基于五体痹、五脏痹理论阐释儿童系统性红斑狼疮的辨证特点

Interpretation on the characteristics of the syndrome differentiation of systemic lupus erythematosus based on the theory of five-tissue and five-zang bi syndromes

目的以五体痹、五脏痹理论为基础,研究儿童SLE各体痹、脏痹分布及组合特点,为儿童SLE临床中医治疗提供指导。方法通过随机抽样的方法,收集2006年6月至2016年6月我院255例SLE患儿的资料。利用统计学方法,研究各体痹、脏痹分布特点,对各痹病的组合类型及方式进行统计分析。结果 (1)在本组资料中,SLE患儿男女比例约为1∶4,平均年龄为(9. 92±2. 78)岁。(2)255例SLE患儿的各痹病病程主要集中在<2月区段。(3)各痹病的分布:五体痹以皮痹(81. 18%)为主,五脏痹中以肾痹(56. 86%)、肝痹(44. 31%)、心痹(34. 12%)为主。(4)各痹病组合类型中,单一痹病型共23例,主要为皮痹(60. 87%)。痹病组合型以三痹病相兼型(36. 47%)和两痹病相兼型(32. 94%)为主。两痹病及以上相组合的类型占90. 59%。结论 (1)255例SLE患儿各痹病多数在短期内发病。(2)痹病的分布:五体痹以皮痹为主,五脏痹以肾痹、肝痹、心痹为主。(3)痹病组合类型以相兼痹病居多。(4)儿童五体痹五脏痹的发病特点与儿童生理病理特点及SLE的病因病机基本一致。

Objective To explore the distribution of the five-tissue and five-zang bi syndromes and the compound characteristics in children with systemic lupus erythematosus(SLE) on the base of the theory of five-tissue and five-zang bi syndromes so as to provide the guideline of TCM for the clinical treatment of SLE in children. Methods According to the randomization method,the data of 255 SLE cases of children were collected from June 2006 to June 2016. Using the statistical method,the distribution of the five-tissue and five-zang bi syndromes was explored. The compounds of bi disorders were analyzed statistically. Results 1. Regarding the basic data,the ratio of male and female was 1 to 4 and the average age was(9. 92 ± 2. 78) years. 2. In 255 cases,the duration of SLE of every type was less than 2 months. 3. Regarding the distribution of the various bi disorders,the bi syndrome of skin was predominated,accounting for 81. 18% of five-tissue bi syndrome,the bi syndromes of kidney(56. 86%),liver(44. 31%) and heart(34. 12%) were predominated among five-zang bi syndrome. 4. Regarding the compound of bi disorders,there were 23 cases of single bi disorder,focusing on bi disorder of skin(60. 87%). The compounds of three bi disorders(36. 47%) and two bi disorders(32. 94%) were predominated. 90. 59% of the compound bi disorders were the combination of two or more two bi disorders. Conclusion1. Among 255 cases of SLE,the bi disorders occur in a short time. 2. Regarding the distribution of bi disorders,the bi syndrome of skin is predominated in the five-tissue bi syndrome and the bi syndromes of kidney,liver and heart are predominated in the five-zang bi syndrome. 3. The compound bi disorders are in the majority. 4. The occurrence characteristics of the five-tissue bi disorders and the five-zang bi disorders are basically in compliance with the physiological and pathological characteristics as well as the etiology and pathogenesis of SLE in children.