北京地区2010～2011年冬季150例流行性感冒样病例中医证候分析

Analysis of TCM syndrome for 150 influenza-like cases from Beijing in the winter of 2010-2011

目的对北京地区2010～2011年冬季流行性感冒样病例中医证候进行调查研究,总结特点,有助于提高对流行性感冒样病例的认识,准确进行辨证论治。方法对150例北京地区2010～2011年冬季流行性感冒样病例中医证候进行调查研究。(1)以首发症状的不同,将病例分为恶寒发热组和咳嗽咽痛组,分析就诊时中医证候特点;(2)以1月10日为时间节点将病例分为两组,分析其就诊时的中医证候特点。结果 (1)发热、肌肉酸痛为流行性感冒样病例通常出现症状;(2)恶寒发热组病例就诊时恶寒恶风、项紧、流涕、头痛等症状明显多于咳嗽咽痛组,以风寒束表证为主;咳嗽咽痛组就诊时咳嗽、咽痛、鼻塞等症状明显多于恶寒发热组,以风热犯卫证为主;(3)1月10日以前组病例就诊时恶寒恶风、项紧、流涕、头痛等症状明显多于1月10日以后组,以风寒束表为主;1月10日以后组就诊时咳嗽、咽痛、鼻塞等症状明显多于1月10日以前组,以风热犯卫证为主。结论流行性感冒样病例监测要重视病人的首发症状,对于判断病邪性质、感邪途径、传变规律以及确定治法有一定的指导意义;不同时间的流行性感冒样病例呈现不同的中医证候特点,可能提示致病病原发生改变。

Objective To investigate TCM syndrome of influenza-like cases in Beijing during winter of 2010-2011.The result can be applied to improve the understanding of influenza-like cases and to guide the syndrome differentiation of this kind of disease.Method The TCM syndromes of 150 cases of influenza-like cases from Beijing in the winter of 2010-2011 were thoroughly investigated and studied.（1）According to the difference of initial symptoms,all cases were divided into aversion to cold with fever group and sore throat with cough group.And their TCM syndrome differentiation was analyzed in the consultations respectively.（2）The cases were divided into two groups by onset time with 10th of January as dividing point.And their TCM syndrome differentiation were analyzed in the consultations respectively,too.Results（1）Fever and muscle soreness was the typical syndrome of influenza-like cases.（2）Symptoms as aversion to cold and wind,neck stiff,nose-bleeding were more frequently found in aversion to cold with fever group.And attacking on the lung by wind and heat was their main syndrome pattern.（3）Symptoms as aversion to cold and wind,neck stiff,nose-bleeding and rhinostegnosis were more frequently found in cases before 10th of January than cases after that date.And wind-cold tightening the exterior was their main syndrome pattern.The group with cases after 10th of January had higher occurrence rate of cough,sore throat and rhinostegnosis than the other group.And attacking on the lung by wind and heat was their main syndrome pattern.Conclusion Initial symptoms should be attached with much more attention in surveillance of influenza-like cases.For they are useful in judging the character of pathogenic factors,ways of infection and progressive pattern of the disease and in establishing therapeutic method.The fact that influenza-like cases with different onset time manifest with distinct syndrome patterns probably indicate that the pathogenic factors are changing.