小儿重症手足口病中医体质与证型的关系研究

目的:探讨重症手足口病(hand food mouth disease,HFMD)的中医体质与中医证型的分布特征及实验室指标的关联性。方法:收集200例重症HFMD患儿,进行一般资料分析,评估中医体质类型、中医辨证分型,并检测常见神经系统受累及心肌损害的实验室指标。结果:重症HFMD患儿偏颇体质占85%,其中特禀质(28%)、气虚质(25%)、阳虚质(13.5%)占多数;重症HFMD中医证型主要为热扰心肝证(94%);重症HFMD患儿神经烯醇化酶(NSE)、谷草转氨酶(AST)、乳酸脱氢酶(LDH)、肌酸激酶同工酶(CK-MB)均明显升高,其中热扰心肝证患儿NSE升高明显(P0.05),可作为该证型的微观化敏感指标。结论:特禀质、气虚质、阳虚质类体质更易发展为重症HFMD;该病主要表现为热扰心肝证,NSE可作为该证型的微观化敏感指标。

Relationship Between TCM Constitution and Syndrome Types in Children with Severe Hand Foot Mouth Disease

  Objective:To investigate the relationship between Traditional Chinese Medicine(TCM) constitution, syndrome type of TCM and laboratory indices in severe hand foot mouth disease.   Methods: 200 cases of severe hand foot mouth disease were analyzed, the TCM constitution types and TCM syndrome differentiation types were evaluated, and the laboratory index of normal nervous system dysfunction and myocardial damage were detected.   Results: Biased TCM constitution accounted for 85% in cases with severe hand foot mouth disease, among them, the special intrinsic quality (28%), Qi deficiency (25%), Yang deficiency (13.5%) were more likely to develop severe hand foot mouth disease. The thermal disturbance heart and liver syndrome type (94%) was the mainly type in sever hand foot mouth disease. Neural enolase (NSE), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), creatine kinase isoenzyme MB (CK-MB) of hand foot mouth disease were significantly increased. NSE increased significantly in the patient of thermal disturbance heart and liver syndrome, could be used as a sensitive index of the microscopic syndrome.   Conclusion: The special intrinsic quality, Qi deficiency and Yang deficiency were more likely to develop severe hand foot mouth disease. TCM syndrome type of hand foot mouth disease was mainly thermal disturbance heart and liver syndrome, and NSE could be used as a sensitive index of the microscopic syndrome.