小儿肺炎中医证型演变特点及不同年龄中医证型分布特点

Evolvement characteristics of syndrome types and distribution characteristics of different ages of TCM syndromes in infantile pneumonia

目的探讨小儿肺炎中医证型演变特点及不同年龄中医证型分布特点。方法通过对纳入的380例小儿肺炎患儿,在治疗当日(基线点)、治疗后第3,5,7,10天观察并记录中医证型,统计小儿肺炎在不同观察时段中医证型演变特点;观察小儿肺炎治疗当日的中医证型分布与发病年龄有否相关性。结果380例小儿肺炎在基线点至治疗后第3天,以风热闭肺证、痰热闭肺证为主,各证型发生转变的病例较少。在治疗后第5天,仍以风热闭肺证、痰热闭肺证为主,大部分证型发生了证型转变。在治疗后第7天,部分证型转至阴虚肺热证、肺脾气虚证。在治疗后第10天,风寒闭肺证、风热闭肺证、痰热闭肺证绝大多数恢复正常。380例小儿肺炎中痰热闭肺证、毒热闭肺证主要见于1～3岁小儿;风热闭肺证、痰热闭肺证主要见于4～7岁肺炎患儿;风寒闭肺证和风热闭肺证主要见于8～14岁肺炎患儿。结论小儿肺炎中医证型在疾病发展过程中,呈现动态演变过程,从而使各证型在不同观察时段的分布具有一定特点;小儿肺炎的中医证型分布与发病年龄有相关性。

Objective To explore evolvement eharaeteristies of syndrome types and distribution charaeteristies of different ages of TCM syndromes in infantile pneumonia. Methods Through the clinical observation of 380 children patients with infantile pneumonia, we observed and recorded the syndrome types of the patients on the day of admission （basic point）, and on the 3rd, 5th, 7th and 10th day after medication, to explore evolvement characteristics of syndrome types in different observation period. We also observed the correlation between the distribution of TCM syndromes and ages on the day of admission, Results Of the 380 cases of pneumonia in children, from baseline point to the 3rd day after treatment, wind-heat lung affection and phlegmaccumulation lung affection were the major types, and fewer cases had change of types. Five days after treatment, the above-mentioned two types were still the major ones, but most cases had change of types. On the 7th day of treatment,some cases changed to Yin-deficiency lung affection and insufficiency of lung-qi and spleen-eli. On the tenth day,most of the wind-cold lung affection, wind-heat lung affection and phlegm-accumulation lung affection turned to normal cases. Of the 380 cases of pneumonia, phlegm-accumulation lung affection and toxic-heat lung affection were presented mainly in children aged one to three, wind-heat lung affection and phlegm-accumulation lung affection were presented mainly in children aged 4 to 7, and wind-cold lung affection and wind-heat lung affection were presented mainly in children aged 8 to 14. Conclusion TCM syndromes of infantile pneumonia is a dynamic evolution process during the whole disease course, so distribution of each type has certain characteris- tics in different periods. There is correlation between distribution of TCM syndromes and ages.