广州大学城312例登革热患者中医体质特征分析

Distribution of Traditional Chinese Medicine Constitution Types of Dengue Fever Patients Dwelling in Guangzhou Higher Education Mega Center:An Analysis of 312 Cases

【目的】分析登革热患者的中医体质特征,为登革热的预防提供科学的依据,为登革热的治疗提供个体化的思路。【方法】312例登革热患者完善血常规、肝功能2项、肾功能、心酶3项、血清登革病毒NS1抗原及胸片检查,并根据《中医体质分类与判定自测表》进行标准化的中医体质类型分类,研究不同体质类型登革热患者的发病特点及临床特征。【结果】(1)临床表现:本研究所纳入的312例登革热患者临床表现为发热、头痛、全身肌肉关节酸软疼痛、疲倦乏力、皮疹和/或皮下出血点;不同体质类型的登革热患者,除发热的症状外,其他主要临床表现的侧重点不同,平和质和气虚质疲倦乏力的表现明显,阳虚质、痰湿质和气郁质头痛的表现明显,湿热质全身肌肉关节酸软疼痛的表现明显。(2)辅助检查:出现血常规异常和合并肺炎,以及出现肝功能、肾功能和心酶3项异常最多的均是湿热质,其次为痰湿质、气虚质、平和质等。(3)中医体质类型:本研究所纳入312例登革热患者中,以偏颇体质占绝大多数,其中以湿热质最多见,其他依次为痰湿质、气虚质、平和质、阳虚质、血瘀质、阴虚质、气郁质、特禀质等。【结论】登革热患者以偏颇体质占绝大多数,其中湿热质最多见,痰湿质和气虚质次之,可为临床有针对性地对易感人群从调整体质的角度预防登革热提供科学的依据,并可为登革热患者依据不同体质类型提供个体化的治疗提供思路。

Objective To analyze the characteristics of traditional Chinese medicine （TCM）physique of dengue fever patients, thus to provide scientific basis for the prevention and individualized way for the treatment of dengue fever. Methods A total of 312 cases of dengue fever patients were enrolled into the study. All of the patients had the routine blood test, hepatic and renal function examination, 3-item heart enzyme test, serum dengue virus NS1 antigen level detection and chest X-ray examination. In accordance with TCM Constitution Type Classification and Discrimination Self-esteem Scale, TCM constitution types and clinical manifestations of the dengue fever patients were investigated. Results （1）The clinical manifestations of the 312 dengue fever patients showed as follows： dengue fever, headache, soreness and weakness of the general body and joint pain, fatigue and weakness, rash and/or hypodermic hemorrhage. Besides the fever, the clinical manifestations varied in patients with different TCM constitution types： harmony constitution and qi-deficiency constitution had obvious fatigue and weakness, yang deficiency constitution, phlegm-dampness constitution and qi-stagnation constitution had obvious headache, and damp-heat constitution had obvious soreness and weakness of the general body and joint pain. （2）Damp-heat constitution patients had the highest incidences of abnormal levels of blood test, complicated pneumonia, hepatic and renal function disorder, and abnormal 3-item heart enzyme levels, and phlegm-dampness constitution, qi-deficiency constitution and harmony constitution came next.（3）The 312 patients were characterized by biased constitution. The percentage of damp-heat constitution was the highest, and then came phlegm-dampness constitution, qi-deficiency constitution, harmony constitution, yang-deficiency constitution, blood-stasis constitution, yin-deficiency constitution, qi-stagnation constitution, and specific constitution in decreasing sequence. Conclusion The constitution of dengue fever patients is dominated by biased constitution, the percentage of damp-heat constitution is the highest, and then come phlegm-dampness constitution and qi-deficiency constitution. The results will provide scientific basis for the prevention and individualized way for the treatment of dengue fever.