基于大样本临床研究数据小儿肺炎危险因素调查及伏九贴敷疗效分析

发布时间：2018-05-21 16:33

本文选题：小儿肺炎 + 危险因素　；参考：《辽宁中医药大学》2017年硕士论文

【摘要】：目的:通过对以往小儿肺炎临床研究数据中一般资料进行收集整理,运用统计分析该数据,探讨小儿肺炎的相关危险因素,并应用伏九贴敷对相关危险因素进行干预,研究干预后的疗效情况,为运用中医特色疗法干预小儿肺炎危险因素提供科学根据。材料与方法:根据本研究制定的纳入与排除标准对2011年2月—2016年1月间小儿肺炎临床研究病例收集,共纳入了3972例。采用回顾性分析的研究方法,记录整理纳入例病例资料中的人口学资料、出生状态、出身方式、出生体重、既往史等内容。通过Excel建立临床数据库,使用软件SPSS20.0进行统计分析,先采用单因素X2检验、t检验筛选出相关因素后,进行多因素logistic回归,分析确立小儿肺炎的危险因素与保护因素。并进行回顾性研究观察其中应用伏九贴敷对小儿肺炎危险因素的进行干预后的疗效,根据纳入排除标准共纳入了475例患儿,整理患儿贴敷时的登记资料,及后期通过电话进行随访,记录应用伏九贴敷后疾病的发生情况、发病次数及发病后治疗方式的改变,对可干预因素进行频次排序,通过自身前后对照方法分析疾病的发生情况、发病次数及发病后治疗方式的改变来判定伏九贴敷的干预疗效,对伏九贴敷对小儿肺炎相关危险因素干预的疗效进行客观的评价。结果:1、肺炎患儿以0~3岁最多,占58.99%,其次是4~6岁占29.25%,7~14岁占11.76%。2、多因素logistic回归分析既往呼吸系统疾病史、湿疹史、佝偻病史、低出生体重是小儿肺炎的独立危险因素。年龄、体重、顺产是小儿肺炎的保护因素。3、贴敷患儿呼吸系统疾病中上呼吸道感染发病率最高,两年间呼吸系统疾病的发病情况有所缓解,上呼吸道感染、支气管炎、肺炎、哮喘、过敏性鼻炎、咽炎前后差异明显(P0.05)。4.贴敷治疗后上呼吸道感染、支气管炎、肺炎、哮喘次数均减少,疗前疗后差异比较有意义(P0.05)。在反复肺炎、反复支气管炎疗效上疗后2年总有效率好于疗后1年,不同贴敷疗程的疗效比较差异明显(P0.05)。结论:1、小儿年龄越小肺炎发病率越高,发病率随年龄增长而逐渐减少。2、小儿肺炎的危险因素与既往史、出生情况有关,保护因素与小儿年龄、体重,出生方式有关。3、伏九贴敷能降低小儿呼吸系统疾病发病率,减少治疗次数,对小儿肺炎的危险因素有干预作用,同时临床疗效与贴敷疗程呈正相关。
[Abstract]:Objective: to investigate the risk factors of pediatric pneumonia by collecting and arranging the general data from the clinical research data of pediatric pneumonia, and to intervene the related risk factors with Fujiu application. To study the curative effect after intervention, to provide scientific basis for intervention of risk factors of pneumonia in children by using characteristic therapy of traditional Chinese medicine. Materials and methods: according to the inclusion and exclusion criteria, 3972 cases of pediatric pneumonia were collected from February 2011 to January 2016. The demographic data, birth status, birth style, birth weight, past history and so on were recorded by retrospective analysis. The clinical database was established by Excel, and the statistical analysis was carried out by using the software SPSS20.0. The related factors were screened by single factor X 2 test and t test, and then multivariate logistic regression was carried out to analyze and establish the risk factors and protective factors of pneumonia in children. A retrospective study was conducted to observe the therapeutic effect of Fujiu application on the risk factors of pneumonia in children. 475 children were included according to the exclusion criteria, and the registration data were sorted out. And later follow up by telephone to record the occurrence of disease, the number of the disease and the changes of treatment methods after the application of Fu Jiu application, and the frequency of interventional factors were ranked. The intervention effect of Fujiu application on risk factors related to pneumonia in children was evaluated objectively by analyzing the occurrence of disease, the frequency of disease and the changes of treatment methods after the onset of the disease before and after the onset of the disease, and the therapeutic effects of Fujiu application on the risk factors related to pneumonia in children were evaluated objectively. Results: the majority of children with pneumonia were 0 to 3 years old (58.99), followed by 4- and 6-year-olds (29.2525 / 714) and 11.76.2. multivariate logistic regression analysis showed that history of respiratory diseases, eczema, rickets and low birth weight were independent risk factors of pneumonia in children. Age, body weight, and natural labor are the protective factors of pneumonia in children. The incidence of upper respiratory tract infection is the highest among children with respiratory diseases, and the incidence of respiratory diseases has been alleviated in the past two years, with upper respiratory tract infection, bronchitis, pneumonia. Asthma, allergic rhinitis, pharyngitis before and after the difference was significant P 0.05. 4. The frequency of upper respiratory tract infection, bronchitis, pneumonia and asthma were all decreased after application. The difference before and after treatment was significant (P 0.05). The total effective rate of 2 years after treatment was better than that of 1 year after treatment in the treatment of recurrent pneumonia and repeated bronchitis. Conclusion the incidence of pneumonia in children is higher with age. The incidence of pneumonia decreases gradually with age. The risk factors of pneumonia in children are related to past history, birth status, protective factors and age and weight of children. The birth style is related to. 3. Fujiu application can reduce the incidence of respiratory system diseases in children, reduce the number of times of treatment, and interfere with the risk factors of pneumonia in children. At the same time, there is a positive correlation between the clinical efficacy and the course of application.
【学位授予单位】：辽宁中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R246.4

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