儿童肺炎痰热闭肺证舌象特点及影响因素分析

发布时间：2018-12-05 19:52

【摘要】：目的：分析痰热闭肺证肺炎患儿舌象特点，观察影响舌象转化的相关因素，阐明其舌象转化规律，为临床辨证及预示疾病的预后提供依据。方法：选择2010年1月-2011年5月辽宁中医药大学附属医院儿科病房符合肺炎诊断的339例住院患儿，采用回顾性分析274例痰热闭肺证患儿的舌象特点及舌象转化的主要时间点，同时分析年龄、既往反复呼吸道感染史、湿疹史对痰热闭肺证患儿的舌象转化的影响程度。结果： 1.儿童肺炎痰热闭肺证患儿以婴幼儿及学龄前期儿童的例数居多，占85%。各年龄段中婴幼儿的舌象的舌质、舌苔的转化最为明显，且变化幅度最大。 2.有湿疹史的肺炎痰热闭肺证患儿的舌苔厚转为苔薄的占67%，高于苔黄转为苔白的百分比（25%。）；反复呼吸道感染病史的痰热闭肺证患儿的舌苔厚转为舌苔薄的比例（88%）也高于舌苔黄转为舌苔白的比例（28%）。 3.痰热闭肺证的患儿的舌象舌质红占82%，显著高于舌质淡红（1.4%）及舌质紫暗（0.4%）的百分数，舌苔以舌苔黄（83.6%）、舌苔厚（44.5%）、舌苔腻（16.4%）为主，较少为舌苔少（0.7%）及剥脱苔（4.0%），，可见以舌质红苔黄厚腻为主。 4.随着病情的好转逐渐大多数转为舌质淡红苔薄白，少数转为舌质紫暗，苔少或剥脱。舌质转为正常的时间点均晚于舌苔转为正常的时间点。舌质由红转化为淡红占大多数，占27.4%，舌质红转化为紫暗者则较少占1.4%，且变化幅度较小。舌苔黄转化为舌苔白的比例为29.7%。舌苔厚转化为薄占58.2%。舌苔腻转为舌苔薄的比例为55.6%。舌苔由厚转化为少苔及剥脱苔的例数则较少，分别为8.2%和5.7%，且随着治疗无明显的变化。结论： 1.年龄不同其舌象的特点也不同。随着年龄的增长其舌苔黄转为苔白的百分比多于苔厚转为苔薄的百分比，即其内热较痰浊更易于清除。 2.既往有湿疹史、反复呼吸道感染病史的患儿内热均不易清除，可推断出内有郁热的患儿感受外邪更易患呼吸系统疾病，且易直接入里化热。 3.舌苔转为正常的时间点均早于舌质转为正常的时间点。 4.儿童肺炎痰热闭肺证有其自身的舌象特点。 5.不同影响因素的舌质转化的时间点大致相同。
[Abstract]:Objective: to analyze the characteristics of tongue picture in children with phlegm heat blocking lung syndrome, observe the related factors affecting tongue image transformation, clarify the law of tongue image transformation, and provide basis for clinical syndrome differentiation and prognosis of disease. Methods: 339 hospitalized children in pediatric ward of affiliated Hospital of Liaoning University of traditional Chinese Medicine from January 2010 to May 2011 were selected. The tongue features and the main time points of tongue transformation were analyzed retrospectively in 274 children with phlegm heat blocking lung syndrome. The influence of age, history of recurrent respiratory tract infection and history of eczema on tongue transformation in children with phlegm and heat blocking lung syndrome was analyzed. Results: 1. Children with pneumonia, phlegm heat blocking lung syndrome, infants and preschool children are the majority of the cases, accounting for 85. The change of tongue coating was the most obvious in all ages. 2. 67 cases with pneumonia with history of eczema turned into thin tongue coating, which was higher than the percentage of yellow fur turning to white fur (25.1%). The proportion of thick tongue coating to thin tongue coating in children with phlegm heat blocking lung syndrome with history of repeated respiratory tract infection (88%) was also higher than that of yellow tongue coating to white tongue coating (28%). 3. The proportion of tongue red in phlegm heat blocking lung syndrome was 82, which was significantly higher than that of light red tongue (1.4%) and purple dark tongue (0.4%). The tongue coating was yellow (83.6%), and the tongue coating was thick (44.5%). Greasy tongue coating (16.4%), less tongue coating (0.7%) and peeling coating (4.0%) showed that Huang Hou was greasy with tongue red fur. 4. With the improvement of the condition, most of them turned to thin white tongue, a few to purple dark tongue, less fur or peeling off. The time point when the tongue became normal was later than that of tongue coating. The percentage of tongue quality changed from red to light red accounted for 27.4%, while the proportion of tongue red to purple dark was 1.4%, and the range of change was small. The ratio of yellow tongue coating to white tongue coating was 29. 7%. The thickness of tongue coating was transformed into thin layer, which accounted for 58.2%. The ratio of greasy tongue coating to thin tongue coating was 55.6. The cases of tongue coating changed from thick to less and exfoliated, which were 8.2% and 5.7%, respectively, and had no obvious change with the treatment. Conclusion: 1. The characteristics of tongue appearance vary with age. With age, the percentage of yellow to white tongue coating is higher than that of thick coating to thin coating, that is, the internal heat is easier to remove than phlegm turbid. 2. Children with history of eczema and history of recurrent respiratory tract infection were not easy to clear their internal heat. It can be inferred that children with internal and external fever are more likely to suffer from respiratory system diseases and are more likely to enter directly into the heat. 3. The time point when tongue coating became normal was earlier than that of tongue quality. 4. The syndrome of phlegm heat blocking lung in children with pneumonia has its own tongue features. 5. The time points of tongue quality transformation of different factors were approximately the same.
【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】：2012
【分类号】：R272

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