甲基丙二酸尿症脑损伤患儿中医证候规律研究

Study on TCM Syndrome Regularity of Brain Injury in Children with Methylmalonic Aciduria

目的:探讨甲基丙二酸尿症(methylmalonic aciduria,MMA)脑损伤患儿中医证素特点、证型分类及分布规律。方法:收集162例MMA脑损伤患儿的中医四诊信息,运用因子分析及系统聚类方法,探讨其中医证候规律。结果:MMA脑损伤患儿病位证素以心、脾、肾、肝为主,病性证素主要为气虚、精亏、阴虚、阳虚、痰、湿、血瘀;中医证候表现为心脾两虚证、脾肾阳虚证、肝肾亏虚证、痰瘀阻滞证和脾虚肝亢证5类;证型分布比例分别为心脾两虚证30.3%(49/162)、脾肾阳虚证29.6%(48/162)、肝肾亏虚证17.3%(28/162)、痰瘀阻滞证14.8%(24/162)、脾虚肝亢证8.0%(13/162)。其中,不同年龄段患儿证型分布存在差异。结论:通过对MMA脑损伤患儿中医证候规律的研究,为中医药诊治本病提供证候学依据和辨证思路。

Objective:To explore the characteristics,classification and distribution of TCM syndromes in children with brain injury caused by methylmalonic aciduria(MMA).Methods:The information on four diagnoses of TCM in 162 children with MMA who were diagnosed with brain injury at the Children′s Encephalopathy Rehabilitation Center of the First Affiliated Hospital to Henan University of Chinese Medicine from February 2016 to February 2018 was collected.The regularity of TCM syndromes was discussed by factor analysis and cluster analysis.Results:The main pathogenic factors of MMA brain injury in children are heart,spleen,kidney and liver.The main pathogenic factors are qi deficiency,essence deficiency,yin deficiency,yang deficiency,phlegm,dampness and blood stasis;TCM syndromes are divided into five types:heart and spleen deficiency,spleen and kidney yang deficiency,liver and kidney deficiency,phlegm and blood stasis blocking and spleen deficiency and hyperactivity of liver.TCM syndromes are divided into five types:syndrome of heart and spleen deficiency,syndrome of spleen and kidney yang deficiency,syndrome of liver and kidney deficiency,syndrome of phlegm and blood stasis stagnation and syndrome of spleen deficiency and liver hyperactivity.The distribution of syndrome types were 30.3%(49/162)of heart-spleen deficiency syndrome,29.6%(48/162)of spleen-kidney yang deficiency syndrome,17.3%(28/162)of liver-kidney deficiency syndrome,14.8%(24/162)of phlegm-blood stasis stagnation syndrome and 8.0%(13/162)of spleen-kidney yang deficiency syndrome.Among them,there are differences in the distribution of syndrome types among children of different age groups.Conclusion:Through the study on the regularity of TCM syndromes in children with MMA brain injury,we can provide the basis of TCM syndromes and the thought of syndrome differentiation for the diagnosis and treatment of this disease.