摘要
目的采用回顾性分析方法,探讨小儿肺炎气道黏液高分泌的中医证素分布规律。方法收集2019年1—12月菏泽市中医医院儿科住院治疗的292例肺炎气道黏液高分泌患儿的病历资料,根据朱文峰教授提出“证候辨证素量表”的简化计量方法对各证素进行诊断,采用主成分分析、聚类分析等方法进行数据挖掘,总结小儿肺炎气道黏液高分泌的证素分布规律,确定证型。结果对提取的中医四诊资料进行规范,共得到39种证候,其中频数在前10位的为咳嗽、肺部湿性啰音、脉滑、咳痰、舌苔滑、胸闷、舌苔白、喉中痰鸣、咽红、舌苔黄。共诊断证素11项,其中病位证素3项,为肺、脾、表;病性证素8项,分别为痰、饮、湿、气虚、阳虚、热、外风、寒。小儿肺炎气道黏液高分泌的证素以肺、痰为主。经主成分分析及聚类分析,小儿肺炎气道黏液高分泌存在外风犯表、气虚饮停、脾阳虚湿困、痰浊阻肺4种不同的证型表现。结论小儿肺炎气道黏液高分泌是中医水液代谢紊乱的结果,其病机不仅在“肺”与“痰”,更与脾、表、外风、饮等密切相关,是内外因多因素综合作用的结果。而其所存在的4种证候则全面揭示了上中二焦(营卫)-肺-脾轴对该病的影响及其调节水液代谢的内在机制。
Objective To explore the distribution of syndrome elements of traditional Chinese medicine in chil-dren with pneumonia with high airway mucus secretion by retrospective analysis.Methods The medical records of 292 children with pneumonia with high airway mucus secretion hospitalized in the Department of Pediatrics of Heze Hospital of Traditional Chinese Medicine from January to December 2019 were collected.According to the simplified measurement method of“syndrome differentiation scale”proposed by professor ZHU Wenfeng,the syndrome ele-ments were diagnosed.Data mining was carried out by principal component analysis and cluster analysis to summa-rize the distribution of syndrome elements of pneumonia with high airway mucus secretion and determine the syn-drome type.Results The extracted data of four traditional Chinese medicine diagnosis were standardized,and 39 syndromes were obtained,among which the top 10 frequency were cough,lung moist rales,pulse slip,sputum,tongue slippery,chest tightness,white tongue coating,phlegm in the throat,pharynx red,and yellow tongue coating.A total of 11 syndrome elements were diagnosed,including 3 disease site syndrome elements,lung,spleen,and sur-face;8 disease-related syndrome elements,respectively sputum,drinking,dampness,qi deficiency,yang deficiency,heat,external wind,and cold.The syndrome elements of pneumonia with high airway mucus secretion were mainly lung and sputum.Through principal component analysis and cluster analysis,there were four different syndromes of airway mucus hypersecretion in children with pneumonia:external wind attacking the surface,qi deficiency and drinking stop,spleen yang deficiency and dampness,and phlegm obstructing the lung.Conclusion Airway mucus hypersecretion in children with pneumonia is the result of water and liquid metabolism disorder in traditional Chi-nese medicine.Its pathogenesis is not only in the lung and the phlegm,but also closely related to spleen,surface,external wind,drinking,etc.It is the result of the comprehensive effect of internal and external factors.The four syn-dromes fully reveal the influence of the upper middle two jiao(yingwei)-lung-spleen axis on the disease and the internal mechanism of regulating water and liquid metabolism.
作者
任光明
REN Guangming(Department of Pediatrics,Heze Hospital of Traditional Chinese Medicine,Heze,Shandong,274035,China)
出处
《中医儿科杂志》
2024年第1期35-40,共6页
Journal of Pediatrics of Traditional Chinese Medicine
基金
山东省2019—2020年度中医药科技发展计划项目(2019-0947)。
关键词
肺炎
小儿
气道黏液高分泌
中医证素
分布规律
回顾性分析
pneumonia
children
airway mucus hypersecretion
syndrome elements of traditional Chinese medi-cine
distribution law
retrospective analysis
