从咳嗽时辰规律探讨小儿咳嗽变异性哮喘的证候分布

Observe syndrome distribution of cough variant asthma from coughing hour

目的从咳嗽时辰规律探讨小儿咳嗽变异性哮喘的证候分布,为临床辨治本病提供参考依据。方法记录咳嗽变异性哮喘患儿咳嗽发作时辰并进行辨证,计算出各证候的构成比,利用圆形统计法分析各证候的发病高峰期及集中趋势。结果 162例咳嗽变异性哮喘患儿证候以痰热壅肺证、阴虚肺热证居多。各证候事件发生率依次为痰热壅肺证(25.93%)>阴虚肺热证(20.37%)>痰湿蕴肺证(18.52%)>肺脾气虚证(15.43%)>肝火犯肺证(13.58%)>外寒内饮证(6.17%);发病时辰具有集中趋势,高峰点在7时4分即辰时,高峰期为辰时、子时、卯时,高峰期处清晨及夜间。痰热壅肺证发病时辰高峰点为8时25分即辰时,高峰期集中于清晨;痰湿蕴肺证发病时辰高峰点为8时15分,高峰期为卯时到辰时,集中于清晨;阴虚肺热证发病时辰高峰点在23时28分即子时,时辰高峰期集中在夜间,为亥时及子时。3个证候时辰集中高峰皆非常明显。肝火犯肺证、肺脾气虚证、外寒内饮证在发病时辰上无一定的集中性,未发现特定的发病高峰期。结论小儿咳嗽变异性哮喘发病时间具有明显的规律性,在临床辨证时应给予重视。

Objective To observe syndrome distribution of cough variant asthma from the coughing hour in order to provide reference for the clinical treatment of the disease. Methods Record coughing hour of the children with cough variant asthma and differentiate the syndrome. Calculate the composition ratio of the syndrome,and the peak incidence of various syndromes and the trend of concentration were analyzed by circular statistical method.Results In the 162 patients with cough variant asthma syndrome,most cases were syndrome of phlegm heat accumulating in the lung,and syndrome of yin deficiency with lung heat. The event rate order were syndrome of phlegm heat in the lung（25. 93%）〉syndrome of Yin deficiency with lung heat（20. 37%）〉syndrome of phlegm dampness in the lung（18. 52%）〉lung and spleen qi deficiency syndrome（15. 43%）〉syndrome of liver fire invading lung（13. 58%）〉syndrome of external cold and internal drink（6. 17%）; the incidence time had the trend of concentration. The peak point was at 7：04; the peak period was at Chen,Zi and Mao,early in the morning or at night. Syndrome of phlegm heat obstructing lung peak point was at 8：25,concentrated in the morning;phlegm dampness in pulmonary heat disease peak at 8：15; yin deficiency of lung heat syndrome peak point was at 23：28. Three syndromes had the own concentration peak hour. Syndrome of liver fire invading lung,syndrome of lung and spleen qi deficiency,syndrome of external cold and internal drink had not fixed concentration hour. Conclusion Pediatric cough variant asthma onset time has obvious regularity,worthy of more attention in clinical differentiation.