儿童春季流行性感冒中医临床特点与证治探讨

Discussion on clinical characteristics and syndrome differentiation and treatment of children's spring influenza in traditional Chinese medicine

2023年春季北京市进入流行性感冒(简称“流感”)高发期,儿童流感以甲型流感病毒感染为主。今年的流感季较之往年错后,考虑与春季气候偏暖、人员流动性增加等相关。流感属中医学“风温”范畴,初期多表现为肺卫表热证,其内传既可顺传至气营分,又可逆传至心包。与成人流感比较,儿童的发热程度通常较成人高,消化道症状多见,并发喉炎、中耳炎、支气管炎、坏死性脑病也较成人普遍,恢复期的患儿咳嗽以及体力恢复时间较成人更长。在中医辨证方面,轻症患儿多以风热犯卫证型多见,也可见肺胃热盛证、湿遏卫气证;重症患儿则多属邪热逆传心包证;恢复期以余邪未尽、肺胃阴伤证为主。春季流感大部分患儿预后良好,应注意合并症的发生,早期及时有效用药,可防止变证、危证的发生。

In the spring of 2023,Beijing enters a high incidence period of influenza,and children's influenza will be dominated by influenza A virus.Compared to the previous years,the influenza season this year is postponed,considering it is relatedto the warmer climate in this spring and increased personnel mobility.Influenza belongs to the category of"wind and febrile pathogenic facotrs"in traditional Chinese medicine.At the initial stage,it is mainly manifested as the syndrome of exterior heatin thelung and it can not only be transmitted interiorly to qi and nutrient level,but also to the pericardium reversibly.Compared to adult influenza,children usually have higher fever than adults,and the gastrointestinal symptoms are more common.Laryngitis,otitis media,bronchitis and necrotizing encephalopathy are also more commonly complicated than adults.Children suffer from longer cough and physical recovery times than adults in the recovery period.In terms of syndrome differentiation in traditional Chinese medicine,the syndrome type of wind heat invading defensive qi is more seen in children with mild condition,the syndrome of excessive lung and stomach heat,and the syndrome of dampness suppressing the defensive qi.Syndrome of inverse transmission of pathogenic heatto pericardiumis mostly found in severe children.In the recovery period,the main symptoms were caused byresidual pathogenic factors not being cleared and lung and stomach yin damaged.The prognosis is goodin most children with influenza in spring.Attention should be paid to the occurrence of complications.Early and effective medication can prevent the occurrence of syndrome change and endangered syndrome.