小儿肺炎风热闭肺证舌象变化的临床研究

发布时间：2018-08-18 09:30

【摘要】：目的动态观察肺炎风热闭肺证患儿的舌象变化，探讨舌象与体温、咳嗽、肺部Up音等临床指标在不同时间段肺炎的病情评估作用及应用价值，为进一步运用中西医结合诊治肺炎提供临床依据。方法采用前瞻性研究方法，选择2011年10月-2012年01月于大连市儿童医院呼吸内科住院，符合纳入标准的49例肺炎风热闭肺证患儿，以人工与舌象仪、电子听诊器双采集的方式、每天定时对肺炎风热闭肺证患儿的舌象、肺部Up音等临床指标进行连续观察，并将观察结果记录于登记表中。结果 1.肺炎风热闭证患儿入院第1天舌象以舌尖红，苔薄，黄白相兼为主，占40.8%。舌色以舌尖红为主，占75.5%；苔色以黄白相兼为主，占65.3%；苔质以苔薄为主，，占69.4%。 2.肺炎风热闭肺证患儿入院第1天异常舌象为95.9%、正常舌象为4.1%；入院第7天异常舌象36.7%、正常舌象为63.3%，肺炎风热闭肺证患儿入院第1天舌象与入院第7天比较，经卡方检验，P＜0.05，差异显著，有统计学意义。 3.随着肺炎风热闭肺证患儿的病情逐渐好转，异常舌象逐渐减少，正常舌象逐渐增多。 4.肺炎风热闭肺证患儿体温、咳嗽、肺部Up音随着病情的好转逐渐恢复，直至正常。 5.舌象与体温、肺部Up音在肺炎风热闭肺证患儿的病情评估作用不一致，舌象与体温、肺部罗音相比，经卡方检验，P＜0.05，差异显著，具有统计学意义；舌象与咳嗽在肺炎风热闭肺证患儿的病情评估作用一致，舌象与咳嗽相比，经卡方检验，P＞0.05，差异不显著，无统计学意义。结论 1.肺炎风热闭肺证患儿入院第1天的舌象以舌尖红，苔薄，黄白相兼多见。 2.肺炎风热闭肺证患儿入院第1天以异常舌象为主，入院第7天以正常舌象为主，入院第1天与第7天相比舌象表现不同，提示肺炎风热闭肺证患儿的舌象随着入院时间的延长、病情的逐渐好转而发生变化，由异常舌象逐渐向正常舌象转变，并呈现一定规律性。 3.舌象、体温、咳嗽及肺部Up音在肺炎风热闭肺证的病情评估中发挥各自的作用，与体温、肺部Up音相比，舌象对其病情评估作用的敏感性较高；与咳嗽相比，二者对其病情评估作用的敏感性一致。
[Abstract]:Objective to observe the changes of tongue picture in children with pneumonia with wind-heat blockage of lung syndrome, and to explore the evaluation effect and application value of tongue sign and body temperature, cough, lung up sound and so on in different time period of pneumonia. To provide clinical basis for the further application of integrated traditional Chinese and western medicine in the diagnosis and treatment of pneumonia. Methods A prospective study was used to select 49 children with pneumonia wind and heat blocking lung syndrome who were hospitalized in Department of Respiratory Medicine of Dalian Children's Hospital from October 2011 to January 2012. The patients were collected by artificial and tongue imaging instrument and electronic stethoscope. The tongue picture, lung up sound and other clinical indexes were observed regularly every day, and the results were recorded in the registration form. Result 1. On the first day of admission, the tongue appearance of pneumonia patients with wind-heat blocking syndrome was mainly red tongue tip, thin fur, yellow and white appearance, accounting for 40.8%. The color of tongue was mainly red on the tip of tongue (75.5%), yellow and white (65.3%), and thin coating (69.4%). On the first day of admission, the abnormal tongue picture was 95.9 and the normal tongue sign was 4.1. On the 7th day of admission, the abnormal tongue picture was 36.7, and the normal tongue sign was 63.3. The first day of admission was compared with that of the 7th day. The chi-square test showed significant difference (P < 0.05). With the pneumonia wind-heat blocking lung syndrome children's condition gradually improved, abnormal tongue gradually decreased, the normal tongue gradually increased. 4. 4. The body temperature, cough and lung up sound of pneumonia wind-heat blocking lung syndrome gradually recovered with the improvement of the condition, until the normal. 5. 5%. Tongue picture and body temperature, lung up sound in the pneumonia wind-heat block lung syndrome children's disease evaluation function is not consistent, tongue picture and body temperature, lung rales, by chi-square test P < 0.05, the difference is significant, there is statistical significance. Tongue picture and cough had the same effect in evaluating the condition of pneumonia patients with wind-heat blocking lung syndrome. Compared with cough, Chi Fang test showed that the difference was not significant (P > 0.05), and there was no significant difference in tongue appearance and cough (P > 0.05). Conclusion 1. On the first day of admission, the tongue appearance of the children with pneumonia wind and heat blocking lung syndrome was red on the tip of tongue, thin fur, and yellow and white appearance. 2. 2. The abnormal tongue on the first day of admission, the normal tongue on the seventh day of admission, and the difference between the first day of admission and the seventh day of admission indicated that the tongue appearance of the children with pneumonia wind-heat blockage lung syndrome was prolonged with the extension of admission time. The condition gradually improved and changed, from abnormal tongue to normal tongue, and showed a certain regularity of 3. 3. Tongue picture, body temperature, cough and lung up sound play their respective roles in the evaluation of pneumonia, compared with body temperature and lung up sound, tongue picture is more sensitive to the evaluation of the disease. The sensitivity of the two to the evaluation of the disease was the same.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R272

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