甲型H1N1流感患者中醫(yī)臨床癥狀分析與溫病患者相關(guān)指標研究
發(fā)布時間：2019-05-17 08:53
【摘要】：目的：探討甲型H1N1流感的中醫(yī)臨床癥狀分布規(guī)律以及各證型的臨床癥狀特點,分布頻數(shù),為流感的后續(xù)治療提供辨證參考依據(jù)。分析甲型H1N1流感溫病濕熱證與溫病溫?zé)嶙C患者的血清免疫球蛋白IgM.IgG和血清白細胞介素—8(IL—8)、轉(zhuǎn)化生長因子—β 1(TGF—β1)、脂多糖結(jié)合蛋白(LBP)、腫瘤壞死因子一α(TNF —α)、Toll樣受體4(TLR4)和血漿可溶性CD14(sCD14)水平,揭示兩證型之間的差異。方法：設(shè)計研究調(diào)查表,根據(jù)制定的參考標準收集門診和住院部的流感樣患者,然后根據(jù)病原學(xué)檢測分析確診甲型H1N1流感病毒感染的患者,收集這些患者的中醫(yī)臨床癥狀進行分析總結(jié)。同時,將確診為甲型H1N1流感病毒感染的患者進行辨證分型,對濕熱證和溫?zé)嶙C的患者進行相關(guān)的實驗研究,進一步發(fā)現(xiàn)不同證型之間的差異。結(jié)果：本次調(diào)查收集的甲型H1N1流感患者的癥狀供28個,出現(xiàn)頻率最高的13個癥狀(出現(xiàn)頻率50%)依次為：發(fā)熱,全身酸痛,倦怠乏力,納呆,咽喉紅腫,咽喉痛,惡寒,口渴,無汗,尿黃,咳嗽,頭重如裹,身體困重,體現(xiàn)了甲型H1N1流感患者常見癥狀特征。對頻率較高的13個癥狀進行聚類分析,聚為3類。最常見的舌象是舌紅,最常見的脈象是浮數(shù)脈,最常見的證型是痰熱壅肺證。而且各證型之間在癥狀的分布上也大不相同。血清免疫球蛋白IgM、IgG、IL-8、TNF-α和TGF-β1水平差異很小,兩組間比較(P0.05),差異無統(tǒng)計學(xué)意義；兩組患者的血清TLR4、LBP和血漿sCD14水平有很大差異,濕熱證組顯著高于溫?zé)岵〗M,兩組間比較(P0.05),差異有統(tǒng)計學(xué)意義。結(jié)論：甲型H1N1流感患者在中醫(yī)臨床癥狀的分布上有一定的規(guī)律性,符合傳統(tǒng)中醫(yī)溫病學(xué)對于該病的理論論述,因此可以參考溫病學(xué)中的理法方藥來治療該類疾��；甲型H1N1流感溫病濕熱證和溫病溫?zé)嶙C患者在相關(guān)的實驗室檢測指標上有一些差異,兩組患者的血清TLR4、LBP和血漿sCD14水平有很大差異,濕熱證組顯著高于溫?zé)嶙C組,提示溫病濕熱證患者體內(nèi)的炎癥反應(yīng)更為嚴重。
[Abstract]:Objective: to explore the distribution of clinical symptoms of influenza A (H1N1) in traditional Chinese medicine (TCM) and the characteristics and frequency of clinical symptoms of each syndrome type, so as to provide dialectical reference for the follow-up treatment of influenza. Analysis of serum immunoglobulin IgM.IgG, serum IL-8 (IL-8), transforming growth factor-尾 1 (TGF- 尾 1) and lipopolysaccharide binding protein (LBP), in patients with influenza A influenza febrile disease dampness-heat syndrome and febrile fever syndrome The levels of tumor necrosis factor-偽 (TNF-偽), Toll-like receptor 4 (TLR4) and plasma soluble CD14 (sCD14) revealed the difference between the two syndromes. Methods: a research questionnaire was designed to collect influenza-like patients in outpatient and inpatient departments according to the established reference standards, and then the patients with influenza A H1N1 virus infection were diagnosed according to etiological detection and analysis. The clinical symptoms of these patients were analyzed and summarized. At the same time, the patients diagnosed with influenza A H1N1 virus infection were classified according to syndrome differentiation, and the patients with dampness-heat syndrome and warm-heat syndrome were studied, and the differences among different syndrome types were further found. Results: the symptoms of H1N1 A patients collected in this survey were 28, and the 13 symptoms with the highest frequency (50%) were fever, systemic soreness, burnout, anorexia, redness and swelling of throat, sore throat and cold. Thirst, no sweat, yellow urine, cough, heavy head, heavy body, reflecting the common symptoms of H1N1 A flu patients. Cluster analysis of 13 symptoms with high frequency was carried out, and the symptoms were grouped into 3 categories. The most common tongue appearance is tongue red, the most common pulse is floating pulse, and the most common syndrome type is phlegm-heat obstruction of lung syndrome. Moreover, the distribution of symptoms is also very different among the syndrome types. There was no significant difference in serum immunoglobulin IgM,IgG,IL-8,TNF- 偽 and TGF- 尾 1 levels between the two groups (P 0.05). The levels of serum TLR4,LBP and plasma sCD14 in the two groups were significantly different from those in the warm heat syndrome group, and there was significant difference between the two groups (P 0.05). Conclusion: patients with influenza A H1N1 have certain regularity in the distribution of clinical symptoms of traditional Chinese medicine, which accords with the theoretical discussion of febrile disease in traditional Chinese medicine, so we can refer to the prescription in febrile disease to treat this kind of disease. There were some differences in the related laboratory test indexes between the patients with influenza A influenza febrile disease dampness-heat syndrome and febrile fever syndrome. The levels of serum TLR4,LBP and plasma sCD14 in the two groups were very different, and the levels of serum TLR4,LBP and plasma sCD14 in the damp-heat syndrome group were significantly higher than those in the warm-heat syndrome group. It is suggested that the inflammatory reaction in patients with febrile disease and dampness-heat syndrome is more serious.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R259
[Abstract]:Objective: to explore the distribution of clinical symptoms of influenza A (H1N1) in traditional Chinese medicine (TCM) and the characteristics and frequency of clinical symptoms of each syndrome type, so as to provide dialectical reference for the follow-up treatment of influenza. Analysis of serum immunoglobulin IgM.IgG, serum IL-8 (IL-8), transforming growth factor-尾 1 (TGF- 尾 1) and lipopolysaccharide binding protein (LBP), in patients with influenza A influenza febrile disease dampness-heat syndrome and febrile fever syndrome The levels of tumor necrosis factor-偽 (TNF-偽), Toll-like receptor 4 (TLR4) and plasma soluble CD14 (sCD14) revealed the difference between the two syndromes. Methods: a research questionnaire was designed to collect influenza-like patients in outpatient and inpatient departments according to the established reference standards, and then the patients with influenza A H1N1 virus infection were diagnosed according to etiological detection and analysis. The clinical symptoms of these patients were analyzed and summarized. At the same time, the patients diagnosed with influenza A H1N1 virus infection were classified according to syndrome differentiation, and the patients with dampness-heat syndrome and warm-heat syndrome were studied, and the differences among different syndrome types were further found. Results: the symptoms of H1N1 A patients collected in this survey were 28, and the 13 symptoms with the highest frequency (50%) were fever, systemic soreness, burnout, anorexia, redness and swelling of throat, sore throat and cold. Thirst, no sweat, yellow urine, cough, heavy head, heavy body, reflecting the common symptoms of H1N1 A flu patients. Cluster analysis of 13 symptoms with high frequency was carried out, and the symptoms were grouped into 3 categories. The most common tongue appearance is tongue red, the most common pulse is floating pulse, and the most common syndrome type is phlegm-heat obstruction of lung syndrome. Moreover, the distribution of symptoms is also very different among the syndrome types. There was no significant difference in serum immunoglobulin IgM,IgG,IL-8,TNF- 偽 and TGF- 尾 1 levels between the two groups (P 0.05). The levels of serum TLR4,LBP and plasma sCD14 in the two groups were significantly different from those in the warm heat syndrome group, and there was significant difference between the two groups (P 0.05). Conclusion: patients with influenza A H1N1 have certain regularity in the distribution of clinical symptoms of traditional Chinese medicine, which accords with the theoretical discussion of febrile disease in traditional Chinese medicine, so we can refer to the prescription in febrile disease to treat this kind of disease. There were some differences in the related laboratory test indexes between the patients with influenza A influenza febrile disease dampness-heat syndrome and febrile fever syndrome. The levels of serum TLR4,LBP and plasma sCD14 in the two groups were very different, and the levels of serum TLR4,LBP and plasma sCD14 in the damp-heat syndrome group were significantly higher than those in the warm-heat syndrome group. It is suggested that the inflammatory reaction in patients with febrile disease and dampness-heat syndrome is more serious.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R259
【參考文獻】
相關(guān)期刊論文 前3條
1 謝慧s，
本文編號：2478965
本文鏈接：http://sikaile.net/zhongyixuelunwen/2478965.html
最近更新
教材專著
