婴幼儿鼠伤寒沙门菌肠炎恢复期带菌者中医证候分析

Analysis of traditional Chinese medicine syndromes in convalescent carriers of Salmonella typhimurium enteritis in infants

目的探讨婴幼儿鼠伤寒沙门菌肠炎恢复期带菌者的中医证候特点,为中医药的辨证证论治提供临床思路。方法在2016年6月至2018年12月诊治的婴幼儿鼠伤寒沙门菌肠炎恢复期带菌者中进行相关调查及分析,通过填写中医证候调查表采集中医症状和体征资料,对此总结和分析后进行辨证证分型。结果研究共纳入40例鼠伤寒沙门菌肠炎恢复期带菌婴幼儿,中医症状及体征方面以纳差、大便有黏液、腹胀满、便溏、舌质淡、形体偏瘦、精神疲倦及舌苔腻为主要表现,中医辨证分型为脾虚夹湿证(35%)、脾失健运证(20%)、脾胃气虚证(20%)、脾胃虚寒证(10%)、脾胃阴虚证(7.5%)及湿困中焦证(7.5%)。结论婴幼儿鼠伤寒沙门菌肠炎恢复期带菌的主要病机为泻下耗伤及药物影响,导致脾胃运化功能受损;治疗上应以健脾助运化湿为基本治则,充分发挥中医药多层次、多环节的治疗优势,达到清除滞留肠道鼠伤寒沙门菌的目的。

Objective To explore the characteristics of TCM syndromes in convalescent carriers of Salmonella typhimurium enteritis in infants,in order to provide clinical ideas for TCM differential treatment.Methods Relevant investigation and analysis were carried out in the convalescent carriers of Salmonella typhimurium enteritis in infants who were diagnosed and treated from June 2016 to December 2018,and the symptoms and signs of TCM were collected by filling in questionnaires of TCM syndromes,which were summarized and analyzed to make differential typing.Results Totally 40 cases of convalescent carriers of Salmonella typhimurium enteritis in infants were included in the study,whose main TCM symptoms and signs were poor appetite,mucus in stool,abdominal distention,loose stool,pale tongue quality,lean body shape,mental fatigue,and greasy tongue coating,and the TCM syndromes included syndrome of spleen denciency and damp trap(35%),spleen insufficiency syndrome(20%),syndrome of deficiency of spleen and stomach-qi(20%),syndrome of deficiency-coldness of spleen and stomach(10%),syndrome of deficiency of spleen and stomach-yin(7.5%)and syndrome of dampness stagnation of Middle Jiao(7.5%).Conclusion The main pathogenesis of convalescent carriers of Salmonella typhimurium enteritis in infants is consumption due to diarrhea and drug effects,which causes damage to the function of spleen and stomach.The basic principle of treatment is to invigorate spleen,promote digestion and remove dampness by giving full play to the treatment advantages of TCM at multiple levels and links,in order to achieve the goal of eliminating Salmonella typhimurium in intestinal tract.