310例小儿手足口病中医证候特征及证候演变规律的研究

发布时间：2018-11-08 21:16

【摘要】：目的探讨黑龙江地区小儿手足口病中医证候特征及证候演变规律,同时对小儿手足口病不同病原的流行情况进行分析。方法采用前瞻性横断面临床流行病学调查方法,通过采集手足口病患儿临床资料,跟踪观察患儿入院当天(基线点)、治疗后第3、5、7、10天的临床表现,填写临床观察表,建立数据库,应用证候演变概率法对手足口病患儿中医证候在不同观察点的证候演变规律进行系统分析,并进一步探讨手足口病患儿不同病原的流行情况。结果对手足口病患儿各中医证候分布情况进行统计,邪犯肺卫证192例(62.54%),显著高于其他证候。从基线点到第3天,邪犯肺卫证和肺胃热炽证持续存在概率分别为67.44%、58.73%,第3~5天,邪犯肺卫证及肺胃热炽证发病人数仍较多,且湿热交阻、心脾积热两证转移概率较高,第5~7天,向肺胃阴伤证演变的病例逐渐增多,第7~10天,大部分患儿向愈,但仍存在向阴虚的转移概率。纳入的307例手足口病患儿病原学检测,共测得肠道病毒通用型RNA阳性176例(57.33%);肠道病毒71型阳性90例(29.32%);柯萨奇病毒A16型阳性27例(8.79%)。3种病原在各中医证候间的分布无显著性差异,但在基线点观察3种病原均以邪犯肺卫证和肺胃热炽证较为多见。结论手足口病患儿在不同观察点有着不同的演变规律。各证候中,邪犯肺卫证出现率最高。本地区手足口病患儿中EV71和Cox A16均有感染,但其中以EV71为主。在基线点观察3种病原均以邪犯肺卫证和肺胃热炽证较为多见。
[Abstract]:Objective to explore the characteristics of TCM syndromes and the evolution of syndromes in children hand foot and mouth disease (HFMD) in Heilongjiang province, and to analyze the prevalence of different pathogens of HFMD in children. Methods A prospective cross-sectional clinical epidemiological survey was conducted to investigate the clinical data of children with hand-foot-mouth disease (HFMD). The clinical manifestations of the children were observed on the day of admission (baseline point) and 10 days after treatment, and the clinical observation forms were filled out. To establish the database and apply the method of syndrome evolution probability to analyze the pattern of TCM syndromes evolution in different observation points in children with hand foot and mouth disease (HFMD), and to further explore the epidemic situation of different pathogens of HFMD children. Results the distribution of TCM syndromes in children with hand-foot-mouth disease was statistically analyzed. 192 cases (62.54%) were infected with pathogenic diseases, which was significantly higher than that of other syndromes. From the baseline point to the third day, the probability of the persistent existence of pathogenic diseases of lung and stomach heat syndrome was 67.44 and 58.73, respectively. On the 3rd day, the number of evil invading lung health syndrome and lung stomach heat syndrome was still more, and dampness and heat resistance were also found. The probability of transferring from heart and spleen to heat and heat was higher. On the 5th day, the number of cases developing to lung and stomach yin injury gradually increased. On the 7th day, most of the children recovered, but there was still the probability of transferring to yin deficiency. A total of 176 cases (57.33%) of enterovirus RNA positive and 90 cases (29.32%) of enterovirus 71 positive were detected in 307 children with hand, foot and mouth disease. Coxsackie virus A16 was positive in 27 cases (8.79%). There was no significant difference in the distribution of three pathogens among TCM syndromes. Conclusion Hand-foot-mouth disease children have different rules of evolution in different observation points. Among the syndromes, the incidence of evil offending lung and health syndrome was the highest. Both EV71 and Cox A 16 were infected in children with HFMD, but EV71 was the main infection. At the baseline, the three pathogens were more common in the syndrome of lung defense and lung stomach heat.
【作者单位】：黑龙江中医药大学附属第二医院;黑龙江中医药大学;黑龙江省哈尔滨市传染病院;
【基金】：黑龙江省中医药管理局中医药中青年科技攻关项目(ZQG-043)
【分类号】：R272

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