学龄前期儿童胃肠积热相关因素的配对病例对照研究

Pair-matched case-control study on factors associated with gastrointestinal heat retention in preschool children

目的探索学龄前期儿童胃肠积热发生的相关因素,为后续胃肠积热临床研究提供参考。方法采用配对病例对照研究,选取2021年5—7月广东省深圳市龙岗区幼儿园的儿童为研究对象。根据《儿童胃肠积热诊断自评量表》分为病例组(纳入胃肠积热儿童)和对照组(纳入非胃肠积热儿童),线上调查儿童饮食行为、抚养人喂养行为、早期抗生素使用情况、起居习惯、出生情况。采用SPSS 27.0软件,根据一般社会人口学信息精准配对,以配对logistic回归分析胃肠积热与上述因素的相关性。结果共获得配对病例51252对。配对logistic回归分析结果显示,多种因素与胃肠积热发病风险升高有关,包括相较于同龄人吃得少、抚养人汇报儿童挑食、进餐分心、强烈饮食偏好、对食物缺乏兴趣、进餐时长≥25 min、不愿尝试新食物、拒绝某类食物1个月以上、进餐地点不固定、迫使儿童进餐、使用微量营养素补充剂、允许儿童随意选择食物、诱导儿童进餐、很少鼓励儿童品尝新食物、早期使用抗生素、缺乏睡眠、早产(P<0.05);而6月龄内纯母乳喂养、适度或较大的运动量、规律午休与胃肠积热发病风险降低有关(P<0.05)。结论不良的饮食行为、不恰当的喂养方式、缺乏运动、缺乏睡眠、早期使用抗生素可能是胃肠积热的危险因素,后续研究探索胃肠积热的病因时应重点关注这些因素。

Objective To identify factors associated with gastrointestinal heat retention in preschool children,and to provide a foundational understanding for future clinical investigations.Methods A case-control study was performed,which involved children from kindergartens in the Longgang District of Shenzhen City,Guangdong Province,from May to July 2021.Using the Children′s Gastrointestinal Heat Retention Diagnostic Self-assessment Scale,subjects were allocated into a case group(children diagnosed with gastrointestinal heat retention)and a control group(children without this condition).An online survey was used to collect data on dietary behaviors,caregivers′feeding behaviors,early antibiotic use,daily routines,and birth conditions.SPSS 27.0 software was used to facilitate precise sociodemographic matching and paired logistic regression analysis to explore the association between gastrointestinal heat retention and the above factors.Results From the analysis of 51,252 matched cases,the study found that several factors contributed to an increased risk of gastrointestinal heat retention.These factors included reduced food intake compared to peers,reports of picky eating by caregivers,distractions during meals,pronounced dietary preferences,disinterest in food,meal durations≥25 min,reluctance to sample new foods,consistent refusal of specific food types for over one month,irregular meal locations,coercive feeding practices,use of micronutrient supplements,allowing children too much freedom in food choice,persuading children to eat,infrequent encouragement to experiment with new foods,early antibiotic introduction,inadequate sleep,and premature birth(P<0.05).In contrast,exclusive breastfeeding in the first six months,engagement in moderate to massive physical activity,and regular napping patterns were associated with a reduced risk of gastrointestinal heat retention(P<0.05).Conclusion The suboptimal dietary habits,improper feeding practices,insufficient physical activity,inadequate sleep,and premature antibiotic exposure may be significant risk factors for gastrointestinal heat retention.Future research dedicated to unraveling the cause of gastrointestinal heat retention should prioritize these elements.