小儿哮喘眼影分级与中医证候的相关性研究

目的观察小儿哮喘患者眼影分布情况及程度,并探索与中医证候的相关性。方法收集2014年12月—2015年11月于湖南中医药大学第一附属医院儿科就诊的小儿哮喘患者400例,其中风寒束肺证68例、痰热阻肺证156例、外寒内热证46例、肺实肾虚证12例、肺脾气虚证67例、脾肾阳虚证10例及肺肾阴虚证41例。统计患儿年龄、性别构成情况,分析发病季节、年龄与中医证候的相关性。对入选患儿进行眼影分级,分析眼影分级与小儿哮喘患者病程、中医证候等的相关性。结果(1)小儿哮喘于学龄前期(44.50%)及幼儿期(42.75%)的发病率高,各年龄段患儿的性别差异无统计学意义(P=0.59)。(2)哮喘患儿以痰热阻肺证(39.00%)多见,风寒束肺证(17.00%)及肺脾气虚证(16.75%)次之,风寒束肺证与痰热阻肺证哮喘患儿多发生在冬春、季(P<0.01)。(3)入选患儿眼影分级情况为:0、Ⅰ、Ⅱ、Ⅲ级分别为71、94、155、80例,其中以Ⅱ级最多见;眼影分级与小儿哮喘病程呈正相关(r=0.581,P<0.01)。风寒束肺证与外寒内热证以0级(39.7%、39.1%)与Ⅰ级(32.4%、34.8%)为主;痰热阻肺证与肺脾气虚证以Ⅱ级(55.8%、47.8%)为主;肺肾阴虚证以Ⅲ级(58.5%)最多,肺实肾虚证、脾肾阳虚证眼影分级差异无统计学意义(P>0.05)。小儿哮喘发作期眼影以Ⅰ级(24.1%)、Ⅱ级(39.4%)为主,缓解期眼影以Ⅱ级(37.3%)、Ⅲ级(28.0%)为主。(4)伴有家族哮喘史或者伴有过敏性鼻炎的小儿哮喘患者的眼影分布中,Ⅱ、Ⅲ级所占比例较大。结论小儿哮喘患儿病程越长,眼影分级越高;风寒束肺证、外寒内热证患者眼影分级低于痰热阻肺证、肺脾气虚证及肺肾阴虚证患者。有家族哮喘史或伴有过敏性鼻炎的患儿眼影分级越高。

Correlations Study of Eye Shadow Stage and TCM Syndromes in Children with Asthma

Objective To observe the distribution and stage of eye shadow in children with asthma,and to explore the correlation between the stage of eye shadow and TCM syndromes of children with asthma.Methods From December 2014 to November 2015,400 children with asthma were enrolled into the study according to the inclusion criteria in the Department of Pediatrics of the First Affiliated Hospital of Hunan University of Traditional Chinese Medicine.According to the TCM syndromes,children with asthma were classified as wind-cold fettering Fei syndrome(68 cases),phlegm and heat-blocking Fei syndrome(156 cases),external cold and internal heat syndrome(46 cases),Fei excess and Shen deficiency syndrome(12 cases),Fei-Pi qi deficiency syndrome(67 cases),Pi and Shen yang deficiency syndrome(10 cases),and Fei and Shen yin deficiency syndrome(41 cases).The data of age and gender of children with asthma were reviewed,and to identify whether the onset season and age were associated with TCM syndromes.Meanwhile,statistical analysis was performed to determine whether the stage of eye shadow was associated with the course and TCM syndromes of children with asthma. Results (1) The incidenee ofchildren with asthma was high in preschool (44. 50%) and early childhood (42. 75%) during all the ages.There was no significant differe nee in gen der betwee n d iff ere nt ages (P =0. 59). (2) On the basis of TCM diagnostic criteria, phlegm heat resista nee phlegm and heat-blocking Fei syn drome (39. 00%) had higher incideneecompared with wind-cold fettering syndrome (17. 00%), and Fei-Pi qi deficiency syndrome(16. 75%). Wind-cold fettering Fei syndrome and phlegm and heat-blocking Fei syndrome mostly occurredin winter and spring (P <0. 01). (3) On the basis of eye shadow grading criteria in this cohort, 71 of the 400patients were in stage 0, 94 in stageⅠ, 155 in stage Ⅱ, 80 in stage Ⅲ, and the patients with stage Ⅱ weremore than any other stages. There was a positive correlation between eye shadow classification and thecourse of children with asthma (r =0.581, P <0.01). As for TCM syndromes, the wind-cold fettering Feisyndrome and the external cold internal and heat syndrome were in stage 0 (39.7%, 39.1 %) and stage I(32.4% , 34. 8%), the phlegm and heat-blocking Fei syndrome and the Fei-Pi qi deficiency syndrome weremainly distributed in stage H (55. 8% , 47.8%), and Fei and Shen yin deficiency syndrome was mainly distributedin stage Ⅲ (58. 5%). There was no significant difference in eye shadow classification between Feiexcess and Shen deficiency syndrome and Pi and Shen yang deficiency syndrome. Eye shadow of acutechildren with asthma was mainly distributed in stage Ⅰ (24.1 %) and grade Ⅱ (39.4%), meanwhile eye shadowsin remission was mainly stage Ⅱ (37. 3%) and stage Ⅲ(28%). (4) In the distribution of eye shadows inpediatric asthma with family history of asthma or allergic rhinitis, stage Ⅱ and ID were comm on. Con clusi ons The eye shadow classification was associated with the course of children with asthma. The stages of eyeshadow in wind-cold bundle Fei syndrome and external cold and internal heat syndrome were lower than inphlegm heat-blocking Fei syndrome, Fei-Pi qi deficiency syndrome or Fei and Shen yin deficiency syn.drome. The stage of eye shadow in children with family history of asthma or allergic rhinitis may be higher.