417例儿童反复呼吸道感染中医证候分型研究

Study on TCM syndrome Classification of Recurrent Respiratory Tract Infection in Children:A Report of 417 Cases

目的:分析儿童反复呼吸道感染(RRTI)的中医证候分型规律。方法:采用调查问卷方式,前瞻性收集417例广州地区非急性感染期患儿的中医四诊资料,对所有指标进行频数统计、聚类分析,归纳中医证候分型特点,确定其基本证候类型及证候特征。结果:根据调查问卷共得出148个指标,进行频数分析,得出检出率大于20%和部分频次低但有重要辨证意义的44个指标。将44个指标进行聚类分析,结果分4类较为满意:肺气虚弱,卫阳不固证;肺脾气虚夹滞证;脾虚肝旺证;肺肾气虚夹痰证。其中以肺脾气虚夹滞证最多见。结论:广州地区儿童RRTI非急性感染期的中医证候分型多见肺气虚弱,卫阳不固证;肺脾气虚夹滞证;脾虚肝旺证和肺肾气虚夹痰证。主要证型是肺脾气虚夹滞证,可立健运脾胃为主要治法。

Objective. To analyze the distribution of TCM syndrome patterns in children with recurrent respiratory tract infection （RRTI）. Methods： The data of four examinations in 417 RRTI children Jn non-acute infective stage were prospectively collected by questionnaire. All indexes were analyzed in terms of frequency count. Cluster analysis was used to explore the distribution of symptom complex in TCM and to find out the basic syndrome patterns. Results： According to the results of survey, 148 indicators were obtained. The results of frequency analysis presented a total of 44 indicators with detection rate more than 20% or lower but having important significance in syndrome differentiation. The results of cluster analysis of 44 indicators showed that TCM syndromes of RRTI were classified into four categories： lung qi deficiency with unconsolidation of defensive yang, qi deficiency of both lung and spleen accompanying with stagnation, spleen asthenia and hyperactive liver, and qi deficiency of both lung and kidney accompanying with phlegm. Qi deficiency of both lung and spleen accompanying with stagnation was the most common-seen type. Conclusion： In Guangzhou, TCM syndrome patterns of RRTI children in non-acute infective stage can be classified into lung qi deficiency with unconsolidation of defensive yang, qi deficiency of both lung and spleen accompanying with stagnation, spleen asthenia and hyperactive liver, and qi deficiency of both lung and kidney accompanying with phlegm. The dominant pattern is qi deficiency of both lung and spleen accompanying with stagnation, and regulating the spleen and stomach to promote transportation and transformation can be used as the main therapeutic method.