摘要
目的分析小儿手足口病的中医证候学特点,总结中医证候演变规律。方法在两个临床中心同时进行调查,采集手足口病的中医证候类型、四诊信息及相关因素,填写临床观察表,建立数据库;将纳入病例根据证候表现分为风热犯肺证、邪犯肺脾证、湿热毒盛证、气阴两虚证、邪陷心肝证、水凌心肺证和阴阳两竭证;跟踪观察患儿在入院当天(基线点)、用药后第3、5、7、10天的临床表现,确定各观察点中医证型;应用证候演变概率法对小儿手足口病中医证候在不同观察点的演变规律进行系统分析。结果小儿手足口病患儿症状以手足疱疹、口痛拒食及发热多见,与其他症状比较差异有统计学意义(P<0.01);风热证出现率多于其他证候,差异有统计学意义(P<0.05);初期以风热犯肺证、邪犯肺脾证为主;中期是由实证向虚证转移的关键时期;后期虽多见实证,但其持续存在概率均有所降低,并逐渐向气阴两虚证和正常转变。结论小儿手足口病证型分布以风热犯肺证最多,其次为邪犯肺脾证;其中医证候在不同观察点有着不同的演变规律。
Objective To analyze the symptomatic characteristics and evolution rule in terms of TCM in children with HFMD.Methods Investigate simultaneously at two clinical centers,collect TCM syndrome patterns of the HFMD and information of the four diagnostic methods and its relevant elements,fill in clinical observation forms,and build up database accordingly.The cases included in the database were classified according to the syndromes as：wind-heat invading lung,pathogenic dampness invading the lung and spleen,damp-heat with exuberance of virulence,deficiency of qi and yin,toxicity invading heart and liver,water pathogen invading heart and liver,and deficiency of both yin and yang.Follow-up observation was made on children＇s clinical performance on the admission day（reference point）,and also on the 3rd,5th and 7th day after medication treatments,so as to identify the TCM syndrome pattern.Apply the probabilistic method to children＇s HFMD,and systematically analyze the evolution rule of TCM syndrome of children＇s HFMD at different observation points.Results It was found that children with HFMD mostly showed symptoms similar to herpes on hands and feet,and they were more likely to have mouth pain,fever and refuse to eat,and the difference had statistical significance（P0.01）;wind-heat appeared more often than other symptoms,and the difference also had statistical significance（P0.05）.At an early stage,the main symptoms were mostly wind-heat invading lung,and pathogenic dampness invading the lung and spleen.The middle period was the vital stage when the excess type developed into deficiency.At the later stage although excess type was more likely to appear,the existing probabilities somewhat decreased,and the syndrome tended to transform into deficiency of qi and yin or normal state.Conclusions The child HFMD in most cases performs as wind-heat invading lung,and pathogenic dampness invading the lung and spleen ranks the second.Its TCM syndromes evolute as different patterns at different observation points.
出处
《中国中西医结合儿科学》
2011年第1期29-32,共4页
Chinese Pediatrics of Integrated Traditional and Western Medicine
基金
湖南省中医药科研计划重点项目(2008003)
关键词
手足口病/诊断
证候学
辨证分型
儿童
Hand-foot-mouth disease/diagnosis
Symptomatology
Dialectical type
Child
