【摘要】：[目的]通過(guò)問(wèn)卷調(diào)查的形式結(jié)合證素辨證方法學(xué)探討兒童咳嗽變異性哮喘的中醫(yī)病位、病性證素特點(diǎn)及其組合規(guī)律,為提高兒童咳嗽變異性哮喘臨床辨證論治水平以及制定防治方案提供依據(jù)。[方法]以廣東省中醫(yī)院兒科門(mén)診部符合診斷標(biāo)準(zhǔn)的91例患者為研究對(duì)象,進(jìn)行問(wèn)卷調(diào)查,收集四診資料,根據(jù)"證候辨證素"量表找到每一癥狀對(duì)各證素的權(quán)值,最后計(jì)算各癥狀對(duì)各證素權(quán)值之和,超過(guò)閾值100分的證素則判斷成立,分析病位證素、病性證素以及病位與病性證素組合規(guī)律。[結(jié)果]咳嗽變異性哮喘中,病位證素共7個(gè),肺為核心病位,其出現(xiàn)的頻率(97.80%)明顯高于其他病位證素,病位證素表(95.60%)相對(duì)常見(jiàn),其他病位證素依次為脾(57.14%)、胃(29.67%)、腎(3.30%)、心(3.30%)、肝(1.10%)。病位肺、表、脾、胃等4個(gè)證素平均積分超過(guò)150分。病位證素組合以二病位、三病位、四病位為主,單一病位出現(xiàn)頻率較低。病性證素方面,實(shí)性病性有9個(gè),虛性病性4個(gè)。實(shí)性病性中,病性痰(53.85%)出現(xiàn)頻率最高,病性外風(fēng)(45.05%)、寒(40.66%)、濕(27.47%)等相對(duì)常見(jiàn),病性飲(10.99%)、氣滯(8.79%)、熱(4.40%)、燥(4.40%)、食積(3.30%)等出現(xiàn)頻數(shù)較低。虛性病性證素依次為氣虛、陽(yáng)虛、血虛、陰虛,出現(xiàn)頻率分別為:87.91%、69.23%、50.55%、26.37%,虛性病性氣虛、陽(yáng)虛平均積分超過(guò)150,提示為重度病變;病性證素組合中,二病性組合最常見(jiàn),頻數(shù)、頻率為61例(67.76%),其次為單一病性證素,頻數(shù)與頻率為19例(21.11%)。病位與病性組合形式中,二病位與單一病性組合"肺+表+氣虛"出現(xiàn)頻數(shù)與頻率為76例(83.52%),三病位與單一病性證素組合"肺+表+脾+氣虛"出現(xiàn)頻率為51例(56.04%)。[結(jié)論]咳嗽變異性哮喘核心病位在肺,與表、脾相關(guān);其發(fā)病虛實(shí)互見(jiàn),氣虛、陽(yáng)虛在本病發(fā)生、發(fā)展中具有重要意義;痰、風(fēng)等為主要實(shí)性病性,其中痰為主要病理產(chǎn)物,亦是主要病因。
[Abstract]:[objective] to explore the TCM disease position, the characteristics and the combination rules of TCM syndrome factors in children with cough variant asthma by means of questionnaire survey combined with syndrome differentiation methodology. In order to improve the children cough variant asthma clinical differentiation and treatment level and make prevention and treatment plan to provide the basis. [methods] 91 patients who met the diagnostic criteria in Department of Pediatrics of Guangdong Provincial Hospital of traditional Chinese Medicine were investigated by questionnaire, and the data of four diagnoses were collected, and the weight of each symptom to each symptom was found according to the "syndrome differentiation factors" scale. Finally, the sum of the weight of each symptom to each syndrome element was calculated, and the syndrome element exceeding the threshold value of 100 points was judged, and the syndrome element of the disease position, the disease syndrome element and the combination rule of the disease position and the disease syndrome element were analyzed. [results] in cough variant asthma, there were 7 syndromes in the disease position, and the lung was the core disease position. The frequency of occurrence of the syndrome elements (97.80%) was significantly higher than that of other syndromes, and it was relatively common in the list of syndromes of the disease site (95.60%). The other syndromes were spleen (57.14%), stomach (29.67%), kidney (3.30%), heart (3.30%) and liver (1.10%). The average score of the four syndromes of lung, surface, spleen and stomach was more than 150 points. The combination of two, three and four disease sites is the main one, and the frequency of single disease is low. In terms of syndromes, there are 9 real venereal diseases and 4 deficiency venereal diseases. The frequency of diseased phlegm (53.85%) was the highest, the incidence of diseased external wind (45.05%), cold (40.66%), dampness (27.47%), diseased drink (10.99%), qi stagnation (8.79%), and so on. The frequency of heat (4.40%), dryness (4.40%) and food production (3.30%) was low. Deficiency venereal disease syndrome factors were qi deficiency, yang deficiency, blood deficiency, yin deficiency, respectively. The frequency of occurrence was 87.91 and 69.230.2350.5550.5510, and the deficiency of venereal disease qi deficiency and the average score of yang deficiency exceeded 150, indicating that the disease was severe. In the combination of disease syndromes, the frequency and frequency were 61 cases (67.76%) and 19 cases (21.11%) respectively. In the combination of disease location and disease, the frequency and frequency of "deficiency of lung surface qi" was 83.52%. The frequency of "deficiency of spleen qi on lung surface" was 56.04% in 51 cases (56.04%). [conclusion] the core disease of cough variant asthma is located in the lung, which is related to the appearance and spleen, and the occurrence of deficiency of qi, deficiency of qi and deficiency of yang are of great significance in the occurrence and development of the disease. Phlegm, wind and so on are the main real venereal diseases, in which phlegm is the main pathological product and the main etiology.
【作者單位】： 廣東省中醫(yī)院;
【基金】：廣東省中醫(yī)藥管理局2013年建設(shè)中醫(yī)藥強(qiáng)省科研課題(20132168) 廣東省中醫(yī)院中醫(yī)藥科學(xué)技術(shù)研究專項(xiàng)資助(No YK2013B2N18)
【分類號(hào)】：R272

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