黑龙江地区小儿手足口病证候特征及证候演变规律的研究

发布时间：2018-05-09 19:16

本文选题：黑龙江地区 + 手足口病　；参考：《黑龙江中医药大学》2017年硕士论文

【摘要】：目的:探讨黑龙江地区小儿手足口病证候特征及证候演变规律,以期为临床制定手足口病中医辨证方案提供依据,从而更好地指导临床防治工作。方法:采用临床流行病学调查方法,通过采集手足口病患儿临床资料,追踪观察患儿入院当天(基线点)、治疗后第3、5、7、10天时的临床表现,填写手足口病中医证候观察表,建立数据库,探讨小儿手足口病中医证候特征,进一步应用证候演变概率法对黑龙江地区手足口病患儿中医证候在不同观察点的演变规律进行系统分析。结果:1.从纳入患儿分布数量上得出,男性多于女性,且发病年龄集中在1-4岁之间,4岁以后,患病人数开始大幅度下降。本病7-9月出现率最高为73.71%,与其他月份相比较,差异有统计学意义。本病病程以第8-10天的痊愈率最高为51.78%,2.患儿发热、手足臀等部位斑丘疹或疱疹、口腔疱疹或溃疡、咽喉疼痛、烦躁等症状出现率高。3.中医各证候分布上,在入院当天和第3天时邪犯肺卫证所占比例最高,其次是肺胃热炽证和心脾积热证,第5天时邪犯肺卫证与肺胃阴伤证分布比例高,第7天和第10天时肺胃阴伤证最多见。4.分析各中医证候演变规律,从基线点到第3天,邪犯肺卫证发病人数最多,各证候的持续存在概率较为突出。第3-5天,邪犯肺卫证及肺胃热炽证发病人数仍较多,以邪犯肺卫证的持续存在概率和肺胃热炽证的转移概率更为明显,且湿热交阻、心脾积热两证的转移概率高于上一阶段。第5-7天,各证候向正常的转移概率明显增大,各证候的持续存在概率大幅度下降,向肺胃阴伤证演变的病例逐渐增多。第7-10天,疾病末期,大部分患儿得以痊愈,但仍存在向肺胃阴伤证及其他证型的转移概率。结论:1.黑龙江地区小儿手足口病患儿男性多于女性,以1-4岁年龄段多发,4岁以后,患病率开始大幅度下降,且在一年中以7-9月份发病人数最多。2.黑龙江地区小儿手足口病主要症状表现为手足臀等部位斑丘疹或疱疹、口腔疱疹或溃疡、咽喉疼痛,发热和烦躁等。3.黑龙江地区手足口病患儿,在入院当天和第3天时邪犯肺卫证所占比例最高,其次是肺胃热炽证和心脾积热证;第5天时邪犯肺卫证与肺胃阴伤证分布比例高;第7天和第10天时肺胃阴伤证最多见。4.黑龙江地区小儿手足口病各中医证候在疾病发展过程中,符合卫气营血传变规律,呈现动态演变的过程,使各证候不同时间段观察点上具有一定的特点。
[Abstract]:Objective: to explore the syndromes characteristics and syndromes evolution of children hand foot and mouth disease (HFMD) in Heilongjiang province in order to provide basis for clinical establishment of TCM syndrome differentiation of HFMD so as to better guide clinical prevention and treatment. Methods: by collecting clinical data of children with hand, foot and mouth disease (HFMD), the clinical manifestations of the patients were observed on the day of admission (baseline point, the 3rd day after treatment), and the observation forms of TCM syndromes of HFMD were filled out. To establish a database to probe into the characteristics of TCM syndromes of hand, foot and mouth disease in children, and to analyze systematically the evolution law of TCM syndromes in different observation points of children with hand foot and mouth disease in Heilongjiang by using the method of syndrome evolution probability. The result is 1: 1. From the distribution of children included, the number of males was more than that of females, and the onset age was mainly between 1-4 years old and 4 years old, and the number of patients began to decline significantly. The highest incidence of this disease in July and September was 73.71, and the difference was statistically significant compared with other months. The highest recovery rate of the disease was 51.78 and 2in the 8th-10th day. Fever, hand, foot and buttock spot papules or herpes, oral herpes or ulcers, throat pain, irritability and other symptoms of high incidence. 3. The distribution of TCM syndromes was the highest on the day of admission and on the third day, followed by the syndrome of heat of the lung stomach and accumulation of heat in the heart and spleen, and on the fifth day, the proportion between the syndrome of evil invading the lung and the syndrome of lung stomach yin injury was high. On the 7th day and the 10th day, the syndrome of lung and stomach yin injury was found mostly. 4. From the baseline point to the third day, the number of pathogenic diseases of lung and health syndrome is the most, and the probability of persistent existence of each syndrome is more prominent. On the 3-5 days, the number of pathogenic diseases of lung health syndrome and lung stomach heat syndrome was still more than that of the previous stage. The probability of persistent existence of evil invading lung health syndrome and the transferring probability of lung stomach heat syndrome were more obvious, and the transfer probability of dampness and heat resistance, heart and spleen accumulation and heat syndrome was higher than that of the previous stage. On the 5th to 7th day, the probability of each syndrome transferring to normal was obviously increased, the probability of persistent existence of each syndrome decreased significantly, and the number of cases evolving to lung and stomach yin injury gradually increased. At the end of the 7-10 days, most of the children were cured, but there was still the probability of metastasis to the lung-stomach yin injury and other syndrome types. Conclusion 1. In Heilongjiang area, the prevalence of HFMD in children with HFMD was more than that in females. After 4 years of age, the prevalence rate of HFMD in children aged 1-4 years began to decrease significantly, and the highest incidence occurred in July-September in July and September of the year. The main symptoms of hand, foot and mouth disease in children in Heilongjiang province were papules or herpes, oral herpes or ulcers, sore throat, fever and irritability. The children with HFMD in Heilongjiang had the highest proportion of lung and health syndrome on the day of admission and the third day, followed by the syndrome of burning lung and stomach heat and the syndrome of accumulation of heat in the heart and spleen, and the distribution ratio of the syndrome of evil invading the lung and the syndrome of Yin injury of the lung and stomach was high on the fifth day. On the 7th day and the 10th day, the syndrome of lung and stomach yin injury was found mostly. 4. In Heilongjiang region, the TCM syndromes of hand, foot and mouth disease of children in the process of disease development, in accordance with the law of blood transmission of Wei Qi Ying, presents a dynamic evolution of the process, so that each syndrome in different periods of time observation points have certain characteristics.
【学位授予单位】：黑龙江中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R272

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