【摘要】：目的：分析痰熱閉肺證肺炎患兒舌象特點(diǎn)，觀察影響舌象轉(zhuǎn)化的相關(guān)因素，闡明其舌象轉(zhuǎn)化規(guī)律，為臨床辨證及預(yù)示疾病的預(yù)后提供依據(jù)。方法：選擇2010年1月-2011年5月遼寧中醫(yī)藥大學(xué)附屬醫(yī)院兒科病房符合肺炎診斷的339例住院患兒，采用回顧性分析274例痰熱閉肺證患兒的舌象特點(diǎn)及舌象轉(zhuǎn)化的主要時(shí)間點(diǎn)，同時(shí)分析年齡、既往反復(fù)呼吸道感染史、濕疹史對(duì)痰熱閉肺證患兒的舌象轉(zhuǎn)化的影響程度。 結(jié)果： 1.兒童肺炎痰熱閉肺證患兒以嬰幼兒及學(xué)齡前期兒童的例數(shù)居多，占85%。各年齡段中嬰幼兒的舌象的舌質(zhì)、舌苔的轉(zhuǎn)化最為明顯，且變化幅度最大。 2.有濕疹史的肺炎痰熱閉肺證患兒的舌苔厚轉(zhuǎn)為苔薄的占67%，高于苔黃轉(zhuǎn)為苔白的百分比（25%。）；反復(fù)呼吸道感染病史的痰熱閉肺證患兒的舌苔厚轉(zhuǎn)為舌苔薄的比例（88%）也高于舌苔黃轉(zhuǎn)為舌苔白的比例（28%）。 3.痰熱閉肺證的患兒的舌象舌質(zhì)紅占82%，顯著高于舌質(zhì)淡紅（1.4%）及舌質(zhì)紫暗（0.4%）的百分?jǐn)?shù)，舌苔以舌苔黃（83.6%）、舌苔厚（44.5%）、舌苔膩（16.4%）為主，較少為舌苔少（0.7%）及剝脫苔（4.0%），，可見以舌質(zhì)紅苔黃厚膩為主。 4.隨著病情的好轉(zhuǎn)逐漸大多數(shù)轉(zhuǎn)為舌質(zhì)淡紅苔薄白，少數(shù)轉(zhuǎn)為舌質(zhì)紫暗，苔少或剝脫。舌質(zhì)轉(zhuǎn)為正常的時(shí)間點(diǎn)均晚于舌苔轉(zhuǎn)為正常的時(shí)間點(diǎn)。舌質(zhì)由紅轉(zhuǎn)化為淡紅占大多數(shù)，占27.4%，舌質(zhì)紅轉(zhuǎn)化為紫暗者則較少占1.4%，且變化幅度較小。舌苔黃轉(zhuǎn)化為舌苔白的比例為29.7%。舌苔厚轉(zhuǎn)化為薄占58.2%。舌苔膩轉(zhuǎn)為舌苔薄的比例為55.6%。舌苔由厚轉(zhuǎn)化為少苔及剝脫苔的例數(shù)則較少，分別為8.2%和5.7%，且隨著治療無明顯的變化。 結(jié)論： 1.年齡不同其舌象的特點(diǎn)也不同。隨著年齡的增長(zhǎng)其舌苔黃轉(zhuǎn)為苔白的百分比多于苔厚轉(zhuǎn)為苔薄的百分比，即其內(nèi)熱較痰濁更易于清除。 2.既往有濕疹史、反復(fù)呼吸道感染病史的患兒內(nèi)熱均不易清除，可推斷出內(nèi)有郁熱的患兒感受外邪更易患呼吸系統(tǒng)疾病，且易直接入里化熱。 3.舌苔轉(zhuǎn)為正常的時(shí)間點(diǎn)均早于舌質(zhì)轉(zhuǎn)為正常的時(shí)間點(diǎn)。 4.兒童肺炎痰熱閉肺證有其自身的舌象特點(diǎn)。 5.不同影響因素的舌質(zhì)轉(zhuǎn)化的時(shí)間點(diǎn)大致相同。
[Abstract]:Objective: to analyze the characteristics of tongue picture in children with phlegm heat blocking lung syndrome, observe the related factors affecting tongue image transformation, clarify the law of tongue image transformation, and provide basis for clinical syndrome differentiation and prognosis of disease. Methods: 339 hospitalized children in pediatric ward of affiliated Hospital of Liaoning University of traditional Chinese Medicine from January 2010 to May 2011 were selected. The tongue features and the main time points of tongue transformation were analyzed retrospectively in 274 children with phlegm heat blocking lung syndrome. The influence of age, history of recurrent respiratory tract infection and history of eczema on tongue transformation in children with phlegm and heat blocking lung syndrome was analyzed. Results: 1. Children with pneumonia, phlegm heat blocking lung syndrome, infants and preschool children are the majority of the cases, accounting for 85. The change of tongue coating was the most obvious in all ages. 2. 67 cases with pneumonia with history of eczema turned into thin tongue coating, which was higher than the percentage of yellow fur turning to white fur (25.1%). The proportion of thick tongue coating to thin tongue coating in children with phlegm heat blocking lung syndrome with history of repeated respiratory tract infection (88%) was also higher than that of yellow tongue coating to white tongue coating (28%). 3. The proportion of tongue red in phlegm heat blocking lung syndrome was 82, which was significantly higher than that of light red tongue (1.4%) and purple dark tongue (0.4%). The tongue coating was yellow (83.6%), and the tongue coating was thick (44.5%). Greasy tongue coating (16.4%), less tongue coating (0.7%) and peeling coating (4.0%) showed that Huang Hou was greasy with tongue red fur. 4. With the improvement of the condition, most of them turned to thin white tongue, a few to purple dark tongue, less fur or peeling off. The time point when the tongue became normal was later than that of tongue coating. The percentage of tongue quality changed from red to light red accounted for 27.4%, while the proportion of tongue red to purple dark was 1.4%, and the range of change was small. The ratio of yellow tongue coating to white tongue coating was 29. 7%. The thickness of tongue coating was transformed into thin layer, which accounted for 58.2%. The ratio of greasy tongue coating to thin tongue coating was 55.6. The cases of tongue coating changed from thick to less and exfoliated, which were 8.2% and 5.7%, respectively, and had no obvious change with the treatment. Conclusion: 1. The characteristics of tongue appearance vary with age. With age, the percentage of yellow to white tongue coating is higher than that of thick coating to thin coating, that is, the internal heat is easier to remove than phlegm turbid. 2. Children with history of eczema and history of recurrent respiratory tract infection were not easy to clear their internal heat. It can be inferred that children with internal and external fever are more likely to suffer from respiratory system diseases and are more likely to enter directly into the heat. 3. The time point when tongue coating became normal was earlier than that of tongue quality. 4. The syndrome of phlegm heat blocking lung in children with pneumonia has its own tongue features. 5. The time points of tongue quality transformation of different factors were approximately the same.
【學(xué)位授予單位】：遼寧中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R272

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