固性咳嗽60例疗效观察.中国卫生产业,2011,8(2-3)：93.
[56]余中成.中西医结合治疗慢性咳嗽84例.实用中医药杂志,2012,28(1)：29.
[57]周建新.中西医结合治疗气道高反应性慢性咳嗽的临床研究.中国民族民间医药会议论文,2011：97.
[58]左明晏,李高兵,范世友.中西医结合治疗慢性咳嗽30例.光明中医,2011,26(12)：2514-2515.
[59]蔡彬.中西医结合治疗慢性咳嗽疗效分析.中医当代医药,2012,19(10)：126.
[60]谭远光.《黄帝内经》慢性咳嗽的证治规律.中国医药导刊,2011,13(12)：2017-2108.
[61]陈先菊.药物配合电动起立床训练缓解慢性咳嗽的效果分析.现代医院,2010,10(9)：46-47.
[62]付强,苏传明,杨永明.中医推拿在治疗慢性咳嗽中的应用.第十一次全国中西医结合防治呼吸系统疾病学术研讨会论文集,2010：365-368.
[63]屈娅婷.脾肾阳虚慢性咳嗽大鼠模型的研制.湖南中医药大学硕士学位论文2012.
[64]谢梦洲,何军锋,屈娅婷.脾肾阳虚慢性咳嗽大鼠模型的研制.湖南中医药大学学报,2010,30(9)：30-33.
[65]刘春芳,朱生梁,曹会杰.通降和胃方及其拆方对胃食管反流性咳嗽豚鼠模型气道炎症及肺通透性影响的实验研究.中国会议论文电子版,2010：96-99.
[66]于树夔.胃蛋白酶检测对喉咽反流的诊断及疗效判定.第四军医大学硕士学位论文,2010.
[67]徐亚军,宋新平,曾勋枝.支气管肺泡灌洗液嗜酸细胞检测在嗜酸细胞性支气管炎诊断中的作用.海南医学,2010,21(21)：53-54.
[1]吕爱平,朱良春.再论证候研究思路与方法.中国中医基础医学杂志.2004,10(8)1-2,7.
[2]郭振球.微观辨证学的研究现状与发展趋势[J].中医药学刊,2003,(5)：646.
[3]王俊,徐丽华,闵捷.慢性支气管炎中医证型与理化指标的关系探要.中医药学刊,2004,22(4)：605,615.
[4]魏春华,温明春,等.COPD患者急性加重期细菌感染状况与肺功能的关系[J].山东医药,2002,42(19)：45
[5]霍建民,杨光,等.COPD患者急性加重期细菌学与肺功能关系的初步研究[J].中国急救医学,2002,22(1)：35
[6]高永翔,龚立,李群英.虚证慢性支气管炎不同中医证型支气管肺泡灌洗液中免疫相关指标的比较研究.成都中医药大学学报,2006,29(1)：5-7.
[7]杨瑶瑶.非小细胞肺癌患者中医证候与免疫等指标的相关性研究.中国中医科学院硕士学位论文,2010.
[8]郭蕾,王永炎,张志斌.关于证候概念的诠释.北京中医药大学,2003,26(2)：5.
[9]李梢.从维度与阶度探讨中医证候的特征及标准化方法.北京中医药大学学报2003,26(3)：1-4.
[10]张文风,林宇春,赵宏杰,等.证候数据多维界面细分与同界面数据分类及证候研究中的逻辑问题探讨.中国会议论文：331-334.
[11]李泽庚,彭波,张念芳,等.证候研究的层次论和阶段论.天津中医药,2007,24(3)：228-229.
[12]郭蕾,王永炎,张志斌,等.证候动态时空特征的复杂性及相应的研究思路.中医研究,2006,19(3)：1-3.
[13]王泓午,王玉来,金章安,等.中风发病前7d-30d内先兆症状的1：2配对病例对照研究[J].中国中医基础医学杂志,2002,8(9)：56.
[14]秦金霞.中晚期非小细胞肺癌中医证候分布规律的研究.现代中医药,2010,30(4)：64-65.
[15]黎敬波,李科威,张征.非小细胞肺癌化疗前后证候变化的临床研究.新中医,2009,41(1)：18-20.
[16]黎敬波,张征,林丽珠非小细胞肺癌手术前后证候变化的对照研究.新中医,2008,40(9)：24-26.
[17]左明焕,王芬,孙韬.晚期肺癌的中医证候研究.北京中医药大学学报(中医临床版)2003,10(4)：7-9.
[18]胡小梅,张培彤,杨宗艳,等.非小细胞肺癌不同病理分类与中医证候分布规律关系探讨.中国中医药信息杂志,2006,13(12)：19-21.
[19]程平荣,晋献春,陈勇鹏.原发性支气管肺癌末次化疗后中医证候演变规律研究.中国中医药信息杂志.2011,18(7)：21-22.
[20]杨丹,田国庆,王景,等.原发性支气管肺癌中医证型分布特点的研究.中国实践2010,13(11B)：3607-3611.
[21]申维玺,孙燕.医学模式和病证的统一性原理[J].中国中医基础医学杂志,2004,(3)：13-15.
[23]林坚.试论中医学方证的相应观[J].中国中医基础医学杂志,2000,(7)：9.
[22]刘艳骄,黄璐琦,杨洪军.中医学关于证候疾病方剂关系的理论研究.中国中医基础医学杂志2006,12(8)：562-563.
[24]李凛.亚急性、慢性咳嗽病因与中医证型相关性研究.北京中医药大学硕士学位论文,2012.
[25]阎碉.感冒后咳嗽证候类型与方证效相关性研究.北京中医药大学博士学位论文,2012.
[26]周伟生,严英,莫伟,等.浅论中医模糊思维阴.中国中西医结合影像学杂志,2003,1(2)：114-116
[27]余兴龙,谭耀麟,竺子民,等.中医舌诊自动识别方法的研究[J].中国生物医学工程学报,1994,13(4)：336—343.
[28]陈荣山,陈东汉,等.模糊数学在中医脉象模式识别中应用[J].医学信息,1998,11(3)：20—21.
[29]马斌荣.中医专家系统与中医知识库—中医领域计算机软件的开发与应用[M].北京：北京出版社,1997.
[30]魏威,魏欣甫,等.模糊数学与中医辨证论治[J].中医教育,1999,18(4)：54·55.
[31]钟铮.300例慢性咳嗽患者中医临床证候规范研究.成都中医药大学硕士学位论文,2008.
[32]洪敏俐,郑伟彬,洪春霖,等.慢性咳嗽的病因调查及其中医证型分布规律探讨.福建中医学院学报2010,20(1)：41-42.
[33]黄敏玲.亚急性及慢性咳嗽证候规律探讨.广州中医药大学硕士学位论文,2008.
[34]张蕊.50例老年慢性咳嗽患者的中医证候特点探讨.中国自然医学杂志,2010,12(1)：47-48.
[35]史利卿,周小娟.慢性咳嗽中医证候学特点观察.中国会议论文：140-143.
[36]何德平,林琳,吴蕾.慢性咳嗽中医证候分布规律探讨.广州中医药大学学报,2008,25(6)：560-562
[37]喻清和,王鹏,黄婉怡,等.难治性慢性咳嗽临床证型研究.新中医,2012,44(2)：27-29.
[38]李鹤鸣.慢性咳嗽中医证候分布规律初探.北京中医药大学硕士学位论文,2009.
[39]张天嵩,唐斌擎,张素,等.基于因子分析的不明原因慢性咳嗽证素研究.中国中医药信息杂志,2010,17(9)：21-22.
[40]刘国华.辨证分型治疗慢性咳嗽刍议[J].实用中医内科杂志,2007,(8)：26.
[41]孙晓春.论老年慢性咳嗽的病机特点与临证辨治[J].北京师范大学学报(自然科学版),1999,(04)：532-535.
[42]王鹏.咳嗽变异性哮喘的病因证治[J].湖北中医杂志,2006,(05)：28-29.
[43]刘朝辉.慢性咳嗽的证素特征及其与常见病因的关联研究[D].福建中医药大学,2012.
[44]万文蓉.干祖望辨治喉源性咳嗽经验探要[J].北京中医,2000,(05)：6-7.
[45]潘文超,赵蓓.上气道咳嗽综合征200例中医证型观察.中国中医药信息杂志,2010,17(6)：22-23
[46]史锁芳.上气道咳嗽综合征中医证治探讨[J].南京中医药大学学报,2009,(03)：164-166.
[47]朱生梁,马淑颖,程艳梅,孙吉,孙永顺,李黎,王晓素,方盛泉.胃食管反流病中医证型与反流类型的临床研究[A].中华中医药学会脾胃病分会.中华中医药学会脾胃病分会第十九次全国脾胃病学术交流会论文汇编[C].中华中医药学会脾胃病分会,2007：3.
[48]水正,乐毅,樊舟,郭志峰.中医辨证分型治疗胃食管反流病52例的临床研究[J].浙江中西医结合杂志,2003,(07)：40-41
[49]谢胜,颜春艳,朱初良,等.66例酸碱混合反流型胃食管反流病中医证型分析[J].北京中医,2004,(03)：147-148.
[50]刘汶,王仲霞,韩偎偎,夏志伟.中西医结合治疗胃食管反流病(下)胃食管反流病中医证候流行病学研究[J].北京中医药,2008,(04)：243-244,251.
[51]戴昕.胃食管反流病中医辨证分型研究概况[J].现代中西医结合杂志,2009,(09)：1073-1075.
[52]叶文彬.50例嗜酸细胞性支气管炎辨证分型治疗[J].福建中医药,2007,(01)：35.
[53]张天锡,李霞,索钢.青果止咳汤治疗过敏性咳嗽300例[J].四川中医,2007,(01)：62.
[54]陆青.桂枝汤合玉屏风散加减治疗过敏性咳嗽50例[J].广西中医药,2007,(03)：53.
[55]张天嵩.不明原因慢性咳嗽从燥论治探析[J].上海中医药杂志,2011,(11)：44-47.
[56]朱晓丹.变应性咳嗽中医证候初步研究[D].北京中医药大学,2012.
[57]唐锐.辨证治疗慢性支气管炎的体会[J].光明中医,2002,(02)：31-32.
[58]金建立,付存穰.中医辨证治疗慢性支气管炎急性发作100例[J].中国民间疗法,2010,5：35.
[59]姜良铎,唐光华.60例内伤基础上外感咳嗽病例观察[A].中华中医药学会、中华中医药杂志社.全国中医药科研与教学改革研讨会论文集[C].中华中医药学会、中华中医药杂志社：,2000：3.
[60]汪海飚,徐卫方,王平,高振.慢性支气管炎的中医证-治相应关系研究[J].中国实验方剂学杂志,2010,(12)：193-196.
[61]李欣,吴银根,张惠勇,邵长荣.支气管扩张症辨证模式初探[J].中西医结合学报,2004,(04)：255-257.
[62]唐雪春,陈小燕.150例支气管扩张住院患者中医证候分布规律的回顾性研究[J].辽宁中医杂志,2008,(08)：1157-1158.
[63]张惠勇,李欣,倪伟,等.支气管扩张证中医辨证分型规律的研究[J].上海中医药杂志,2005,(01)：16-18.
[64]李丛煌,花宝金.283例中晚期非小细胞肺癌患者证候分布及证候要素组合特点分析[J].北京中医药大学学报,2009,(10)：712-715.
[65]谢长生,王东建,潘磊,等.561例肺癌中医证型与TNM分期及病理类型的相关性探索[J].浙江中医杂志,2010,(06)：398-399.
[66]张月,张培彤,赵冰,等.基于聚类分析的肺癌中医证候分类及诊断的研究[J].北京中医药大学学报,2009,(02)：132-135.
[67]赵琳,尤辉,任郭侠,等.肺结核中医证候规律的临床研究[J].陕西中医,2011,(02)：173-1 74.
[68]王胜圣,田洋,刘嵋松,等.基于中医文献检索的肺结核病中医证候规律分析[J].中华中医药杂志,2011,(11)：2491-2493.
[69]郭晓燕,张惠勇,耿佩华,等.基于现代文献的肺结核中医证候及证候要素分布规律研究[J].辽宁中医杂志,2012,(01)：68-70.
[1]刘丽梅,陈琳,王瑞海,等.病证结合方证相应基础研究的现状[J].中国中医基础医学杂志,2009,5：334-336.
[2]中华医学会呼吸病学分会哮喘学组.咳嗽的诊断与治疗指南(2009版)[J].全科医学临床与教育,2009,7(5)：453-456.
[3]Moher D, Schulz KF, Altman DG. The CONSORT statement:revised recommendations for improving the quality of reports of parallel-group randomized trials [J]. Lancet 2001,357:1191-1194.
[4]王波,詹思延.如何撰写高质量的流行病学研究论文第一讲观察性流行病学研究报告规范——STROBE介绍[J].中华流行病学杂志,2006,27(6)：547-549.
[5]全国科学技术名词审定委员会.《中医药学名词》[M].北京：科学出版社,2004.
[6]朱文峰,袁肇凯主编.《中医诊断学》[M].北京：人民卫生出版社,2011.
[7]姚乃礼主编.《中医证候鉴别诊断学》[M].北京：人民卫生出版社,2005.
[8]游海.加减咳血方治疗嗜酸粒细胞性支气管炎肝火犯肺证的临床观察[D].湖南中医药大学,2010.
[9]陈海涛.上气道咳嗽综合征中医证治规律研究[D].南京中医药大学,2010.
[10]何伟平,邱宝珊,王士贞.慢性咽炎中医证型与相关因素分析[A].中华中医药学会、中华中医药学会耳鼻喉科分会、“世中联”耳鼻喉口腔科专业委员会.中华中医药学会耳鼻喉科分会第15届学术交流会论文集[c].2009：5.
[11]潘文超,赵蓓.上气道咳嗽综合征200例中医证型观察[J].中国中医药信息、杂志,2010,(6)：22-23.
[12]徐青菁.咳嗽变异性哮喘的中医证候学特点研究[D].北京中医药大学,2009.
[13]张小梅.小儿咳嗽变异性哮喘中医证候量化分析初步研究[D].南京中医药学,2010.
[14]罗社文,李友林,晁恩祥.咳嗽变异性哮喘的中医证候学研究[J].北京中医药大学学报(中医临床版),2007,(3)：11-14.
[15]朱生梁,马淑颖,程艳梅,等.胃食管反流病中医证型与反流类型的临床研究[A].中华中医药学会脾胃病分会.中华中医药学会脾胃病分会第十九次全国脾胃病学术交流会论文汇编[c].中华中医药学会脾胃病分会,2007：3.
[16]刘静.和胃降逆法治疗肝胃不和型胃食管反流病的临床研究及作用机制探讨[D].广州中医药大学,2009.
[17]朱晓丹.变应性咳嗽中医证候初步研究[D].北京中医药大学,2012
[18]谢长生,王东建,潘磊,等.561例肺癌中医证型与TNM分期及病理类型的相关性探索[J].浙江中医杂志,2010,(6)：398-399.
[19]瞿彬,张培彤.肺癌并发胸水患者中医证型分布规律研究[J].中医杂志,2011,(6)：483-485.
[20]朱婴,李萍萍,黄立中.肺癌初诊患者的中医证候分布规律研究[J].湖南中医药大学学报,2009,(6)：71-72.
[21]李际强,徐凯,罗翌,等.肺癌患者中医证候分型与T淋巴细胞亚群及NK细胞的相关性研究[A].中国中西医结合学会.第三届世界中西医结合大会论文摘要集[C].中国中西医结合学会,2007：2.
[22]沈敏鹤,阮善明,舒琦瑾.肺癌中医实证证候要素与临床相关因素的单因素分析[J].世界中医药,2008,(4)：209-212.
[23]张月,张培彤,赵冰,等.基于聚类分析的肺癌中医证候分类及诊断的研究[J].北京中医药大学学报,2009,(2)：132-135.
[24]苏婉,徐振晔,王中奇,等.肺癌中医证候与代谢酶基因CYPlA1、CYP2E1多态性的关联研究[J].上海中医药大学学报,2010,(5)：29-32.
[25]张月.中晚期肺癌患者中医证候的聚类分析研究[D].北京中医药大学,2008.
[26]左明焕,王芬,孙韬.晚期肺癌的中医证候研究[J].北京中医药大学学报(中医临床版),2003,(4)：7-9.
[27]胡凯文,王芬,左明焕,等.中晚期肺癌患者合并肺部细菌感染的中医证候危险因素分析[J].中国中医基础医学杂志,2004,(8)：45-46.
[28]王芬,周而复,陈文强,等.中晚期肺癌中医证候与患者生存质量关系的分析[J].中国中医药信息杂志,2007,(2)：21-22,108.
[29]李丛煌,花宝金.283例中晚期非小细胞肺癌患者证候分布及证候要素组合特点分析[J].北京中医药大学学报,2009,(10)：712-715.
[30]黎敬波,李科威,张征,等.非小细胞肺癌化疗前后证候变化的临床研究[J].新中医,2009,(1)：18-20.
[31]胡小梅,张培彤,杨宗艳,等.非小细胞肺癌不同病理分类与中医证候分布规律关系探讨[J].中国中医药信息杂志,2006,(12)：19-21.
[32]黎敬波,张征,林丽珠,等.非小细胞肺癌417例证候分布的临床研究[J].广州中医药大学学报,2009,(1)：73-77.
[33]黄立中,邹彩亮,何欣,等.非小细胞肺癌术后Ⅲ、Ⅳ期患者的中医证候分布规律初探[J].湖南中医药大学学报,2010,(11)：48-50.
[34]叶磊,欧阳学农,戴西湖,等.非小细胞肺癌中医证候分析[J].中医杂志,2011,(16)：1393-1395.
[35]张淑香.晚期非小细胞肺癌(NSCLC)的证候研究[J].中医药学刊,2006,(4)：678-679.
[36]曹洋.晚期非小细胞肺癌的中医证候规律研究[J].中华中医药学刊,2011,(04)：754-757.
[37]侯丽,姜苗,陈信义,等.晚期非小细胞肺癌中医证候特征回顾性临床研究[J].中国中医药信息杂志,2007,(04)：19-21.
[38]王芬,胡凯文,陈文强,等.晚期非小细胞肺癌中医证候与生存质量的关系[J].中国中医药信息杂志,2005,(06)：16-17.
[39]秦金霞,黎敬波.中晚期非小细胞肺癌中医证候分布规律的研究[J].现代中医药,2010,(04)：64-65.
[42]李国勤,边永君,李光熙,等.冬病夏治消喘膏治疗慢性肺系疾病的回顾性研究.北京中医药,2008,27(11)：835-837.
[43]闫平,张庆祥,燕欣鹏.慢性支气管炎中医辨证的流行病学调查研究[J].辽宁中医药大学学报,2008,(04)：107-108.
[44]徐丽华,王俊,陈启光,等.慢性支气管炎中医四诊信息调查及EFA分析[J].浙江中西医结合杂志,2003,(11)：12-13.
[45]王俊,徐丽华,闵捷.慢性支气管炎中医证型与理化指标的关系探要[J].中医药学刊,2004,(04)：605-615.
[46]高永翔,龚立,李群英,等.虚证慢性支气管炎不同中医证型支气管肺泡灌洗液中免疫相关指标的比较研究[J].成都中医药大学学报,2006,(01)：5-7.
[47]牛锐,郑运松.中医咳证分型与影像分析[J].陕西中医学院学报,2008,(05)：17-18.
[48]唐雪春,陈小燕.150例支气管扩张住院患者中医证候分布规律的回顾性研究[J].辽宁中医杂志,2008,(08)：1157-1158.
[49]陈小燕.支气管扩张中医证候规律研究[D].广州中医药大学,2007.
[50]张惠勇,李欣,倪伟,等.支气管扩张证中医辨证分型规律的研究[J].上海中医药杂志,2005,(01)：16-18.
[51]陈沁.支气管扩张中医证型的聚类分析探讨[J].中国中医急症,2010,(9)：1537-1539.
[52]刘贤会,罗威.120例初治继发性肺结核患者中医证候规律总结[J].中国临床研究,2011,(21)：3-5.
[53]赵琳,尤辉,任郭侠,等.肺结核中医证候规律的临床研究[J].陕西中医,2011,(2)：173-174.
[54]王胜圣,周杰,董芳,等.肺结核中医证候规律及其与客观指标相关性的研究[J].中医临床研究,2011,(15)：13-14.
[55]郭晓燕,张惠勇,鹿振辉,等.耐多药肺结核中医证候分布规律研究[J].中华中医药杂志,2011,(11)：2494-2497.
[56]温绍惠,席宁,史利卿.72例慢性咳嗽患者中医相关病理因素及生活质量调查分析[J].北京中医药大学学报(中医临床版),2011,(2)：11-14.
[57]洪敏俐,郑伟彬,洪春霖,等.慢性咳嗽的病因调查及其中医证型分布规律探讨[J].福建中医学院学报,2010,(1)：41-43.
[58]杨溯,刘渊.慢性咳嗽证型与时辰规律的研究[J].云南中医中药杂志,2012,(3)：7-8.
[59]何德平,林琳,吴蕾,等.慢性咳嗽中医证候分布规律探讨[J].广州中医药大学学报,2008,(6)：560-562.
[60]周小娟.慢性咳嗽中医证候学特点观察[D].北京中医药大学,2010.
[61]唐彦,何平,王艳芬,等.昆明地区小儿慢性咳嗽中医证型与体质关系探讨[J].中国中医药信息杂志,2011,(9)：21-22.
[62]张蕊.50例老年慢性咳嗽患者的中医证候特点探讨[J].中国自然医学杂志,2010,(1)：47-48.
[63]喻清和,王鹏,黄婉怡,等.难治性慢性咳嗽临床证型研究[J].新中医,2012,(2)：27-29.
[1]姜桂峰.辨证治疗慢性支气管炎合并感染[J].湖北中医杂志,2000,(01)：22.
[2]苏玲,徐磊.分型穴位贴敷法治疗慢性支气管炎、支气管哮喘研究[J].江苏中医,1999,(07)：36-37.
[3]王端权.大青龙汤治疗52例慢性支气管炎合并肺部感染[J].河南中医,2000,(05)：37.
[4]吴小华,杨文庆,宋郁河.从哮论治咳嗽变异性哮喘58例[J].福建中医药,2004,(06)：26-27.
[5]刘松山,何成诗,杨仁旭,等.复方薤白胶囊治疗慢性支气管炎急性发作期Ⅲ期临床研究[J].中国新药杂志,2010,(15)：1333-1336+1354.
[6]曹红洲.固本止咳汤治疗慢性支气管炎45例[J].河南中医,2000,(04)：45.
[7]尹英杰,张洪春,晁恩祥.固本止咳胶囊治疗慢性支气管炎迁延期的临床研究[J].北京中医药大学学报,2001,(02)：58-61.
[8]陈泉.化瘀宣肺汤治疗慢性支气管炎63例[J].时珍国医国药,1999,(04)：50-51.
[9]毛兵,张瑞明,李廷谦,等.咳速宁颗粒剂治疗慢性支气管炎急性发作的临床观察[J].中国中西医结合杂志,2002,(08)：597-598.
[10]张芬兰.理气和胃止咳方治疗胃食管反流性咳嗽临床研究[J].长春中医药大学学报,2010,(05)：667-668.
[11]冯尔和.麻龙黄芩汤治疗慢性支气管炎(痰热证)102例[J].新中医,2008,(07)：76.
[12]王洪.从肝论治慢性咳嗽肝咳证临床观察[J].北京中医药,2012,(07)：531-532.
[13]史苗颜,毕小利,张炜.平金方治疗慢性咳嗽的临床研究[J].上海中医药杂志,2010,(11)：54-56.
[14]韩峰,张竞之,刘美英.慢咳饮治疗慢性咳嗽35例[J].中医研究,2008,(08)：22-24.
[15]陈红,姜成,丁念,等.清肺止咳方加炎琥宁治疗慢性咳嗽疗效观察[J].湖北中医药大学学报,2012,(03)：47-48.
[16]游柏稳,游海,杜海燕.清肝宁肺方治疗嗜酸粒细胞性支气管炎肝火犯肺证的临床观察[J].湖南中医药大学学报,2011,(09)：61-63+67.
[17]潘文超,赵蓓,史锁芳.上气道咳嗽综合征风痰恋肺证中医药临床治疗观察[J].中医临床研究,2012,(08)：11-12.
[18]胡崇静.加味止嗽颗粒治疗风邪恋肺型慢性咳嗽的临床疗效观察[D].广州中医药大学,2011.
[19]游海.加减咳血方治疗嗜酸粒细胞性支气管炎肝火犯肺证的临床观察[D].湖南中医药大学,2010.
[20]黄纯美.加味三叶汤治疗鼻后滴流综合征慢性咳嗽临床疗效观察[D].广州中医药大学,2008.
[21]郁晓维,王明明.加味玉屏风散治疗小儿慢性咳嗽肺脾两虚证疗效评价[J].中医儿科杂志,2010,(01)：23-27.
[22]徐宁.苍屏散加减治疗小儿UACS所致慢性咳嗽的临床疗效观察[D].成都中医药大学,2010.
[23]王富春.抗支糖浆对小儿咳嗽变异性哮喘肺功能和血清中IgE的影响和临床研究[D].黑龙江中医药大学,2010.
[24]黄叶.祛风止咳方治疗变应性咳嗽的临床研究[D].南京中医药大学,2011.
[25]毛薇薇.参附注射液联合TP/GP方案治疗晚期非小细胞肺癌32例临床观察[J].中国现代医生,2011,(15)：61+65.
[26]贾学科,胡立新,刘建国,等.慈桃软坚胶囊对非小细胞肺癌抑瘤作用的临床研究[J].中国实验方剂学杂志,2011,(16)：265-266.
[27]刘红健,秦鉴,吴国珍.健脾益气补肾法辅助化疗治疗非小细胞肺癌临床观察[J].中国中医急症,2009,(12)：1959-1960+2016.
[28]张长花.加味止嗽散治疗小儿风邪犯肺型咳嗽变异性哮喘30例疗效观察[J].北京中医药,2009,(08)：619-621.
[29]王艳.宣肺止咳方治疗小儿咳嗽变异性哮喘的临床疗效学研究[D].南京中医药大学,2010.
[30]甄润平.中西医结合治疗小儿咳嗽变异性哮喘58例[J].中国中医急症,2011,(08)：1311-1312.
[31]陈昌华.“慢咳宁方”治疗慢性咳嗽32例临床观察[J].江苏中医药,2011,(10)：43-44.
[32]伍德军.小柴胡汤加味治疗咳嗽变异性哮喘36例[J].甘肃中医,2009,(09)：20-21.
[33]杨树升,林丽,向艳丽.小青龙汤治疗咳嗽变异性哮喘的临床疗效分析[J].现代医药卫生,2012,(06)：901-903.
[34]程珍.小青龙汤加减治疗成人咳嗽变异型哮喘34例[J].医药导报,2012,(06)：749-751.
[35]魏鹏草.分型辨证论治咳嗽变异性哮喘临床研究[D].北京中医药大学,2011.
[36]祁海燕.润肺止咳法治疗咳嗽变异性哮喘的临床和实验研究[D].中国中医科学院,2009.
[37]夏露.止咳定喘汤治疗咳嗽变异性哮喘60例临床分析[D].湖北中医学院,2009.
[38张金举,向希雄.通鼻止咳方颗粒治疗儿童上气道咳嗽综合征40例[J].湖北中医杂志,2012,(02)：32-33.
[39]徐昕.中西医结合治疗鼻后滴漏综合征所致慢性咳嗽疗效观察[J].河北中医,2010,(03)：378-380.
[40]张芬兰.理气和胃止咳方治疗胃食管反流性咳嗽临床研究[J].长春中医药大学学报,2010,(05)：667-668.
[41]陈茹琴,梁兆球.泻白散合清燥救肺汤加味治疗支气管扩张症35例临床观察[J].中医药导报,2006,(07)：22-24.
[42]赵杜鹃,陈秀妹.通支饮对稳定期支气管扩张痰热壅肺证生活质量的影响[J].辽宁中医杂志,2012,(04)：669-671.
[43]王玉明.泻白散合清燥救肺汤在支气管扩张症治疗中的临床应用[J].内蒙古中医药,2012,(10)：25-26.
[44]黄海茵,秦鸿,杨佩兰,等.支扩稳定方治疗稳定期支气管扩张症临床研究[J].上海中医药杂志,2011,(01)：33-36.
[45]张剑辉.加味清金化痰汤治疗痰热蕴肺型支气管扩张症的临床疗效观察[D].广州中医药大学,2011.
[46]邱婧.麻杏石甘汤加味治疗慢性支气管炎急性发作期(痰热郁肺证)临床观察[D].长春中医药大学,2010.
[47]闫国友,张立民,王兴.参百止咳合剂治疗慢性支气管炎急性发作30例临床观察[J].河北中医,2011,(1 0)：1468-1470.
[48]李广诚,曾江正,曾望远.参麦注射液对慢性支气管炎气虚证患者T细胞亚群的影响[J].湖南中医学院学报,2004,(03)：35-36+41.
[49]高宏,魏素丽,杨建宇,等.川贝养亲口服液治疗慢性支气管炎215例临床观察[J].山东中医杂志,2003,(10)：592-593.
[50]孙淑荣,莫霄云.当归六黄汤加味治疗慢性支气管炎迁延期临床研究[J].辽宁中医药大学学报,2007,(02)：104-105.
[51]杨仁旭,胡勇刚,景瑞,等.复方薤白胶囊治疗慢性支气管炎急性发作期的Ⅱ期临床研究[J].中药新药与临床药理,2008,(02)149-152.
[52]李红.加减清气化痰丸治疗痰热壅肺型慢支咳嗽的疗效观察[J].中医临床研究,2011,(11)：1-2.
[53]周建伟.金水六君煎治疗慢性支气管炎迁延期肺肾阴虚证45例[J].中国中医药现代远程教育,2011,(03)：23-24.
[54]熊四毛,葛正清.清热化痰祛湿法治疗慢性支气管炎急性发作60例[J].实用中西医结合临床,2010,(06)：48-49.
[55]黄孝锦.慢性支气管炎肺气肿中医辨证治疗效果观察[J].中医临床研究,2012,(04)：89-90.
[56]董玉华.清化宣肺汤治疗痰热郁肺型慢性支气管炎疗效观察[J].山西中医,2009,(01)：9-10.
[57]李崇红,廖莎.清气化痰汤治疗慢性支气管炎急性发作期的临床观察[J].中医药导报,2009,(11)：14-15.
[58]杨宏志,田正鉴.痰热清注射液治疗急性发作期慢性支气管炎(痰热郁肺证)疗效观察[J].吉林中医药,2005,(10)：15-16.
[59]肖庆龄,黄雅菊,朱启勇,等.三子咳喘胶囊治疗慢性支气管炎痰湿阻肺证疗效观察[J].河南中医,2007,(07)：20-22.
[60]张明利.痰热清注射液治疗慢性支气管炎急性发作60例[J].河南中医,2005,(09)：75-76.
[61]简永英.西医常规疗法加中医辨证治疗慢性支气管炎急性发作疗效观察[J].广西中医学院学报,2006,(03)：32-34.
[62]刘淦新.小青龙汤治疗慢性支气管炎急性发作56例疗效观察[J].国际医药卫生导报,2006,(04)：83.
[63]谭文秀,呼翠萍,乔牡玲.中西医结合治疗慢性喘息型支气管炎急性发作疗效观察[J].内蒙古中医药,2012,(02)：26-27.
[64]张军.中西医结合治疗慢性支气管炎52例疗效观察[J].山西中医学院学报,2009,(04)：47-48.
[65]李淼.中西医结合治疗慢性支气管炎100例[J].中国医药指南,2011,(26)：322-323.
[66]徐桐柏,邵娜,杨力宁.中西医结合治疗慢性支气管炎急性发作临床观察[J].实用中医药杂志,2008,(02)：100.
[67]张儒斌,葛润明.中医辨证分型治疗慢性支气管炎的临床疗效分析[J].内蒙古中医药,2012,(08)：10+31.
[68]彭淑芳.中医辨证治疗80例慢性支气管炎的临床研究[J].亚太传统医药,2012,(03)：73-74.
[69]李雄.中医辨证治疗慢性支气管炎肺气肿效果分析[J].中医临床研究,2012,(07)：42-43.
[70]吕俊芳.中医辨证治疗慢性支气管炎临床分析[J].中国实用医药,2011,(21)：241-242.
[71]孙海霞.中医辩证治疗慢性支气管炎肺气肿126例临床疗效观察[J].医学信息、(中旬刊),2010,(05)：1306-1307.
[1]吕爱平,朱良春.再论证候研究思路与方法.中国中医基础医学杂志,2004,10(8)：1-2，7.
[2]邓铁涛,郑洪.中医五脏相关学说研究-从五行到五脏相关[J].中国工程科学,2008,10(2)：7-12.
[1]吕爱平,朱良春.再论证候研究思路与方法.中国中医基础医学杂志,2004,10(8)1-2，7.
[1]中华医学会呼吸病学分会哮喘学组.咳嗽的诊断与治疗指南(2009版).全科医学临床与教育,2009,7(5)：453-456.
[2]国家技术监督管理局.《中华人民共和国国家标准-中医临床诊疗术语》[S].北京：中国标准出版社,1997.
[3]中华人民共和国卫生部.《中药新药临床研究指导原则》[S].北京：中国医药科技出版社,2002.
[1]胡立胜,周强.中医临床研究设计与SAS编程统计分析[M].学苑出版社,2004(5)：2.
[1]史周华,张雪飞.中医药统计学[M].北京：科学出版社.
[2]李建生,王至婉,余学庆.基于慢性阻塞性肺病COPD急性加重期文献的多元统计方法在证候研究的应用探讨[J].河南中医学院学报,2007,22(133)：8-10.
[3]薛富波,张文彤,田晓燕.SAS8.2统计应用教程[M].北京：北京希望电子出版社,2004.
[1]曹昧,马伯艳.多元统计分析方法在中医证候研究中的应用.中医药信息2008,25(3)：76-78.
[2]史周华,张雪飞.中医药统计学[M].北京：科学出版社.
[3]杜彩凤,王天芳,辛意.绝经后期更年期综合征常见证候要素的Logistic回归分析.北京中医药大学学报,2009,32(4)：238-242.
[1]中华人民共和国卫生部.《中药新药临床研究指导原则》[S].北京：中国医药科技出版社,2002.