甲型H1N1流感患者中医临床症状分析与温病患者相关指标研究
发布时间：2019-05-17 08:53
【摘要】：目的：探讨甲型H1N1流感的中医临床症状分布规律以及各证型的临床症状特点,分布频数,为流感的后续治疗提供辨证参考依据。分析甲型H1N1流感温病湿热证与温病温热证患者的血清免疫球蛋白IgM.IgG和血清白细胞介素—8(IL—8)、转化生长因子—β 1(TGF—β1)、脂多糖结合蛋白(LBP)、肿瘤坏死因子一α(TNF —α)、Toll样受体4(TLR4)和血浆可溶性CD14(sCD14)水平,揭示两证型之间的差异。方法：设计研究调查表,根据制定的参考标准收集门诊和住院部的流感样患者,然后根据病原学检测分析确诊甲型H1N1流感病毒感染的患者,收集这些患者的中医临床症状进行分析总结。同时,将确诊为甲型H1N1流感病毒感染的患者进行辨证分型,对湿热证和温热证的患者进行相关的实验研究,进一步发现不同证型之间的差异。结果：本次调查收集的甲型H1N1流感患者的症状供28个,出现频率最高的13个症状(出现频率50%)依次为：发热,全身酸痛,倦怠乏力,纳呆,咽喉红肿,咽喉痛,恶寒,口渴,无汗,尿黄,咳嗽,头重如裹,身体困重,体现了甲型H1N1流感患者常见症状特征。对频率较高的13个症状进行聚类分析,聚为3类。最常见的舌象是舌红,最常见的脉象是浮数脉,最常见的证型是痰热壅肺证。而且各证型之间在症状的分布上也大不相同。血清免疫球蛋白IgM、IgG、IL-8、TNF-α和TGF-β1水平差异很小,两组间比较(P0.05),差异无统计学意义；两组患者的血清TLR4、LBP和血浆sCD14水平有很大差异,湿热证组显著高于温热病组,两组间比较(P0.05),差异有统计学意义。结论：甲型H1N1流感患者在中医临床症状的分布上有一定的规律性,符合传统中医温病学对于该病的理论论述,因此可以参考温病学中的理法方药来治疗该类疾病；甲型H1N1流感温病湿热证和温病温热证患者在相关的实验室检测指标上有一些差异,两组患者的血清TLR4、LBP和血浆sCD14水平有很大差异,湿热证组显著高于温热证组,提示温病湿热证患者体内的炎症反应更为严重。
[Abstract]:Objective: to explore the distribution of clinical symptoms of influenza A (H1N1) in traditional Chinese medicine (TCM) and the characteristics and frequency of clinical symptoms of each syndrome type, so as to provide dialectical reference for the follow-up treatment of influenza. Analysis of serum immunoglobulin IgM.IgG, serum IL-8 (IL-8), transforming growth factor-尾 1 (TGF- 尾 1) and lipopolysaccharide binding protein (LBP), in patients with influenza A influenza febrile disease dampness-heat syndrome and febrile fever syndrome The levels of tumor necrosis factor-伪 (TNF-伪), Toll-like receptor 4 (TLR4) and plasma soluble CD14 (sCD14) revealed the difference between the two syndromes. Methods: a research questionnaire was designed to collect influenza-like patients in outpatient and inpatient departments according to the established reference standards, and then the patients with influenza A H1N1 virus infection were diagnosed according to etiological detection and analysis. The clinical symptoms of these patients were analyzed and summarized. At the same time, the patients diagnosed with influenza A H1N1 virus infection were classified according to syndrome differentiation, and the patients with dampness-heat syndrome and warm-heat syndrome were studied, and the differences among different syndrome types were further found. Results: the symptoms of H1N1 A patients collected in this survey were 28, and the 13 symptoms with the highest frequency (50%) were fever, systemic soreness, burnout, anorexia, redness and swelling of throat, sore throat and cold. Thirst, no sweat, yellow urine, cough, heavy head, heavy body, reflecting the common symptoms of H1N1 A flu patients. Cluster analysis of 13 symptoms with high frequency was carried out, and the symptoms were grouped into 3 categories. The most common tongue appearance is tongue red, the most common pulse is floating pulse, and the most common syndrome type is phlegm-heat obstruction of lung syndrome. Moreover, the distribution of symptoms is also very different among the syndrome types. There was no significant difference in serum immunoglobulin IgM,IgG,IL-8,TNF- 伪 and TGF- 尾 1 levels between the two groups (P 0.05). The levels of serum TLR4,LBP and plasma sCD14 in the two groups were significantly different from those in the warm heat syndrome group, and there was significant difference between the two groups (P 0.05). Conclusion: patients with influenza A H1N1 have certain regularity in the distribution of clinical symptoms of traditional Chinese medicine, which accords with the theoretical discussion of febrile disease in traditional Chinese medicine, so we can refer to the prescription in febrile disease to treat this kind of disease. There were some differences in the related laboratory test indexes between the patients with influenza A influenza febrile disease dampness-heat syndrome and febrile fever syndrome. The levels of serum TLR4,LBP and plasma sCD14 in the two groups were very different, and the levels of serum TLR4,LBP and plasma sCD14 in the damp-heat syndrome group were significantly higher than those in the warm-heat syndrome group. It is suggested that the inflammatory reaction in patients with febrile disease and dampness-heat syndrome is more serious.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259
[Abstract]:Objective: to explore the distribution of clinical symptoms of influenza A (H1N1) in traditional Chinese medicine (TCM) and the characteristics and frequency of clinical symptoms of each syndrome type, so as to provide dialectical reference for the follow-up treatment of influenza. Analysis of serum immunoglobulin IgM.IgG, serum IL-8 (IL-8), transforming growth factor-尾 1 (TGF- 尾 1) and lipopolysaccharide binding protein (LBP), in patients with influenza A influenza febrile disease dampness-heat syndrome and febrile fever syndrome The levels of tumor necrosis factor-伪 (TNF-伪), Toll-like receptor 4 (TLR4) and plasma soluble CD14 (sCD14) revealed the difference between the two syndromes. Methods: a research questionnaire was designed to collect influenza-like patients in outpatient and inpatient departments according to the established reference standards, and then the patients with influenza A H1N1 virus infection were diagnosed according to etiological detection and analysis. The clinical symptoms of these patients were analyzed and summarized. At the same time, the patients diagnosed with influenza A H1N1 virus infection were classified according to syndrome differentiation, and the patients with dampness-heat syndrome and warm-heat syndrome were studied, and the differences among different syndrome types were further found. Results: the symptoms of H1N1 A patients collected in this survey were 28, and the 13 symptoms with the highest frequency (50%) were fever, systemic soreness, burnout, anorexia, redness and swelling of throat, sore throat and cold. Thirst, no sweat, yellow urine, cough, heavy head, heavy body, reflecting the common symptoms of H1N1 A flu patients. Cluster analysis of 13 symptoms with high frequency was carried out, and the symptoms were grouped into 3 categories. The most common tongue appearance is tongue red, the most common pulse is floating pulse, and the most common syndrome type is phlegm-heat obstruction of lung syndrome. Moreover, the distribution of symptoms is also very different among the syndrome types. There was no significant difference in serum immunoglobulin IgM,IgG,IL-8,TNF- 伪 and TGF- 尾 1 levels between the two groups (P 0.05). The levels of serum TLR4,LBP and plasma sCD14 in the two groups were significantly different from those in the warm heat syndrome group, and there was significant difference between the two groups (P 0.05). Conclusion: patients with influenza A H1N1 have certain regularity in the distribution of clinical symptoms of traditional Chinese medicine, which accords with the theoretical discussion of febrile disease in traditional Chinese medicine, so we can refer to the prescription in febrile disease to treat this kind of disease. There were some differences in the related laboratory test indexes between the patients with influenza A influenza febrile disease dampness-heat syndrome and febrile fever syndrome. The levels of serum TLR4,LBP and plasma sCD14 in the two groups were very different, and the levels of serum TLR4,LBP and plasma sCD14 in the damp-heat syndrome group were significantly higher than those in the warm-heat syndrome group. It is suggested that the inflammatory reaction in patients with febrile disease and dampness-heat syndrome is more serious.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259
【参考文献】
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