1228例过敏性紫癜儿童中医证候分布规律研究

TCM Pattern Distribution in 1 228 Children with Allergic Purpura

目的探讨过敏性紫癜患儿中医证候分布规律及其相关因素。方法采用回顾性研究，收集1228例过敏性紫癜患儿的临床资料，总结其中医证候分布规律，并比较各证型患儿一般资料、发病季节、诱因、病程、疾病类型、实验室指标不同水平分布情况。结果1228例患儿中血热妄行证846例（68．9％），风热伤络证362例（29．5％），气阴两虚证13例（1．1％），阴虚火旺证7例（0.5％）。1228例患儿中3^＋～14岁1133例（92．3％），冬季、春季发病853例（69．5％），由上呼吸道感染诱发322例（26．2％），病程在4周以内111例（90．5％），血小板计数升高591例（48．1％），血浆纤维蛋白原升高403例（32．8％）。各证型患儿性别分布、外周血白细胞不同水平分布差异无统计学意义（P〉0.05）；年龄、发病季节、诱发因素、西医临床类型、病程，血小板、血浆纤维蛋白原、D-二聚体不同水平分布差异有统计学意义（P〈0.05）。结论过敏性紫瘢患儿中医证型以血热妄行型、风热伤络为主，男女发病比例相当，以春季、冬季多发，病程多在4周以内，呼吸道感染为其主要诱发因素，且患儿多有高凝表现。

Objective To study the TCM pattern distribution of allergic purpura （AP） in children. Methods A retrospective study was used to collect the clinical data in 1228 AP children and the TCM pattern distribution was analyzed. The general information, seasonal incidence, predisposing factors, duration, type of disease and laboratory parameters were compared in children with various patterns. Results There were 846 cases （68. 9%） of bleeding due to blood-heat pattern, 362 cases （29.5 % ） of wind-heat damaging collaterals pattern, 13 cases （1.1%） of qi-yin deficiency pattern and 7 cases （0.5 %） of yindeficiency fire-hyperactivity pattern. There were 1125 （91.6 %） 3＋-to-14-year-old children, 853 cases （69.5 %） were onset in winter or spring, 322 cases （26.2%） were induced by upper respiratory tract infection, 111 cases （90.5%） within 4-week duration, 591 cases （48.1%） with increased platelet count and 403 cases （32.8 %） with elevated plasma fibrinogen. There was no significant difference between various patterns in the gender distribution or in the distribution of levels of white blood cells （P〉 0.05）. There were significant differences between various patterns in the distributions of age, seasonal incidence, predisposing factors, clinical types, duration, and levels of platelets, fibrinogen and D-2 dimer （P〈0.05）. Conclusion The common TCM patterns of AP in children are bleeding due to blood-heat pattern and wind-heat damaging collaterals pattern. The male and female incidence of AP is same. AP is mainly occurred in spring or winter within 4-week duration, mainly induced by respiratory tract infection with a hypercoagulable performance.