中医类教材及诊疗方案关于慢乳蛾的认识演变及对比研究*
作者：周 涛1，贺丽丽2,3，赵 霞1,4，潘青云4
单位：1.南京中医药大学附属医院，江苏 南京 210029； 2.南京中医药大学附属中西医结合医院，江苏 南京 210028； 3.江苏省中医药研究院，江苏 南京 210028； 4.南京中医药大学，江苏 南京 210023
引用：引用：周涛，贺丽丽，赵霞，潘青云.中医类教材及诊疗方案关于慢乳蛾的认识演变及对比研究[J].中医药导报,2025,31(6):233-237.
DOI：10.13862/j.cn43-1446/r.2025.06.046
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摘要：
目的：探讨中医类教材、指南、诊疗方案关于慢乳蛾的认识演变与异同。方法：检索1949—2024年出版的儿科、耳鼻咽喉科、五官科的中医和中西医结合教材、诊疗方案等，整理慢乳蛾相关内容，分析不同时期中医类教材、诊疗方案对其认识的演变过程，比较中医儿科学与中医耳鼻咽喉科学、现行教材与诊疗方案之间的差异。结果：纳入中医耳鼻咽喉科学教材8本，中西医结合耳鼻咽喉科学教材5本，诊疗方案3项，补充参考教材7本。本病早期以虚火乳蛾命名，后逐渐命名为慢乳蛾、慢性扁桃体炎；病因病机以脏腑虚损、虚火上炎为主；主要证型为肺肾阴虚证、脾胃虚弱证及痰瘀互结证，其中脾胃虚弱证，儿科以肺脾气虚证区别，耳鼻喉科指南以脾气虚弱证替代；推荐方剂分别为百合固金汤、六君子汤及会厌逐瘀汤合二陈汤。结论：关于慢乳蛾，中医类教材与诊疗方案等不断探索与丰富完善，病因病机、辨证论治等在探索中逐渐统一，中医、中西医结合教材各有侧重，儿科、耳鼻喉科有所差异。
关键词：慢乳蛾；慢性扁桃体炎；中医；教材；指南；临床路径
Abstract：
Objective: To explore the evolution and
similarities and differences in the understanding of Man Ru'e in traditional
Chinese medicine (TCM) teaching materials, guidelines and diagnosis and
treatment plans. Methods: Literatures including TCM and integrated Chinese and
western medicine teaching materials and diagnosis and treatment plans on
pediatrics, otorhinolaryngology, and ophthalmology-otorhinolaryngology
published between 1949 and 2024 were retrieved. Contents related to Man Ru'e
were sorted out to analyze the evolutionary process of its cognition in TCM
teaching materials and diagnosis and treatment plans across different periods,
and compare the differences between TCM pediatrics and TCM otorhinolaryngology,
as well as between current textbooks and treatment protocols. Results: A total
of 8 TCM otorhinolaryngology teaching materials, 5 integrated Chinese and
western otorhinolaryngology teaching materials, 3 diagnostic and treatment
plans, and 7 supplementary reference teaching materials were included. The
disease was named Xu Huo Ru'e in the
early stage, and gradually named as Man Ru'e and chronic tonsillitis. The
etiology and pathogenesis mainly focus on viscera deficiency and upward flaming
of deficient fire. The main syndromes include lung-kidney Yin deficiency,
spleen-stomach weakness, and phlegm-blood stasis intermingling. Among them,
spleen-stomach weakness syndrome is distinguished as lung-spleen Qi deficiency
syndrome in pediatrics, while otorhinolaryngology guidelines replace it with spleen Qi deficiency syndrome. The
recommended prescription are Baihe Gujin Tang (百合固金汤), Liujunzi Tang
(六君子汤), and the combination of Huiyan Zhuyu Tang (会厌逐瘀汤) and
Erchen Tang (二陈汤). Conclusion: Regarding Man Ru'e, TCM teaching materials and
diagnostic and treatment plans have been continuously explored and refined. The
etiology, pathogenesis and syndrome differentiation and treatment have
gradually converged during this process, while TCM and integrated Chinese and
western medicine teaching materials show distinct emphases, and the diagnosis
and treatment of pediatrics and otolaryngology are different.
Key words：Man Ru'e; chronic tonsillitis; traditional Chinese medicine; teaching materials; guidelines; clinical pathway
发布时间：2026-01-04
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