基于现代文献分析普通型手足口病证候、证素分布特点及常见证候与症状对应关系

Distribution of patterns,pattern elements and the relationship between common patterns and corresponding symptoms/signs: a modern literature study on common hand-foot-mouth disease

目的分析20年手足口病临床研究文献,归纳其证候、证素分布特点及常见证候与症状对应关系,以期为中医药辨证论治手足口病提供参考。方法以主题"手足口病"或者"手足口"和主题"中医"或者"证"作为检索词,从中国期刊全文数据库、维普期刊全文数据库、万方数据资源系统中检索文献,剔除不相关文献,运用Epidata 3.0软件建立规范数据库,运用SPSS 17.0软件对症状/体征、证候和证素出现的频次和频率进行统计分析和相关Logistic回归分析。结果普通型手足口病症状/体征频次较高的为皮疹、发热和纳差等。证候频次较高的是肺脾湿热证、湿热郁蒸证和邪犯肺卫证。证素方面,频次较高的病位是肺、脾、卫分;病性是湿热、热。Logistic回归分析,肺脾湿热证最可能的症状依次是口流涎、指纹紫;湿热郁蒸证最可能的症状依次是厚苔、壮热、指纹浓滞;邪犯肺卫证最可能的症状依次是鼻流涕、咳嗽。结论普通型手足口病最常见的证候类型是肺脾湿热证、湿热郁蒸证和邪犯肺卫证;手足口病常见的病位证素为肺、脾、卫分,常见的病性类证素为湿热、热。

Objective Through retrospective study of latest 20 years＇ modern literature related to common hand-foot-mouth disease,the distribution of pattern elements and the relationship between common patterns and corresponding symptoms / signs were analyzed,so as to provide the basis for standardization of TCM pattern differentiation for hand-foot-mouth disease. Methods ＂hand-foot-mouth disease ＂OR＂hand-foot-mouth＂AND＂pattern＂OR＂Chinese medicine＂were used as subject words in CNKI,Wanfang and VIP database to retrieve the relevant literature. Search results were input to establish the standard database by using Epidata 3. 0 software,then frequency of symptoms,pattern and pattern elements logistic regression analysis were analyzed by SPSS 17. 0. Results The leading symptoms and signs of common hand-foot-mouth disease were rash,fever and anorexia. The common patterns were damp-heat pattern of lung and spleen,pattern of stagnation and steaming of damp-heat and pattern of pathogen invading lung-defense phase. The disease-locations with high frequency were lung,spleen and defense and the disease-natures with high frequency were damp-heat and heat. After Logistic regression analysis,the symptoms / signs of damp-heat pattern of lung and spleen were slobbering and purple venule of index finger,those of pattern of stagnation and steaming of damp-heat were thick tongue coating,high fever and dark,thick venule of index finger,and those of pattern of pathogen invading lung-defense phase were running nose and cough. Conclusion The common patterns types of common hand-foot-mouth disease were damp-heat pattern of lung and spleen,pattern of stagnation and steaming of damp-heat and pattern of pathogen invading lung-defense phase. And the common location elements were lung,spleen and defense with the common nature elements of damp-heat and heat.