学龄期儿童肺炎支原体肺炎的中医体质和治疗探讨

Discussion on the traditional Chinese medicine constitution and treatment of school-age children with Mycoplasmal pneumoniae pneumonia

目的探讨学龄期儿童肺炎支原体肺炎(Mycoplasmal pneumoniae pneumonia,MPP)的中医体质、病机、治疗方法。方法选取2023年9月至12月在北京市石景山医院中医科门诊就诊的110例学龄期MPP患儿作为观察组;选取同期门诊就诊的无发热、呼吸系统症状的35例学龄期患儿作为对照组。比较两组患儿的中医体质、证型、病因、病位等。结果观察组患儿中医体质以平和质、湿热质为多;证型以痰热闭肺证、风热闭肺证、阴虚肺热证为多。体质与证候无明显相关性(χ^(2)=3.16,P=0.21,Cramer’s V=0.17)。观察组患儿病位多为肺-大肠、心;病因多为热、痰湿、瘀血、风。两组患儿的中医体质分布比较,差异有统计学意义(χ^(2)=12.32,P=0.002)。结论湿热质患儿对MPP可能有一定的易感性。对学龄期儿童MPP的治疗应注意不能忽略心系病症和瘀血,同时采用病证症结合的中西医结合治疗,并注意体质调整。

Objective To explore the constitution,pathogenesis and treatment of school-age children with Mycoplasmal pneumoniae pneumonia(MPP).Methods A total of 110 school-age children with Mycoplasmal pneumoniae pneumonia treated in the outpatient Traditional Chinese Medicine Department,Beijing Shijingshan Hospital from September to December 2023 were selected as observation group.35 school-age children with no fever or respiratory symptoms were selected as control group,and the traditional Chinese medicine constitution,syndrome type,etiology and disease location of the two groups were compared.Results The traditional Chinese medicine constitution of the children in observation group was mainly peaceful quality and moist heat quality.The syndrome types were phlegm-heat blocking lung syndrome,wind-heat blocking lung syndrome and Yin deficiency lung heat syndrome.There was no significant correlation between physical constitution and syndrome(χ^(2)=3.16,P=0.21,Cramer’s V=0.17).In observation group,most of the diseases were lung,large intestine and heart.The causes were heat,phlegm dampness,blood stasis and wind.There was a statistically significant difference in the distribution of traditional Chinese medicine constitution between two groups of pediatric patients(χ^(2)=12.32,P=0.002).Conclusion Children with damp-heat constitution may have a certain susceptibility to Mycoplasmal pneumoniae pneumonia.The treatment of school-age children with Mycoplasmal pneumoniae pneumonia should not ignore the disease of the heart system and blood stasis,at the same time,the combination of“disease,syndrome and symptom”,and pay attention to physical adjustment.