摘要
脏腑相合理论是藏象学说的重要内容。脏腑相合理论认为,相表里的脏与腑之间,在生理状态下相互协调、相互制约,在病理状态下相互影响、相互传变,因此在治疗中强调脏病勿忘治腑、腑病勿忘治脏,通过恢复脏腑之间阴阳平衡、气血调和,从而达到“既病防变”和提高临床疗效的目的。
“肺与大肠相表里”理论是脏腑相合理论的内容之一,该理论自《黄帝内经》始,在历代医家长期的临床实践中得到证实,其理论发展日臻丰富,在肺系疾病和肠系疾病的治疗中应用广泛,因此,深入挖掘“肺与大肠相表里”理论的临床应用规律,对于丰富和发展藏象学说具有重要意义。
本文主要从两方面进行了研究和分析。
第一部分——理论探讨：通过全面梳理《名医类案》、《续名医类案》、《二续名医类案》中肺系疾病和大肠系疾病,归纳和总结二者相关的病、证、症,探讨在病理状态下,肺系疾病和大肠系疾病的哪些疾病,或者在某种疾病的哪些阶段会产生相互的影响,以期揭示肺系与大肠系病、证、症发生传变的临界条件和规律,从而提炼总结肺与大肠发生特异性联系的核心内容。本部分通过研读三部《名医类案》中肺系疾病和大肠系疾病的相关论述,提取在论述中明确包含肺与大肠相关、肺与大肠相表里以及相关(包括肺病及肠、肠病及肺、肺肠同病、从肠治肺、从肺治肠、肺肠同治)医案,共收集了肺肠相关医案234例,排除医案信息记录不完整者,最终收录病案162例。其中属肺病兼有大肠病者104例,属大肠病兼有肺病者58例。提取医案的相关研究要素,包括朝代、医家姓名、病案出处、患者姓名、患者性别、患者年龄、病名、病因、病史、症状、病位、病机、证型、治则、治法、方剂、药物组成、转归、传变类型、互治类型,建立肺肠相关疾病研究数据库,应用频数分析对医案的信息要素进行描述性统计,得到高频次出现的病名、症状、病机、证型、治法、药物等数据；应用关联式规则Apriori算法,分析容易发生肺与大肠病理传变的肺系疾病与大肠系疾病的病种、症状、证型,以及促进肺系疾病或者大肠系疾病向愈好转的药物之间的关联规则,总结治疗肺肠相关疾病的用药特点、药物配伍特点以及各病、证的治疗基本方案。研究结果表明,从辨证角度,肺病及肠的常见肺系疾病主要集中在咳嗽、喘证、肺痈,病机主要集中在肺主宣肃的功能失常,证型集中在肺热移肠、痰热蕴肺、肺热肠燥、肺肠气机阻滞,病因主要集中在热、燥、痰方面；在关联分析中我们发现,咳嗽肺热移肠证或者肺热肠燥证与大肠系症状便秘的指向性较强,喘证痰热壅肺证与大肠系症状腹泻的关联性较强。从论治角度,我们发现在肺病治肠中,常用治法包括清热法、化痰法、滋阴法、利湿法、降气法,常用药物包括杏仁、甘草、瓜蒌、麦冬、紫苑、桔梗、栀子、黄芩、郁金等,在证型、药物之间的相关规则中,肺热移肠、肺肠气机阻滞、痰热蕴肺和杏仁有较强的关联性,肺肠气机阻滞、痰热蕴肺和瓜蒌有较强的关联性,肺热移肠和麦冬有较强的关联性。从辨证角度,肠病及肺的大肠系疾病主要集中在泄泻、便秘、痢疾、便血,证型集中在大肠湿热、阴虚肠燥、风伤肠络,病因主要集中在热、湿、燥、风方面；在关联分析中我们发现,大肠湿热证和阴虚肠燥证均对肺系症状咳嗽的指向性较强,大肠气滞证对肺系症状胸闷的指向性较强。从论治角度,我们发现在肺病治肠中,常用治法包括清热法、利湿法、滋阴法、益气法,常用药物包括茯苓、瓜蒌、甘草、黄芩、枳实、大黄、杏仁、麦冬等,在证型、药物之间的相关规则中,大肠湿热和茯苓、大黄有较强的关联性,阴虚肠燥和黄芩有较强的关联性,大肠气滞和瓜蒌、枳实、杏仁有较强的关联性。以上分析结果表明,在肺系和大肠系的特定病种、特定证型中容易出现出肺病及肠、肠病及肺的的病理过程,从而引起大肠或肺损害的可能性较大,肺与大肠在病理层面确实存在明显的传变现象与特定的传变规律。
第二部分——红外热像研究：通过使用医用红外热成像技术分析部分肺系疾病和大肠系疾病患者的脏腑热值,观察在病理状态下肺、大肠的热态变化特点,以及二者对其他脏腑热态变化的影响,以期从一定层面为“肺与大肠相表里”理论提供可视化佐证。本部分纳入了106例健康受试者、50例支气管哮喘患者、36例慢性支气管炎患者、43例溃疡性结肠炎患者、40例慢性便秘患者,使用非制冷医用红外热像仪(型号：ATIR-M301)采集受试者躯干正面、侧面和背面红外热像图,使用非制冷医用红外热像仪分析系统定位量人体三焦(上焦、中焦、下焦)、脏腑(肺、肝、心、肾、横结肠、升结肠、降结肠、小肠、胃、胆、膀胱)的体表投影区,并采集红外热值数据。使用SPSS17.0统计软件,分别对数据进行描述性统计、方差分析、秩和检验。研究结果表明,健康受试者三焦、脏腑的热值次序分布明显,性别因素对于受试者心、膀胱、横结肠的体表投影区热值有显著影响,年龄因素对于受试者升结肠、降结肠、胃的体表投影区热值有显著影响。在肺系疾病患者的脏腑红外热值分析中,肺脏、升结肠、降结肠、小肠的红外热值有明显升高的趋势,不同的肺病种类(支气管哮喘、慢性支气管炎)之间,肺、大肠、小肠的红外热值差别并不显著,不同的肺病证型(寒痰阻肺证、痰热壅肺证)之间,肺、大肠、胃的红外热值差异显著,这提示肺病确实会引起肺、大肠红外热值的显著增高,但是不同肺病种类不会对肺、大肠红外热值产生显著性影响作用,不同肺病证型会对肺、大肠红外热值产生显著性影响作用。在大肠系疾病患者的脏腑红外热值分析中,肺、肾、升结肠、降结肠、小肠的红外热值有明显升高的趋势,不同的大肠病种类(溃疡性结肠炎、慢性便秘)之间,升结肠、降结肠的红外热值有显著性差异,肺的红外热值差别并不显著,这提示大肠病确实会引起大肠、肺的红外热值的显著增高,不同大肠病种类会对大肠红外热值产生显著性影响作用,对肺的红外热值影响有限。研究结果说明,在肺系疾病和大肠系疾病中,肺病及肠、肠病及肺的传变规律是普遍存在的客观现象,红外热像图从影像学角度为“肺与大肠相表里”提供了确凿证据。
本论文的创新点在于,将理论研究与红外热像研究结合起来,从病理角度,通过分析医案,归纳总结了容易发生肺肠传变的病、证、症及其常用药物,证明肺与大肠发生的病理传变,集中于特定的疾病和证型中；通过应用红外热像技术,发现肺与大肠常见病患者在红外热像图中确实呈现出肺肠温度的特异性联系,在肺发生病变时,肺的温度明显增高,同时大肠的温度也随之明显增高；在大肠发生病变时,大肠的温度明显增高,同时肺的温度也随之明显增高,这不仅为“肺与大肠相表里”理论提供了确凿、客观的可视化证据,也使古老的中医理论从脏腑能量状态角度获得新的诠释。
As an important part of visceral manifestation,the viscera-related theory focus on the physiological pathological relations between the specific zang and fu, which can be used in clinical treatment programs to promote the body's internal environment back to balance. The concept that the lung and large intestine are exterior-interiorly related is an integral part of this viscera-related theory, and plays great role in clinical guidance to some respiratory diseases and digestive diseases. The research on the biological mechanisms and clinical application of the concept that the lung and large intestine are exterior-interiorly related has a magnificent Influence influence to the study on the visceral manifestation as well as the concept of holism. This paper includes the following two parts, which are theoretical studies and infrared imaging study respectively
In the first part of the study, classical cases in which the pathological contact between the lung and large intestine happens are extracted from three canons, e.g. three editions of Mingyi Lei'an. From the162cases,the information about dynasties, names of physicians, medical record provenance.patient name, patient's gender, patient's age,disease name, etiology, medical history. symptoms, disease location, pathogenesis, syndrome type, prescriptions, drugs are extracted to built up a database The statistical methods such as frequency analysis and association rules are used to study on the intrinsic links among the diseases, symptoms, disease, syndrome and drugs. The results show that respiratory diseases which have a pathological effect on large intestine are cough, asthma and lung abscess, the symptoms that have high frequency include diarrhea and constipation, the syndromes that are prone to cause colon damage include three different types, the pathogenic factors that arc prone to cause pulmonary intestinal cross talk include heat, dry, and sputum, and the Chinese herbal medicine that are frequently appear in the clinical treatment include almond, licorice, trichosanthes, ophiopogon, aster, bcllflower, gardenia, skullcap, turmeric,et.al. The digestive diseases which have a pathological effect on respiratory system are Diarrhea, constipation, dysentery, blood in the stool, the symptoms that have high frequency include coughing, wheezing, and chest tightness, the syndromes that are prone to cause respiratory damage include three different types, the pathogenic factors that are prone to cause pulmonary intestinal cross talk include heat, dry, wetness and wind, and the Chinese herbal medicine that are frequently appear in the clinical treatment include poria, trichosanthes, licorice, skullcap, citrus aurantium, rhubarb, almonds, ophiopogon, et.al.
In the second part of the study, medical infrared thermal imaging technology are used in this research.106healthy volunteers,50patients with bronchial asthma,36patients with chronic bronchitis patients,43cases of patients with ulcerative colitis, and40patients with chronic constipation are enrolled in this project,and the infrared heat values of shangjiao,zhongjiao,xiajiao, lung, liver, heart, kidney, transverse colon, ascending colon, descending colon, small intestine, stomach, gall, bladder are recorded The statistical methods such as frequency analysis and variance analysis are used to study on the intrinsic links among the infrared heat values of zang and fu. The results show that the sanjiao and zangfu infrared heat values of healthy volunteers are different and fluctuate within a certain range respectively.The factors of age gender have an significantly effect on the sanjiao and zangfu infrared heat values of healthy volunteers. For the patients with bronchial asthma and patients with chronic bronchitis patients, the infrared heat values of lung, ascending colon, and small intestine are significantly higher. For the patients with ulcerative colitis, and patients with chronic constipation, the infrared heat values of descending colon, small intestine, lung, kidney re significantly higher.The research results indicate that the pathological cross-talk between lung and large intestine a common objective phenomenon.
The innovation of this paper is to combine theoretical studies and infrared thermal imaging studies. The pathological cross-talk between lung and large intestine happens in specific lung diseases and bowel diseases, as well as specific syndromes. Moreover, with the application of infrared thermal imaging technology, we find that the temperature of the lung in patient with lung disease increases significantly, at the same time the temperature of large intestine will also increase significantly; and find that the temperature of the large intestine in patient with bowel disease increases significantly, at the same time the temperature of lung t will also increase significantly.This not only provides conclusive, visualized evidence for the theory that the lung and large intestine are exterior-interiorly related, but also get a new interpretation for this classical theory from the perspective of energy.
引文
[1]李鸿涛,高思华,王柳青,等.藏象学说中“肺与大肠相表里”内涵及其在温病辨治中的运用[J].中医杂志,2011,52(4)：271-273.
[2]哈木拉提·吾甫尔,李风森,艾买江·吐尼亚孜.“肺与大肠相表里”的科学性及其对哮喘治疗的指导意义[J].新疆医科大学学报,2000,23(2)：151-152.
[3]严兴科,王宇,张广全,等.肺与大肠相表里理论与研究进展[J].陕西中医,2003,24(4)：378-381.
[4]董丽,张茂平,王俊峰.“肺与大小肠相表里”的探讨[J].中国医药指南,2008,6(24)：219-222.
[5]宫振甲,宋顺鹏,韩哲.《内经》对皮毛与大肠关系的论述[J].中医杂志,2009,50(2)：189.
[6]蒋洪耀.“肺与大肠相表里”理论的重新认识[J].中国中医基础医学杂志,2001,7(2)：16-17.
[7]周吕.胃肠生理学[M].北京：科学技术出版社,1991.726-727.
[8]杨胜兰.肺与大肠相表里的现代研究[J].中国中西医结合消化杂志,2002,6：371-374.
[9]盛新华，石汉平.肠道在多器官功能障碍综合征中的作用[J].世界华人消化杂志,2005,13(16)：2029-2032.
[10]顾大勇,李艳,陈莉,等.LPS的直接诱导对肺微血管内皮细胞IL-8的表达及对PMN趋化作用影响的研究[J].中国微循环,2003,7(4)：214-217.
[11]靳文学,杨宇.从黏膜免疫系统看“肺与大肠相表里”[J].四川中医,2005,23(12)：1-3.
[12]王月兰,龙迪和,何璐,等.肺与大肠相表里动物实验模型建立的探讨[J].内蒙古中医药,2008,5：40-41.
[13]张学英,谭毅.肺与大肠相表里临床运用举隅[J].实用中医内科杂志,2008,22(9)：61-62.
[14]廖荣鑫,黄礼明,吴仕九.肺病治肠在慢性肺心病急性发作期中的运用[J].辽宁中医杂志,2004,31(6)：461-462.
[15]孙元莹,李志军,王今达.从“肺与大肠相表里”论治多脏器功能障碍综合征[J].时珍国医国药,2007,18(5)：1220-1221.
[16]王儒平,陈雪梅.通腑泻下法在喘证急性期治疗中的运用[J].中医药学刊,2006,24(7)：1317-1318.
[17]刘刚.通因通用法治疗重症肺气肿[J].四川中医,1995,(6)：23.
[18]汪丙柱.从肺与大肠相表里论治慢性阻塞性肺疾病稳定期的临床观察[J].中国中医药信息杂志,2008,15(9)：76-77.
[19]刘恩顺,王海英,孙增涛.浅谈肺与大肠相表里与ARDS防治[J].时珍国医国药,2009,11：2836-2837.
[20]连建伟.“治未病”理论在肺与大肠易发疾病防治中的应用[J].浙江中医药大学学报,2009,5：628-629.
[21]谢邦军,史国梅,肖琳.加味宣白承气汤直肠滴注治疗痰热腑实型肺性脑病20例[J].中医外治杂志,1997,6(3)：16.
[22]孙元莹,李志军,王今达.从“肺与大肠相表里”论治多脏器功能障碍综合征[J].时珍国医国药,2007,18(5)：1220-1221.
[23]曾兆麟,李玉梅.从中医肺与大肠相表里理论探索难治性非典型性肺炎(SARS)治疗的新思路[J].上海中医药杂志,2003,37(s).
[24]郑云,何玲.浅谈耳针治疗功能性便秘[J].甘肃中医,2008,9.
[25]杜洪彬,仇爱玲.理肺汤治疗习惯性便秘例[J].映西中医,2005,26(9)：954.
[26]张书生.肠易激综合征从肺论治[J].四川中医,2005,23(3)：17-18.
[27]张小军.漫性肠炎从肺论治[J].陕西中医,1996,17(7)：336.
[28]刘小雨,毛以林.从肺论治顽固性消化性溃疡92例[J].湖南中医药导报,1999,5(3)：17-18.
[29]刘钦伟,李旱萍.芍药汤加味治疗慢性非特异性渍疡性结肠炎42例[J].河北中医,2001,23(11)：880.
[30]郭永红.麻杏石甘汤治疗嵌顿痔[J].浙江中医杂志,2002,37(9)：391.
[31]杨胜兰,李道本,陈瑞.肺肠并治法治疗小儿外感咳嗽30例[J].中国中西 医结合消化杂志,2004,12(6)：360.
[32]闫力,宫晓燕.宣白承气汤治疗慢性支气管炎急性发作30例[J].长春中医药大学学报,2007,(23)：4.
[33]宋勉,王亚梅.肺肠同治法在治疗支气管哮喘急性发作期的运用[J].光明中医,2005,20(1)：5-6.
[34]于雪峰.基于“肺与大肠相表里”论治慢性阻塞性肺疾病探析[J].光明中医,2009,24(5)：847-848.
[35]吴成雁,侯苍远,龙梅.肃肺通下法治疗开胸术后并发症的体会[J].中医研究,1996,9(1)：37.
[1]B.T科洛勃罗夫,N.舒斯特,航天工业总公司第三研究院三部、八三五八所联合翻译.红外热成像.《红外与激光技术》编辑部,1993,136.
[2]Alderson JKA and Ring EFJ.1995'Sprite'high resolution thermal imaging system Thermology 1110.
[3]Roekly, GJ. BreakthroughsineomPuter-assistedthermalimagers. Today's Chiorpractie,1990, May/June:55-57.
[4]Ring E F J and Dicks J M.1999 Spatial resolution of new thermal imaging systems Thermol. Int.97-14.
[5]Report of the Working Group to Review the National Cancer Institute Breast Cancer Detection Demonstration Projects, Journal of National Cancer Institute, v.62,1979,641-709.
[6]Plassmann P, Ring E F J and Jones C D 2006 Quality assurance of thermal imaging systems in medicine Thermol. Int.16:10.
[7]Simpson R C et al.2008 In-field-of-view thermal image calibration system for medical thermography applications Int. J. Thermophys.29:1123.
[8]IEC.2008 Medical electrical equipment-part 2-59:particular requirements for the basic safety and essential performance of screening thermographs for human febrile temperature screening IEC 80601-2-59.
[9]ISO/TR.2009Medical electrical equipment-deployment,implementation and operational guidelines for identifying febrile humans using a screening thermograph ISO/TR 13154:2009.
[10]ISO/TR 2009 Medical electrical equipment-deployment,implementation and operational guidelines for identifying febrile humans using a screening thermograph ISO/TR 13154:2009.
[11]Ammer K.2008a The Glamorgan Protocol for recording and evaluation of thermal images of the human body Thermol. Int.18:125.
[12]Ammer K 2008b The sensitivity of infrared imaging for diagnosing Raynaud's phenomenon and for Thoracic OutletSyndrome is dependent on the method of temperature extraction from thermal images Thermol. Int.18:81.
[13]Esselinckx W, Bacon P A, Ring E F J, Crooke D, Collins A J and Dermottaz D.1978 Thermographic assessment of three intra-articular prednisolone analogues given in rheumatoid arthritis Br. J. Clin. Pharm.5447.
[14]Bird H A, Ring E F J and Bacon P A.1979. thermographic and clinical comparison of three intraarticular steroid preparations in rheumatoid arthritis Ann. Rheum. Dis.3836.
[15]Bacon P A, Ring E F J and Collins A J.1977. hermography in the assessment of anti rheumatic agents Rheumatoid Arthritis ed J L Gordon and B L Hazleman (Amsterdam:Elsevier/North Holland Biomedical Press) 105.
[16]Spalding S J, Kwoh C K, Boudreau R, Enama J, Lunich J, Huber D, Denes L and Hirsch R 2008 Three-dimensional and thermal surface imaging produces reliable measures of joint shape and temperature:a potential tool for quantifying arthritis Arthritis Res. Ther.10 R10.
[17]Varju G, Pieper C F, Renner J B and Kraus V B 2004 Assessment of hand osteoarthritis:correlation between thermographic and radiographic methods Rheumatology 43 915.
[18]Warashina H, Hasegawa Y, Tsuchiya H, Kitamura S, Yamauchi K-I, Torii Y, KawasakiMand Sakano S 2002 Clinical,radiographic, and thermographic assessment of osteoarthritis in the knee joints Ann. Rheum. Dis.61:52.
[19]Denoble A E, Hall N, Pieper C F and Kraus V B 2010 Patellar skin surface temperature by thermography reflects knee osteoarthritis severity Clin. Med. Insights:Arthritis and Musculoskeletal Disord.369.
[20]Glehr M, Stibor A, Sadoghi P, Schuster C, Quehenberger F, Gruber G, Leithner A and Windhager R 2011 Thermal imaging as a noninvasive diagnostic tool for anterior knee pain following implantation of artificial knee joints Int. J. Thermodyn.1471.
[21]Romano C L, Romano D, Loguluso N and Drago L 2011 Healing of surgical site after total hip and knee replacements show similar thermographic patterns J. Orthop. Traumatol.1281.
[22]Lambiris E and Stoboy H 1981 Thermographie bei Osteosynthesen und Totalendoprothesen des Kniegelenks mit undohne Infektion Z. Orthop.119 521.
[23]Mayr H 1995 Thermographic evaluation after knee surgery The Thermal Image in Medicine and Biology ed K Ammer and E F J Ring (Wien:Uhlen) pp 182.
[24]Tauchmannova H, Gabrhel J andCibakM1993 Thermographic findings in different sports, their value in the prevention of soft tissue injuries Thermol. sterr.391.
[25]Fischer A A and Chang C H 1986 Temperature and pressure threshold measurements in trigger points Thermology 1212.
[26]Menachem A, Kaplan 0 and Dekel S 1993 Levator scapulae syndrome:an anatomic-clinical study Bull. Hosp. Jt Dis.5321.
[27]Graber J.1980. Tendosynovitis detection in the hand Verh. Dtsch. Ges. Rheumatol.657.
[28]Mayr H 1997 Thermograf ische Befunde bei Schmerzen am Ellbogen Thermol. sterr.75.
[29]Binder A, Parr G, Page Thomas D P and Hazleman B 1983 A clinical and thermographic study of lateral epicondylitis Br. J. Rheumatol.2277.
[30]Thomas D and Savage J P 1989 Persistent tennis elbow:evaluation by infrared thermography and nuclear medicine isotope scanning Thermology 3132.
[31]罗芸,薛毅珑,高宇红.急、慢性颈肩痛患者的远红外热像特征分析[J].中国激光医学杂志,2008,17(6)：431-433.
[32]贾桂林,吕少文,韩世发,等.颈椎病治疗前后的红外热像分析[J].激光与红外,2006,36(6)：431-433.
[33]王军,邓方阉,王州,等.红外热成像在腰椎间盘突出症诊断中的地位[J]临床军医杂志,2010,38(1)：133-134.
[34]宓轶群,吴耀持,陈一.腕踝针对不同病因所致下腰痛疗效的研究[J].现代康复,2001,5(12)：116.
[35]Schulz-Wend land R. Infrared thermograph-Early diagnosis of breast cancer. GynakologischePraxis 2002,26(1):86-88.
[36]卢桂森,庞伟,王玲玲,等.红外热像仪在诊断鼻咽癌中的应用[J].激光与红外,2001,31(1)：42-44.
[37]陈杰翔,缪克红,李利,等.医用红外热像技术诊断无功能性肾上腺肿瘤的临床价值[J].中国现代医学杂志,2006,16(5)：793-795.
[38]杨纪华,张贺龙,康艳霞.红外热像技术在肿瘤诊断中的应用[J].现代肿瘤医学,2009,17(9)：1817-1819
[39]郭艳萍,谌河琴,王昭兰,等.医用红外热像仪对乳腺癌的诊断价值[J].中国疼痛医学杂志,2010,16(5)：320.
[40]杨子彬.医用热像图的理论基础和临床应用生物医学工程研究杂志,2003,22(3)：1-8.
[41]于如同,李祥,邹雄伟,等.红外热像图在神经外科疾病中应用价值的评价[J].徐州医学院学报,2003,23(5)：410-413.
[42]熊键,廖维靖,杨万同.红外热像图对颈心综合征阻滞疗法的疗效评价[J].中华物理医学与康复杂志,2006,28(4)：265-268.
[43]华珍,孟申,恽晓平.2型糖尿病并发下肢血管病变的热像图观察[J].中国康复理论与实践,2008,14(1)：75-76.
[44]汪培清,余文珍,郭水英,等.糖尿病肢体动脉闭塞症红外热像图研究[J].中国中西医结合外科杂志,2005,11(5)：382-385.
[45]钟红雨,梁业安,卢桂森.红外热像图诊断慢性盆腔炎305例临床分析[J].2005,29(6)：424-425.
[46]李自立,赵敏.热像图对强直性脊柱炎的诊断价值[J].激光与红外,2008,38(1)：47-51.
[47]麦丽,严颖,朱建芸红,等.外热像图诊断自发性细菌性腹膜炎的应用研究[J].胃肠病学和肝病学杂志,2005,14(3)：299-300.
[48]许金森,郑淑霞,潘晓华,等.电针对人体体表微循环血流灌注量及红外辐射轨迹影响的比较观察[J].福建中医学院学报,2010,20(1)：13-15.
[49]袁云峨,李洪娟,吴英杰,王青,董丽娟,许俊秦.80例乳腺肿瘤病人的经络穴位异常热辐射现象探索性研究[J].中华中医药学会第九次中医诊断学术会议论文集2008,10：227-230.
[50]陈日新,陈明人,李巧林.灸感法与红外法检测支气管哮喘(慢性持续期)患者肺俞穴热敏态的对比研究.[J].江西中医药,2011,1(1)：12-14.
[51]兰彩莲,潘晓华,许金森,郑淑霞.艾灸刺激循督脉线及其旁开非经对照点反应的比较观察.[J].福建中医药大学学报,2011,6,21(3)：4-6.
[52]方镇洙,应用DITI对中医经络学再认识.[J].世界中西医结合杂志,2006,1(1)：357-359.
[53]宋晓晶,张栋.针刺合谷与光明穴在面部的红外热像显示研究.[J].中国针灸,2010,1,30(1)：51-54.
[54]武哲丽,陈群,徐志伟.肝病瘀血舌象与血瘀证舌温临床研究[J].中国中医药信息杂志,2008,15(7)：22-24.
[55]朱明,李宇航.关于中药寒热药性试验的红外成像观测[J].中国体视学与图像分析,2007,12(1)：53-5
[56]张世亮,张蕴慧,庄欣.红外成像技术对不同证型高血压患者面部温度的研究[J].山东中医药大学学报,2000,24(5)：359.
[57]李洪娟,刘颖,邹雯,董继鹏,沙莎,王玉光,王健HIV/AIDS患者不同寒热证候的热态数据分祈及临床意义探讨.[J].北京中医药大学学报,2011,3,18(2)：43-45.
[58]许金森,胡翔龙,汪培清,叶蕾,杨杰.经脉线与非经脉线相关组织导热性的比较.[J].中国针灸,2005,7,25(7)：477-482.
[59]杜昌华,王伏峰.红外热像技术在儿童哮喘分型中的应用[J].中国中西医结合杂志,1998,18(12)：75
[60]王伟钢,王微,符思.尪痹病变关节的红外线热图象改变[J].北京中医药大学学报,1997,(3)20：62-63.
[61]谷华,孙丽斌,于畅,李海存.红外热图温度与肿瘤中医证型的关系[J].临床军医杂志,2009,(3)37：389-390.
[62]刘肖瑜,周肃陵,王正.红外热图技术与腰椎间盘突出症中医证型的相关性研究[J].中国中医骨伤科杂志,2008(5)16：10-12
[63]罗华,罗宏明,古吉敏,贾饪铭.乳腺增生病红外线扫描图像一与中医证型的关系探讨[J].山西中医学院学报,2000,(2)1：21.
[64]张耀如.乳腺增生病中医分型与近红外像关系临床观察[J].山西中医,2006,(2)22：20-21.
[65]吴青.中医药结合红外热像仪治疗286例脑供血不足[J].上海医学影像,2004(3)13：189-191.
[66]袁永明,陈晓,潘志强,等.寒证热证大鼠模型的红外热图研究[J].辽宁中医杂志,2008,35(5)：785-787.
[67]杨文涛,马学强.红外热像技术对中西医结合治疗大鼠肢体缺血模型疗效的观察[J].山东中医药大学学报,2000,24(3)：232-234.
[68]张栋,付卫星.动物实验中红外热成象方法的使用[J].红外技术,1997,1：45-48.
[69]李小梅,黄雪群等.采用红外热扫描成像系统研究归胃经寒性中药对胃热证大鼠的热效应[J].激光生物学报,2007,16(2)：180-185.
[70]李小梅,李续娥等.采用红外热扫描成像系统进行复方寒凉中药热效应的研究[J].激光生物学报,2006,15(5)：516-519.
[1]余日新.感冒、水肿、便秘证治体会[J].上海中医药杂志,2004,38(10)：20.
[2]宋起佳,苏云放.从《临证指南医案》看叶天士辨治便秘的特色[J].中医药学刊,2006,24(5)：912-913.
[3]宋起佳,苏云放.从《临证指南医案》看叶天士辨治便秘的特色[J].中医药学刊,2006,24(5)：912-913.
[4]黄绍刚,于丰彦,周福生.从整体观探讨功能性便秘的中医治疗[J].中国民族民间医药,2009,18(13)：83-84.
[5]张沙尘,刘红.补益宣通法治疗老年糖尿病伴便秘浅识[J].实用中医内科杂志,2005,19(1)：1.
[6]刘文娜,张思超.“源清则流自洁”临床意义探讨[J].吉林中医药.2011,31(8)：751.
[7]何拯华.验案[M].上海科技出版社.1960：59.
[8]姚晓东.逆流挽舟法寻源及配伍风药内涵考辨[J].山东中医药大学学报.2004,28(4)：262-263.
[9]谢慧明.泄泻从肺论治举隅[J].江西中医药,1995,26(2)：52.
[10]吴国霞.慢性泄泻从肺治验3则[J].云南中医中药杂志.2008,29(12)：72.