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[1]张伟,林连升,王融冰,等.手足口病并发中枢神经系统感染327例中医证候及核心病机分析[J].环球中医药,2012,5(07):512-0.
　ZHANG Wei,Lin Lian-sheng,Wang Rong-bing,et al.TCM syndromes and etiology-pathogenesis in 327 cases of hand-foot-mouth disease with central nervous system infections[J].,2012,5(07):512-0.
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手足口病并发中枢神经系统感染327例中医证候及核心病机分析()
     
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《环球中医药》[ISSN:1006-6977/CN:61-1281/TN]

卷:
第5卷
期数:
2012年07期
页码:
512-0
栏目:
论著
出版日期:
2012-07-06

文章信息/Info

Title:
TCM syndromes and etiology-pathogenesis in 327 cases of hand-foot-mouth disease with central nervous system infections
作者:
张伟; 林连升; 王融冰; 田庆玲; 杨巧芝; 杨朝晖; 庞保东; 金敏; 杨金玲; 陈志海; 蒋荣猛; 李兴旺; 吴昊; 张永利; 王玉光; 刘清泉;
Author(s):
ZHANG Wei;  Lin Lian-sheng;  Wang Rong-bing;  et al.
Centre of Infection Disease,Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China.
关键词:
手足口病;  中枢神经系统感染;  核心病机;  湿热动风
Keywords:
Hand-foot-mouth disease;  Central nervous system infection;  Core pathogenesis;  Wind symptom caused by dampness-heat
分类号:
R272.5
DOI:
-
文献标志码:
A
摘要:
目的探索手足口病并发中枢神经系统感染的中医证候特征及核心病机。方法采用前瞻性的临床研究方法,纳入327例手足口病并发中枢神经系统感染的住院病例,按照统一的中医证候观察表进行动态观察,主要根据舌象将证候分为湿热证、温热证,湿热证又分为湿重于热证、热重于湿证,由两名主治医师根据临床资料确定本病的中医证候分型和核心病机。结果 327例患儿证候分型为:湿重于热证208例(63.8%)、热重于湿证79例(24.2%)、温热证40例(12.2%); 热重于湿证与温热证的入组前最高体温高于湿重于热证(P<0.01); 湿重于热证入组前病程长于热重于湿证(P<0.05); 湿重于热证的住院天数较温热证有延长的趋势(P=0.083); 热重于湿证皮疹色泽较红,口腔皮疹比例高于湿重于热证及温热证(P<0.05); 温热证出现嗜睡及颈项强直比例要高于湿重于热证及热重于湿证(P<0.05); 湿重于热证及热重于湿证出现易惊的比例要高于温热证(P<0.05)。不同证型的病原学分布频率无差异。结论手足口病并发中枢神经系统感染病因是以湿热疫疠毒邪为主,病位主要在脾、心、肝,核心病机为湿热动风。湿重于热证及热重于湿证易见易惊等动风表现,湿重于热证热像不显,热势不彰,病情发展较缓,缠绵难愈; 热重于湿证疹色较红且口腔皮疹多见; 温热证则易见颈项强直、嗜睡表现。
Abstract:
Objective To explore the traditional Chinese medicine syndromes and etiology-pathogenesis of hand-foot-mouth disease(HFMD)with central nervous system infections. Methods With prospective clinical research, 327 inpatients of HFMD were enrolled and observed with unified TCM syndrome form, they were divided into damp-heat syndrome and warm-heat syndrome mainly according to tongue presentations, and the damp-heat syndrome is divided into wet more than hot syndrome and hot more than wet syndrome. The syndrome was determined by two attending physicians of TCM. Results There were 208 cases in wet more than hot syndrome(63.8%), 79 cases in hot more than wet syndrome(24.2%), 40 cases in warm-heat syndrome(12.2%); The highest temperature before enrolled of hot more than wet syndrome and warm-heat syndrome was higher than wet more than hot syndrome(P<0.01); The course of disease in wet more than hot syndrome before enrolled was longer than hot more than wet syndrome(P<0.05); The hospital day seems to be longer in wet more than hot syndrome compared to warm-heat syndrome(P=0.083); The color of rash are redder in hot more than wet syndrome, and the ratio of oral rashes was higher than wet more than hot syndrome and warm-heat syndrome(P<0.05); The ratio of stiff neck and drowsiness in warm-heat syndrome was higher than wet more than hot syndrome and hot more than wet syndrome; The ratio of hyperarousal in wet more than hot syndrome and hot more than wet syndrome was higher than warm-heat syndrome(P<0.05). There is no significance in distribution frequency of etiology in different syndromes. Conclusion Dampness-heat was the main etiological factor of HFMD with central nervous system infections, the illness positions were spleen heart and liver, the core pathogenesis was wind symptom caused by dampness-heat. Hyperarousal was common in wet more than hot syndrome and hot more than wet syndrome. The hot was not significant and it had longer courses in wet more than hot syndrome. The rash are redder in hot more than wet syndrome, and there were more rashes in hot more than wet syndrome. And stiff neck and drowsiness were more common in warm-heat syndrome.

参考文献/References:

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备注/Memo

备注/Memo:
基金项目:财政部、国家中医药管理局2009年中医药行业科研专项(200907001-1); 北京市“十一五”中医药“51510”科技工程计划(JJT-2010-18)
作者单位：100015 首都医科大学附属北京地坛医院感染性疾病诊疗中心(张伟、王融冰、陈志海、蒋荣猛、李兴旺、张永利); 广州市第八人民医院中西医结合科(林连升); 山东省聊城市人民医院儿科(杨巧芝); 山东省临沂市人民医院感染科(杨朝晖); 河北省唐山市妇幼保健院儿科(田庆玲、庞保东); 首都医科大学附属北京市佑安医院感染科(吴昊); 山东省日照市中医院儿科(金敏); 山东省莒县人民医院感染科(杨金玲); 首都医科大学附属北京中医医院(王玉光、刘清泉)
作者简介：张伟(1980- ),博士,主治医师。研究方向:中西医结合感染性疾病。E-mail:snowpine12@sina.com; 林连升(1986- ),硕士,医师。研究方向:中西医结合感染病工作。E-mail:lin_lian_sheng@yahoo.cn。张伟、林连升并列为第一作者。
通讯作者：王玉光(1969- ),博士,主任医师。研究方向:中西医结合感染性疾病E-mail:influenzatcm@163.com; 刘清泉(1965- ),硕士,主任医师。研究方向:中西医结合急诊。E-mail: liuqingquan_2003@yahoo.com.cn。王玉光、刘清泉并列为通讯作者。
更新日期/Last Update: 1900-01-01