基于伏邪理论探讨天津市2007—2017年过敏性鼻炎滞后发病与气象因素的相关性

Correlation between Delayed Onset of Allergic Rhinitis and Meteorological Factors in Tianjin from 2007 to 2017:Based on the Theory of Hidden Pathogen

目的探讨气象因素对过敏性鼻炎滞后发病的影响。方法收集天津市2007年1月—2017年12月逐月过敏性鼻炎病例资料及气象资料,采用Spearman相关分析及R 3.5.1软件提供的分布滞后非线性模型(DLNM)和Splines软件包,分析气象因素对过敏性鼻炎发病滞后性的影响。结果天津市过敏性鼻炎病例就诊率出现两个高峰,主高峰出现在8—9月,次高峰出现在4—5月,而在1—2月就诊率最低。过敏性鼻炎月病例数与月相对湿度(rs=0.176)、月平均气温(rs=0.241)、月最高气温(rs=0.309)、月日照时数(rs=0.255)呈正相关(P<0.05);与月平均风速(rs=0.229)呈负相关(P<0.05)。当月平均气温、月相对湿度、月日照时数分别在25~30℃、35%~50%、300 h,滞后时间分别为1个月、0.5个月、0.5~1个月时过敏性鼻炎滞后发病的效应达到第一个高峰;而当月平均风速分别在1~1.5m/s、2~2.5m/s,滞后时间分别为1个月、2个月时,过敏性鼻炎滞后发病效应出现第二个高峰。各气象因素滞后效应与过敏性鼻炎发病的关系,月最高气温为27.5℃的滞后效应均在滞后1个月时达到最高,相对危险度(RR值)为1.583(1.051~2.384)(P<0.05);相对湿度为45%的滞后效应在滞后0个月时达到最高,RR值为1.087(1.015~1.217)(P<0.05);月日照时数256 h的滞后效应在滞后1个月时达到最高,RR值为1.113(1.001~1.258)(P<0.05);低风速1 m/s的滞后效应在滞后0个月时达到最高,RR值为1.062(1.003~1.213)(P<0.05),高风速2 m/s的滞后效应在滞后2个月时达到最高,RR值为1.075(1.010~1.194)(P<0.05)。结论月平均气温、月相对湿度、月日照时数及月平均风速对过敏性鼻炎滞后发病具有影响,其中尤以月平均风速滞后影响时间最长。

Objective To explore the influence of meteorological factors on the delayed onset of allergic rhinitis.Methods The monthly data of allergic rhinitis cases and meteorological data in Tianjin from January 2007 to December 2017 were collected.Spearman correlation analysis and distributed lag nonlinear model(DLNM)provided by R 3.5.1 software and Splines software package were used to analyze the influence of meteorological factors on the delayed onset of allergic rhinitis.Results There were 2 peaks in the medical consultation rate of allergic rhinitis in Tianjin.The main peak occurred in August to September,the secondary peak occurred in April to May,and the medical consultation rate was the lowest in January to February.The number of monthly cases of allergic rhinitis was positively correlated with monthly relative humidity(rs=0.176),monthly average temperature(rs=0.241),monthly maximum temperature(rs=0.309),and monthly sunshine hours(rs=0.55)(P<0.05);it was negatively correlated with monthly average wind speed(rs=0.229)(P<0.05).Allergic rhinitis delayed onset reached the first peak when the monthly average temperature was 25-30℃,monthly relative humidity was 35%-50%,and monthly sunshine hours was 300 h,and the lag time was respectively 1 month,0.5 month,and 0.5-1 month.The effect of onset reached the second peak while the monthly average wind speed was 1-1.5 m/s,2-2.5 m/s,and the lag time was 1 month and 2 months.The relationship between the hysteresis effect of various meteorological factors and the onset of allergic rhinitis,the hysteresis effect of high temperature 27.5℃reached the highest at 1 month lag,and the relative risk(RR value)was 1.583(1.051-2.384)(P<0.05);The hysteresis effect of 45%humidity reached the highest at 0 month lag,and the RR value was 1.087(1.015-1.217)(P<0.05);the hysteresis effect of high sunshine hours of 256h reached the highest at 1 month lag,and the RR value was 1.113(1.001-1.258)(P<0.05);the hysteresis effect of low wind speed of 1m/s reached the highest when the lag was 0 months,the RR value was 1.062(1.003-1.213)(P<0.05).The hysteresis effect of the high wind speed of 2m/s reached the highest when the lag was 2 months,and the RR value was 1.075(1.010-1.194)(P<0.05).Conclusion Monthly average temperature,monthly relative humidity,monthly sunshine hours and monthly average wind speed have an impact on the delayed onset of allergic rhinitis,especially the monthly average wind speed has the longest impact.