中医视角下发热门诊2021-2022全年7203例患者发病时令特征研究

Study on the Seasonal Characteristics of 7203 Cases in the Fever Clinic from 2021 to 2022 from a Traditional Chinese Medicine Perspective

目的 研究发热门诊就诊的发热性疾病(以下称为“普通外感发热性疾病”)的发病时令特点。方法选取首都医科大学附属北京中医医院发热门诊2021年1月20日(大寒节气)至2022年1月20日(大寒节气)全年就诊的患者为研究对象,总结普通外感发热性疾病的发病时令特点。结果 1)普通外感发热性疾病二十四节气均有发病,且发病人数与节气变化存在显著的非线性相关关系(R2=0.755 2,adj.R2=0.703 7,AIC=239.081,F=14.65,P <0.001),发病人数最高的3个节气为小寒、冬至、大暑,发病人数最低的3个节气为立春、惊蛰、大寒,平均每个节气发病人数为131.29例;2)高发病节气为小寒、冬至、大暑、芒种、夏至、立秋(1 232例,占比39.10%),低发病节气为小雪、立冬、处暑、白露、寒露、秋分、雨水、大寒、惊蛰、立春(860例,27.29%);从四季来区分发病水平,则夏季发病水平最高(935例,29.67%),秋季发病水平最低(622例,19.74%);此外发热性疾病的就诊人数与当日气象的最高温/最低温存在显著非线性相关关系(最高温F=16.36,P <0.001;最低温F=15.89,P <0.001),过高温和过低温均出现就诊人数增多现象。结论 普通外感发热性疾病的发病具有时令特征,且气候温度太高或太低均会导致发热就诊人数增加。针对民众可指导其随时令养生防病,在极端气候天气尤其应注意健康,针对医疗机构,可在高发病时令做好人力支援、药品储备、患者分流等应对预案。

Objective:To study the seasonal characteristics of fever cases caused by febrile disease(common ex⁃ogenous febrile diseases)in the fever clinic.Methods:Patients who visited the fever clinic of the Beijing Hospi⁃tal of Traditional Chinese Medicine affiliated to Capital Medical University from January 20,2021(the Great Cold)to January 20,2022(the Great Cold)were selected as the research subjects,summarizing the seasonal characteris⁃tics of common exogenous febrile diseases.Results:1)Common exogenous febrile diseases occurred during all twenty-four solar terms,and the number of cases had a significant nonlinear correlation with the change of solar terms(R2=0.7552,adj.R2=0.7037,AIC=239.081,F=14.65,P<0.001).The three solar terms with the highest number of cases were Minor Cold,Winter Solstice,and Major Heat,while the three solar terms with the lowest number of cases were Start of Spring,Awakening of Insects,and Great Cold,with an average of 131.29 cases per solar term;2)The solar terms with the highest incidence were Minor Cold,Winter Solstice,Major Heat,Grain in Ear,Summer Solstice,and Start of Autumn(1232 cases,accounting for 39.10%),while those with the lowest inci⁃dence were Light Snow,Start of Winter,Limit of Heat,White Dew,Cold Dew,Autumn Equinox,Rain Water,Great Cold,Awakening of Insects,and Start of Spring(860 cases,27.29%).Dividing by seasons,summer had the highest incidence level(935 cases,29.67%),while autumn had the lowest incidence level(622 cases,19.74%).Additional⁃ly,the number of fever cases correlated significantly with the maximum and minimum temperatures of the day(maximum temperature:F=16.36,P<0.001;minimum temperature:F=15.89,P<0.001),with increases noted when temperatures were either too high or too low.Conclusion:Common exogenous febrile diseases exhibit seasonal characteristics,and both extremely high and low temperatures lead to an increase in the number of fever cases.For the public,this suggests that health preservation should be adjusted according to the seasons,especially during ex⁃treme weather conditions.For medical institutions,it is necessary to prepare for staffing support,drug reserves,pa⁃tient diversion and contingency plans during periods of high incidence.