成都片区0-14岁儿童哮喘的先天禀赋因素分析

发布时间：2018-03-23 11:25

本文选题：儿童哮喘　切入点：先天禀赋　出处：《成都中医药大学》2012年硕士论文

【摘要】：目的以数据和资料来验证和探索儿童哮喘先天禀赋因素的科学内涵,丰富哮喘病因,推动儿童哮喘中医病因研究的发展及丰富儿童哮喘的治疗。方法本次研究以“第三次全国儿童哮喘流行病学调查”为依托,采用横断面筛查法,进行分层随机整群抽样。在成都市约抽取12000人。将12000份资料录入Epi_Info软件,筛选出病例组504例,对照组223例(对照组为随机整群抽样中非哮喘、无慢性呼吸系统炎症的儿童。对照的选择要求与病例儿童的年龄、性别及民族相匹配,年龄要求相差±1岁)。将所有问卷中涉及先天禀赋的问题进行赋值处理,采用spss17.0统计软件分析,单因素分析采用X2检验,计算P值。再将单因素分析中有统计学意义的问题带入多因素非条件Logistic回归分析,计算OR值及95%置信区间,综合分析哮喘先天禀赋因素。结果单因素卡方分析示母亲孕期患疾病、孕期有不良习惯、母亲多胎或多产史、有家族过敏史、儿童被诊断过敏性鼻炎、儿童被诊断荨麻疹、儿童被诊断湿疹、非母乳喂养、孕期寒热偏嗜、孕期五味偏嗜、肺虚质、脾虚质、肾虚质、出生前后家中有装修的P值0.05,有统计学意义。多因素非条件Logistic回归分析示母亲孕期患疾病、家族过敏史、儿童被诊断过敏性鼻炎、儿童被诊断荨麻疹、儿童被诊断湿疹、孕期嗜食辛辣、嗜食生冷、酸味偏嗜、辛味偏嗜、儿童体质瘦弱、易感冒、腹胀纳差、夜间盗汗、便溏、出生前后家中有装修的OR值分别为1.123、1.959、4.039、1.356、2.411、1.480、3.141、3.514、1.007、4.952、5.254、1.981、2.174、2.516、4.624,为哮喘的危险因素。结论经单因素卡方检验及多因素非条件Logistic回归分析,结果提示禀赋的主要内容即父母基质、胎育保养、天时地利、体质因素与哮喘的发生关系密切。结果提示我们在平时的生活调护中,应加强上述因素的干预,做到未病先防、既病防变。禀赋为中医学的特有概念,有广义与狭义之分。狭义的禀赋与现代医学的遗传相似,其基础是基因和染色体。而在临床中,应用更多的禀赋是广义的,包括文中所述父母基质、胎育保养、天时地利、体质因素等相关内容。常见的禀赋不足类疾病,未必都能在基因的层面得到反映。故广义的禀赋概念更能真实地反映人与疾病的关联,这也正是中医禀赋学说的优势所在。哮喘是一种多基因遗传病,由遗传因素及环境因素共同作用,在本文中也得到证实。
[Abstract]:Purpose. To verify and explore the scientific connotation of congenital endowment factors of childhood asthma with data and data, to enrich the etiology of asthma, to promote the development of TCM etiology research of children's asthma and to enrich the treatment of children's asthma. Method. Based on the third National Epidemiology Survey of Childhood Asthma, this study used cross-sectional screening method to carry out stratified random cluster sampling. About 12000 people were sampled in Chengdu. 12000 data were entered into Epi_Info software, and 504 cases were selected from the case group. Control group (control group: random cluster sampling of non-asthmatic children without chronic respiratory inflammation. Control group selection requirements were matched with age, sex and nationality of the children. The difference in age requirement was 卤1 year old. All the questions related to innate endowment in all questionnaires were assigned and analyzed by spss17.0 statistical software, and X2 test was used for single factor analysis. The P value was calculated, and then the statistical significance in univariate analysis was introduced into the multivariate Logistic regression analysis, OR value and 95% confidence interval were calculated, and the congenital endowment factors of asthma were comprehensively analyzed. Results. Univariate chi-square analysis showed that the mother was ill during pregnancy, had bad habits during pregnancy, had a history of multiple births or multiple births, had a family history of allergies, diagnosed allergic rhinitis in children, diagnosed urticaria in children, diagnosed eczema in children, and was not breast-fed. There were significant differences in cold and heat during pregnancy, five flavors in pregnancy, lung deficiency, spleen deficiency, kidney deficiency, P value of decoration at home before and after birth (P = 0.05). Multivariate Logistic regression analysis showed that the mother was suffering from diseases during pregnancy and family allergies. Children are diagnosed with allergic rhinitis, children are diagnosed with urticaria, children are diagnosed with eczema, pregnant women are spicy, cold, sour, pungent, weak, susceptible to colds, abdominal distension and anorexia, night sweating, loose stools, The OR values of decorated home before and after birth were 1.123 / 1.959 / 4.039 / 1.356/ 1.356/ 2.4111.80/ 3.141/ 3.5141/ 1.007 / 4.952 / 5.2541.981/ 2.174/ 2.516 / 4.624, respectively, which were risk factors of asthma. Conclusion. By univariate chi-square test and multivariate unconditioned Logistic regression analysis, the results showed that the main contents of endowment were parental matrix, fetal maintenance, timing and geographical location. The results suggest that we should strengthen the intervention of the above factors in our daily life and nursing, so as to prevent the disease before we get sick and prevent the change of the disease, and the endowment is a special concept of traditional Chinese medicine. There is a broad sense and a narrow sense. The narrow endowment is similar to the inheritance of modern medicine and is based on genes and chromosomes. In clinical practice, the application of more endowments is broad, including the parental matrix mentioned in the article, fetal maintenance, timing, geographical location, The general concept of endowment can reflect the relationship between human beings and diseases more truly, so the general concept of endowment can reflect the relationship between human beings and diseases more realistically, so the general concept of endowment can not always be reflected at the level of gene, so the concept of endowment in a broad sense can reflect the relationship between human and disease. This is the advantage of the endowment theory of traditional Chinese medicine. Asthma is a polygenetic disease, which is combined by genetic factors and environmental factors, which is also confirmed in this paper.
【学位授予单位】：成都中医药大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R272

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