儿童孤独症谱系障碍180例中医证型分布及规律探讨

目的:总结180例孤独症谱系障碍(autism spectrum disorder,ASD)病例中医证型分布及规律。方法:依据辨证标准搜集180例ASD患儿的病历资料,采用SPSS 19.0软件统计分析ASD中医证型分布及变化情况。结果:180例病例中首诊心脾两虚证最为常见(62.2%),其次为肾精亏虚证(14.4%)及脾虚肝亢证(11.1%),心肝火旺证及痰蒙心窍证出现频次较少。其证型随治疗存在虚实转化的变化规律,心脾两虚证始终占据主导地位。发病年龄及病程与中医证型变化无相关性,发病年龄在24月龄以前病例28例(15.56%),24~48月龄108例(60%),48~72月龄33例(18.33%)。结论:ASD中医证型以虚证为主,部分属本虚标实证,随着病程及治疗显现出由实转虚的趋势,证型分布具有以心脾两虚证为主导的典型规律,早期诊断及干预符合临床发病特征。

Distribution and Regularity of TCM Syndrome Types in 180 Children with Autism Spectrum Disorder

Objective:To summarize the distribution and regularity of TCM syndromes in 180 cases of Autism spectrum disorder(ASD).Methods:Datas on the 180 children with ASD were collected by using dialectical criteria.SPSS 19.0 was used to statistically analyze the distribution and change of TCM syndromes.Results:Among the 180 cases,deficiency of heart and spleen was the most common syndrome in the first diagnosis(62.2%),followed by kidney essence deficiency syndrome(14.4%)and spleen deficiency liver hyperactivity syndrome(11.1%).However,heart and liver-fire hyperactivity syndrome and syndrome of heart spirit mistaken for phlegm were less frequent.The syndromes had a change pattern of deficient and excess transformation during the treatment.Meanwhile,deficiency of heart and spleen remained the most common syndrome during the entire period.There were no correlations between age of onset or the course of disease and the change of TCM syndrome.The age of onset was younger than 24 months in 28 cases(15.56%),24 to 48 months in 108 cases(60%),and 48 to 72 months in 33 cases(18.33%).Conclusions:The main TCM syndrome of ASD was deficiency syndrome,some of which belong to actual deficiency syndrome with a false excess manifestation.The syndrome changes tended to range from excess to deficient during the treatment.The distribution of syndromes was dominated by deficiency of the heart and spleen syndrome.Early diagnosis and intervention are consistent with the clinical characteristics.