食积与小儿反复呼吸道感染病因学相关性研究

发布时间：2018-05-23 15:59

本文选题：病例对照研究 + 肺胃积热　；参考：《北京中医药大学》2012年硕士论文

【摘要】：小儿反复呼吸道感染(recurrent respiratory tract infections, RRTI)是属于小儿常见呼吸系统感染性疾病,它是指在一定的时间内,反复受到外邪,其临床症状表现为往复不已。在中医的疾病典籍中虽然无此疾病名称,但是各朝代的医家学者,根据其临床症状和病位,均给予多种疾病名称来描述。例如在急性期的时候,根据其病位的不同与临床的症状,可以分属于感冒、外感咳嗽等不同疾病的范围领域里。而在缓解期的时候,可以分类于内伤咳嗽等不同疾病的范围领域里。在整个疾病过程中,根据其反复出现的某种临床状态中症状的特点,可见到久咳、虚人感冒、阴虚喉痹等等。本文以小儿反复呼吸道感染为例,通过查阅文献资料和总结其相关文献,认为造成小儿反复呼吸道感染的疾病与小儿自身阳明积热,存在着重要关联性。本研究以谷晓红教授运用肺胃同治法,治疗小儿反复呼吸道感染证的经验为切入点,探讨阳明积热为内因与小儿反复呼吸道感染的关联性,并揭示阳明积热对小儿反复呼吸道感染病变的发展影响。方法：分为两部分理论研究和临床研究理论研究：以小儿反复呼吸道感染与阳明积热关联性的中医理论研究,分别从小儿独特的脏腑、病因病机、治疗原则等方面来论证二者相关性,并从小儿特殊的生理病理特点方面,来探讨平素有阳明积热,是复感儿易于发生外感热病的内在因素。中医药学是一个基于长期经验理论的临床实践医学,病例对照研究的证据级别在循证医学里是属于三级证据,优于个案报告和无对照的病例系列。临床研究：病例对照研究设计通过问卷调查,回顾性总结2011年5月至2012年5月期间前来就诊的临床小儿外感热病病例,对肺胃积热证患儿的一般临床特征进行探索,找寻对饮食的相关记录,是否有不良饮食嗜好等。以探索阳明积热证和肺热证病因与发病学的相关性。并通过同期对照研究,单纯清肺法和肺胃同清法治疗肺胃积热证的疗效观察,以反证阳明积热作为肺热证内因理论的正确性。结果：理论研究：肺、胃在生理上密切相关,病理上相互影响,肺胃积热证,属阳明有热促进肺热证的发生发展,而平素阳明积热,则易招致外邪,表里互为相引,积蕴而导致发热,最终成为肺与阳明同病之热证；小儿脏腑娇嫩,加上饮食自我节制能力较低,易于成积而蕴热,而小儿的体质易寒、易热、易虚、易实,外邪侵犯肺,阳明积热引邪深入,病邪顺传阳明而积热,通过肺、脾胃之脏腑、气血、经络之间的表里关系,使脾胃积热上熏于肺,肺失宣降就会导致反复发生呼吸道感染。临床研究：阳明积热与肺热病的病因与发病学具有正相关性,并且通过饮食问卷调查病例对照研究,小儿饮食不当,可造成小儿食积状态下,产生反复发生呼吸道感染。同期对照试验的结果是小儿食积状态下的反复发生呼吸道感染用肺胃同治法,在治疗疗效方面明显优于单纯清.肺法。
[Abstract]:Children ' s recurrent respiratory tract infections ( RRTI ) belong to the common respiratory system infectious diseases in children . It is characterized by repeated clinical symptoms and symptoms in a certain period of time .

In this study , Professor Gu Xiaohong ' s experience in the treatment of recurrent respiratory tract infection in children was studied by using the lung - stomach Tongzhi method . The relationship between the fever of Yangming and the recurrent respiratory tract infection in children was studied , and the effect of Yangming heat accumulation on the development of the recurrent respiratory tract infection in children was revealed .

Methods : Two parts of theory and clinical study were divided into two parts .

Theoretical Study :

This paper studies the relationship between the infant ' s repeated respiratory tract infection and the heat of Yangming ' s heat accumulation , and discusses the correlation between them from the unique viscera , pathogenesis and therapeutic principles of children . It is a clinical practice medicine based on long - term experience theory . The evidence level of case - control study is a case series which belongs to the evidence of evidence in evidence - based medicine , which is superior to case report and control .

Clinical Study :

Case - control study was designed by questionnaire to summarize the clinical characteristics of clinical children who came to visit from May 2011 to May 2012 to explore the correlation between the etiology of lung heat syndrome and the etiology of lung heat syndrome .

Results :

Theoretical study : The lung and stomach are closely related to physiology and pathology , and the heat syndrome of lung and stomach can promote the development of lung heat syndrome .
Children ' s zang - fu organs are delicate and delicate , and the self - restraint ability of diet is low , it is easy to accumulate and accumulate heat , and the infant ' s constitution is easy to cold , easy to heat , easy to deficiency , easy to implement , exogenous pathogenic factors invade lung , yangming product heat causes pathogenic factors to penetrate deeply , and the pathogenic factors follow the superficial relation of the lung , the spleen and stomach , the qi and blood , and the meridian and collaterals , so that the heat of the spleen and stomach is heat up to the lung , and the lung loss and loss can lead to repeated respiratory tract infections .

Clinical study : The etiology and pathogenesis of Yangming product heat and lung heat disease have positive correlation , and through the control study of diet questionnaire , children ' s diet is improper , which can cause recurrent respiratory tract infection in children ' s food product state . The result of the control experiment in the same period is the repeated occurrence of respiratory tract infection in children ' s food product .
【学位授予单位】：北京中医药大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R272

【参考文献】