本文選題：黑龍江地區(qū) + 手足口病��； 參考：《黑龍江中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:探討黑龍江地區(qū)小兒手足口病證候特征及證候演變規(guī)律,以期為臨床制定手足口病中醫(yī)辨證方案提供依據(jù),從而更好地指導(dǎo)臨床防治工作。方法:采用臨床流行病學(xué)調(diào)查方法,通過(guò)采集手足口病患兒臨床資料,追蹤觀察患兒入院當(dāng)天(基線點(diǎn))、治療后第3、5、7、10天時(shí)的臨床表現(xiàn),填寫手足口病中醫(yī)證候觀察表,建立數(shù)據(jù)庫(kù),探討小兒手足口病中醫(yī)證候特征,進(jìn)一步應(yīng)用證候演變概率法對(duì)黑龍江地區(qū)手足口病患兒中醫(yī)證候在不同觀察點(diǎn)的演變規(guī)律進(jìn)行系統(tǒng)分析。結(jié)果:1.從納入患兒分布數(shù)量上得出,男性多于女性,且發(fā)病年齡集中在1-4歲之間,4歲以后,患病人數(shù)開(kāi)始大幅度下降。本病7-9月出現(xiàn)率最高為73.71%,與其他月份相比較,差異有統(tǒng)計(jì)學(xué)意義。本病病程以第8-10天的痊愈率最高為51.78%,2.患兒發(fā)熱、手足臀等部位斑丘疹或皰疹、口腔皰疹或潰瘍、咽喉疼痛、煩躁等癥狀出現(xiàn)率高。3.中醫(yī)各證候分布上,在入院當(dāng)天和第3天時(shí)邪犯肺衛(wèi)證所占比例最高,其次是肺胃熱熾證和心脾積熱證,第5天時(shí)邪犯肺衛(wèi)證與肺胃陰傷證分布比例高,第7天和第10天時(shí)肺胃陰傷證最多見(jiàn)。4.分析各中醫(yī)證候演變規(guī)律,從基線點(diǎn)到第3天,邪犯肺衛(wèi)證發(fā)病人數(shù)最多,各證候的持續(xù)存在概率較為突出。第3-5天,邪犯肺衛(wèi)證及肺胃熱熾證發(fā)病人數(shù)仍較多,以邪犯肺衛(wèi)證的持續(xù)存在概率和肺胃熱熾證的轉(zhuǎn)移概率更為明顯,且濕熱交阻、心脾積熱兩證的轉(zhuǎn)移概率高于上一階段。第5-7天,各證候向正常的轉(zhuǎn)移概率明顯增大,各證候的持續(xù)存在概率大幅度下降,向肺胃陰傷證演變的病例逐漸增多。第7-10天,疾病末期,大部分患兒得以痊愈,但仍存在向肺胃陰傷證及其他證型的轉(zhuǎn)移概率。結(jié)論:1.黑龍江地區(qū)小兒手足口病患兒男性多于女性,以1-4歲年齡段多發(fā),4歲以后,患病率開(kāi)始大幅度下降,且在一年中以7-9月份發(fā)病人數(shù)最多。2.黑龍江地區(qū)小兒手足口病主要癥狀表現(xiàn)為手足臀等部位斑丘疹或皰疹、口腔皰疹或潰瘍、咽喉疼痛,發(fā)熱和煩躁等。3.黑龍江地區(qū)手足口病患兒,在入院當(dāng)天和第3天時(shí)邪犯肺衛(wèi)證所占比例最高,其次是肺胃熱熾證和心脾積熱證;第5天時(shí)邪犯肺衛(wèi)證與肺胃陰傷證分布比例高;第7天和第10天時(shí)肺胃陰傷證最多見(jiàn)。4.黑龍江地區(qū)小兒手足口病各中醫(yī)證候在疾病發(fā)展過(guò)程中,符合衛(wèi)氣營(yíng)血傳變規(guī)律,呈現(xiàn)動(dòng)態(tài)演變的過(guò)程,使各證候不同時(shí)間段觀察點(diǎn)上具有一定的特點(diǎn)。
[Abstract]:Objective: to explore the syndromes characteristics and syndromes evolution of children hand foot and mouth disease (HFMD) in Heilongjiang province in order to provide basis for clinical establishment of TCM syndrome differentiation of HFMD so as to better guide clinical prevention and treatment. Methods: by collecting clinical data of children with hand, foot and mouth disease (HFMD), the clinical manifestations of the patients were observed on the day of admission (baseline point, the 3rd day after treatment), and the observation forms of TCM syndromes of HFMD were filled out. To establish a database to probe into the characteristics of TCM syndromes of hand, foot and mouth disease in children, and to analyze systematically the evolution law of TCM syndromes in different observation points of children with hand foot and mouth disease in Heilongjiang by using the method of syndrome evolution probability. The result is 1: 1. From the distribution of children included, the number of males was more than that of females, and the onset age was mainly between 1-4 years old and 4 years old, and the number of patients began to decline significantly. The highest incidence of this disease in July and September was 73.71, and the difference was statistically significant compared with other months. The highest recovery rate of the disease was 51.78 and 2in the 8th-10th day. Fever, hand, foot and buttock spot papules or herpes, oral herpes or ulcers, throat pain, irritability and other symptoms of high incidence. 3. The distribution of TCM syndromes was the highest on the day of admission and on the third day, followed by the syndrome of heat of the lung stomach and accumulation of heat in the heart and spleen, and on the fifth day, the proportion between the syndrome of evil invading the lung and the syndrome of lung stomach yin injury was high. On the 7th day and the 10th day, the syndrome of lung and stomach yin injury was found mostly. 4. From the baseline point to the third day, the number of pathogenic diseases of lung and health syndrome is the most, and the probability of persistent existence of each syndrome is more prominent. On the 3-5 days, the number of pathogenic diseases of lung health syndrome and lung stomach heat syndrome was still more than that of the previous stage. The probability of persistent existence of evil invading lung health syndrome and the transferring probability of lung stomach heat syndrome were more obvious, and the transfer probability of dampness and heat resistance, heart and spleen accumulation and heat syndrome was higher than that of the previous stage. On the 5th to 7th day, the probability of each syndrome transferring to normal was obviously increased, the probability of persistent existence of each syndrome decreased significantly, and the number of cases evolving to lung and stomach yin injury gradually increased. At the end of the 7-10 days, most of the children were cured, but there was still the probability of metastasis to the lung-stomach yin injury and other syndrome types. Conclusion 1. In Heilongjiang area, the prevalence of HFMD in children with HFMD was more than that in females. After 4 years of age, the prevalence rate of HFMD in children aged 1-4 years began to decrease significantly, and the highest incidence occurred in July-September in July and September of the year. The main symptoms of hand, foot and mouth disease in children in Heilongjiang province were papules or herpes, oral herpes or ulcers, sore throat, fever and irritability. The children with HFMD in Heilongjiang had the highest proportion of lung and health syndrome on the day of admission and the third day, followed by the syndrome of burning lung and stomach heat and the syndrome of accumulation of heat in the heart and spleen, and the distribution ratio of the syndrome of evil invading the lung and the syndrome of Yin injury of the lung and stomach was high on the fifth day. On the 7th day and the 10th day, the syndrome of lung and stomach yin injury was found mostly. 4. In Heilongjiang region, the TCM syndromes of hand, foot and mouth disease of children in the process of disease development, in accordance with the law of blood transmission of Wei Qi Ying, presents a dynamic evolution of the process, so that each syndrome in different periods of time observation points have certain characteristics.
【學(xué)位授予單位】：黑龍江中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R272

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