【摘要】：目的動態(tài)觀察肺炎風熱閉肺證患兒的舌象變化，探討舌象與體溫、咳嗽、肺部Up音等臨床指標在不同時間段肺炎的病情評估作用及應(yīng)用價值，為進一步運用中西醫(yī)結(jié)合診治肺炎提供臨床依據(jù)。 方法采用前瞻性研究方法，選擇2011年10月-2012年01月于大連市兒童醫(yī)院呼吸內(nèi)科住院，符合納入標準的49例肺炎風熱閉肺證患兒，以人工與舌象儀、電子聽診器雙采集的方式、每天定時對肺炎風熱閉肺證患兒的舌象、肺部Up音等臨床指標進行連續(xù)觀察，并將觀察結(jié)果記錄于登記表中。 結(jié)果 1.肺炎風熱閉證患兒入院第1天舌象以舌尖紅，苔薄，黃白相兼為主，占40.8%。舌色以舌尖紅為主，占75.5%；苔色以黃白相兼為主，占65.3%；苔質(zhì)以苔薄為主，，占69.4%。 2.肺炎風熱閉肺證患兒入院第1天異常舌象為95.9%、正常舌象為4.1%；入院第7天異常舌象36.7%、正常舌象為63.3%，肺炎風熱閉肺證患兒入院第1天舌象與入院第7天比較，經(jīng)卡方檢驗，P＜0.05，差異顯著，有統(tǒng)計學意義。 3.隨著肺炎風熱閉肺證患兒的病情逐漸好轉(zhuǎn)，異常舌象逐漸減少，正常舌象逐漸增多。 4.肺炎風熱閉肺證患兒體溫、咳嗽、肺部Up音隨著病情的好轉(zhuǎn)逐漸恢復(fù)，直至正常。 5.舌象與體溫、肺部Up音在肺炎風熱閉肺證患兒的病情評估作用不一致，舌象與體溫、肺部羅音相比，經(jīng)卡方檢驗，P＜0.05，差異顯著，具有統(tǒng)計學意義；舌象與咳嗽在肺炎風熱閉肺證患兒的病情評估作用一致，舌象與咳嗽相比，經(jīng)卡方檢驗，P＞0.05，差異不顯著，無統(tǒng)計學意義。 結(jié)論 1.肺炎風熱閉肺證患兒入院第1天的舌象以舌尖紅，苔薄，黃白相兼多見。 2.肺炎風熱閉肺證患兒入院第1天以異常舌象為主，入院第7天以正常舌象為主，入院第1天與第7天相比舌象表現(xiàn)不同，提示肺炎風熱閉肺證患兒的舌象隨著入院時間的延長、病情的逐漸好轉(zhuǎn)而發(fā)生變化，由異常舌象逐漸向正常舌象轉(zhuǎn)變，并呈現(xiàn)一定規(guī)律性。 3.舌象、體溫、咳嗽及肺部Up音在肺炎風熱閉肺證的病情評估中發(fā)揮各自的作用，與體溫、肺部Up音相比，舌象對其病情評估作用的敏感性較高；與咳嗽相比，二者對其病情評估作用的敏感性一致。
[Abstract]:Objective to observe the changes of tongue picture in children with pneumonia with wind-heat blockage of lung syndrome, and to explore the evaluation effect and application value of tongue sign and body temperature, cough, lung up sound and so on in different time period of pneumonia. To provide clinical basis for the further application of integrated traditional Chinese and western medicine in the diagnosis and treatment of pneumonia. Methods A prospective study was used to select 49 children with pneumonia wind and heat blocking lung syndrome who were hospitalized in Department of Respiratory Medicine of Dalian Children's Hospital from October 2011 to January 2012. The patients were collected by artificial and tongue imaging instrument and electronic stethoscope. The tongue picture, lung up sound and other clinical indexes were observed regularly every day, and the results were recorded in the registration form. Result 1. On the first day of admission, the tongue appearance of pneumonia patients with wind-heat blocking syndrome was mainly red tongue tip, thin fur, yellow and white appearance, accounting for 40.8%. The color of tongue was mainly red on the tip of tongue (75.5%), yellow and white (65.3%), and thin coating (69.4%). On the first day of admission, the abnormal tongue picture was 95.9 and the normal tongue sign was 4.1. On the 7th day of admission, the abnormal tongue picture was 36.7, and the normal tongue sign was 63.3. The first day of admission was compared with that of the 7th day. The chi-square test showed significant difference (P < 0.05). With the pneumonia wind-heat blocking lung syndrome children's condition gradually improved, abnormal tongue gradually decreased, the normal tongue gradually increased. 4. 4. The body temperature, cough and lung up sound of pneumonia wind-heat blocking lung syndrome gradually recovered with the improvement of the condition, until the normal. 5. 5%. Tongue picture and body temperature, lung up sound in the pneumonia wind-heat block lung syndrome children's disease evaluation function is not consistent, tongue picture and body temperature, lung rales, by chi-square test P < 0.05, the difference is significant, there is statistical significance. Tongue picture and cough had the same effect in evaluating the condition of pneumonia patients with wind-heat blocking lung syndrome. Compared with cough, Chi Fang test showed that the difference was not significant (P > 0.05), and there was no significant difference in tongue appearance and cough (P > 0.05). Conclusion 1. On the first day of admission, the tongue appearance of the children with pneumonia wind and heat blocking lung syndrome was red on the tip of tongue, thin fur, and yellow and white appearance. 2. 2. The abnormal tongue on the first day of admission, the normal tongue on the seventh day of admission, and the difference between the first day of admission and the seventh day of admission indicated that the tongue appearance of the children with pneumonia wind-heat blockage lung syndrome was prolonged with the extension of admission time. The condition gradually improved and changed, from abnormal tongue to normal tongue, and showed a certain regularity of 3. 3. Tongue picture, body temperature, cough and lung up sound play their respective roles in the evaluation of pneumonia, compared with body temperature and lung up sound, tongue picture is more sensitive to the evaluation of the disease. The sensitivity of the two to the evaluation of the disease was the same.
【學位授予單位】：大連醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2013
【分類號】：R272

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