儿童咳嗽变异性哮喘中医证素分布规律研究

发布时间：2018-12-31 19:29

【摘要】：[目的]通过问卷调查的形式结合证素辨证方法学探讨儿童咳嗽变异性哮喘的中医病位、病性证素特点及其组合规律,为提高儿童咳嗽变异性哮喘临床辨证论治水平以及制定防治方案提供依据。[方法]以广东省中医院儿科门诊部符合诊断标准的91例患者为研究对象,进行问卷调查,收集四诊资料,根据"证候辨证素"量表找到每一症状对各证素的权值,最后计算各症状对各证素权值之和,超过阈值100分的证素则判断成立,分析病位证素、病性证素以及病位与病性证素组合规律。[结果]咳嗽变异性哮喘中,病位证素共7个,肺为核心病位,其出现的频率(97.80%)明显高于其他病位证素,病位证素表(95.60%)相对常见,其他病位证素依次为脾(57.14%)、胃(29.67%)、肾(3.30%)、心(3.30%)、肝(1.10%)。病位肺、表、脾、胃等4个证素平均积分超过150分。病位证素组合以二病位、三病位、四病位为主,单一病位出现频率较低。病性证素方面,实性病性有9个,虚性病性4个。实性病性中,病性痰(53.85%)出现频率最高,病性外风(45.05%)、寒(40.66%)、湿(27.47%)等相对常见,病性饮(10.99%)、气滞(8.79%)、热(4.40%)、燥(4.40%)、食积(3.30%)等出现频数较低。虚性病性证素依次为气虚、阳虚、血虚、阴虚,出现频率分别为:87.91%、69.23%、50.55%、26.37%,虚性病性气虚、阳虚平均积分超过150,提示为重度病变;病性证素组合中,二病性组合最常见,频数、频率为61例(67.76%),其次为单一病性证素,频数与频率为19例(21.11%)。病位与病性组合形式中,二病位与单一病性组合"肺+表+气虚"出现频数与频率为76例(83.52%),三病位与单一病性证素组合"肺+表+脾+气虚"出现频率为51例(56.04%)。[结论]咳嗽变异性哮喘核心病位在肺,与表、脾相关;其发病虚实互见,气虚、阳虚在本病发生、发展中具有重要意义;痰、风等为主要实性病性,其中痰为主要病理产物,亦是主要病因。
[Abstract]:[objective] to explore the TCM disease position, the characteristics and the combination rules of TCM syndrome factors in children with cough variant asthma by means of questionnaire survey combined with syndrome differentiation methodology. In order to improve the children cough variant asthma clinical differentiation and treatment level and make prevention and treatment plan to provide the basis. [methods] 91 patients who met the diagnostic criteria in Department of Pediatrics of Guangdong Provincial Hospital of traditional Chinese Medicine were investigated by questionnaire, and the data of four diagnoses were collected, and the weight of each symptom to each symptom was found according to the "syndrome differentiation factors" scale. Finally, the sum of the weight of each symptom to each syndrome element was calculated, and the syndrome element exceeding the threshold value of 100 points was judged, and the syndrome element of the disease position, the disease syndrome element and the combination rule of the disease position and the disease syndrome element were analyzed. [results] in cough variant asthma, there were 7 syndromes in the disease position, and the lung was the core disease position. The frequency of occurrence of the syndrome elements (97.80%) was significantly higher than that of other syndromes, and it was relatively common in the list of syndromes of the disease site (95.60%). The other syndromes were spleen (57.14%), stomach (29.67%), kidney (3.30%), heart (3.30%) and liver (1.10%). The average score of the four syndromes of lung, surface, spleen and stomach was more than 150 points. The combination of two, three and four disease sites is the main one, and the frequency of single disease is low. In terms of syndromes, there are 9 real venereal diseases and 4 deficiency venereal diseases. The frequency of diseased phlegm (53.85%) was the highest, the incidence of diseased external wind (45.05%), cold (40.66%), dampness (27.47%), diseased drink (10.99%), qi stagnation (8.79%), and so on. The frequency of heat (4.40%), dryness (4.40%) and food production (3.30%) was low. Deficiency venereal disease syndrome factors were qi deficiency, yang deficiency, blood deficiency, yin deficiency, respectively. The frequency of occurrence was 87.91 and 69.230.2350.5550.5510, and the deficiency of venereal disease qi deficiency and the average score of yang deficiency exceeded 150, indicating that the disease was severe. In the combination of disease syndromes, the frequency and frequency were 61 cases (67.76%) and 19 cases (21.11%) respectively. In the combination of disease location and disease, the frequency and frequency of "deficiency of lung surface qi" was 83.52%. The frequency of "deficiency of spleen qi on lung surface" was 56.04% in 51 cases (56.04%). [conclusion] the core disease of cough variant asthma is located in the lung, which is related to the appearance and spleen, and the occurrence of deficiency of qi, deficiency of qi and deficiency of yang are of great significance in the occurrence and development of the disease. Phlegm, wind and so on are the main real venereal diseases, in which phlegm is the main pathological product and the main etiology.
【作者单位】：广东省中医院;
【基金】：广东省中医药管理局2013年建设中医药强省科研课题(20132168) 广东省中医院中医药科学技术研究专项资助(No YK2013B2N18)
【分类号】：R272

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