上呼吸道感染患者抗生素治疗前后中医证型变化关系*

[目的]观察上呼吸道感染患者抗生素治疗前后中医证型的变化。[方法]观察86例上呼吸道感染患者抗生素治疗前和治疗后第3天、第6天的舌象及症状变化情况,记录症状及评分。每6天为1个疗程。对新增症状进行统计学聚类分析处理,确定相关的中医证型。用图像软件处理数字舌图,探讨其与中医证型的相关性。[结果]上呼吸道感染患者抗生素治疗前中医证型分布为:风寒证28例,风热证27例,风寒挟湿证12例,风热挟湿证19例;治疗后第3天中医证型分布为:风寒证2例,风热证3例,风寒挟湿证36例,风热挟湿证45例;治疗后第6天中医证型分布为:风寒证2例,风热证1例,风寒挟湿证27例,风热挟湿证56例。聚类分析为湿热蕴脾证和寒湿困脾证2型。治疗后第6天寒湿困脾证与湿热蕴脾证的相同证型评分均和第3天的证型评分有统计学意义(P<0.05)。寒湿困脾证患者舌苔的R、G、B值均低于湿热蕴脾证。[结论]上呼吸道感染患者使用抗生素治疗后多转变为湿热蕴脾证和寒湿困脾证,提示用相应的中医药搭配抗生素使用。

Change of syndrome type of TCM in patients with upper respiratory tract infection before and after antibiotics treatment

[Objective] To observe the change of syndrome type of TCM in patients with upper respiratory tract infection before and after antibiotics treatment.[Methods] We observed tongue picture and the change of symptoms in 86 cases with upper respiratory infection before the treatment and 3 days and 6 days after treatment,recorded the symptoms and the scores.A course was 6 days.Using statistics cluster analysis method to deal with new added symptoms,the relative TCM syndromes were ascertained.Using picture software to handle the tongue picture the dependability with TCM syndromes was determined.[Results] TCM syndrome distribution of upper respiratory tract infection before treatment was:wind-cold syndrome in 28 cases,wind-heat syndrome in 27 cases,wind-cold with damp syndrome in 2 cases,wind-heat with damp syndrome in 19 cases.The TCM syndrome distribution 3 days after treatment was:wind-cold syndrome in 2 cases,wind-heat syndrome in 3 cases,wind-cold with damp syndrome in 36 cases,wind-heat with damp syndrome in 45 cases.The TCM syndrome distribution 6 days after treatment was:wind-cold syndrome in 2 cases,wind-heat syndrome in 1 case,wind-cold with damp syndrome in 27 cases,wind-heat with damp syndrome in 56 cases.The cluster analysis showed that there were two syndromes of damp-heat stagnating in the spleen and cold-damp invasion of spleen.Compared with the syndromes scores at third day,the scores of cold-damp invasion of spleen syndrome and damp-heat stagnating in the spleen syndrome 6 days after treatment had significant difference (P<0.05).The value of coated tongue R,G,and B in patients with cold-damp invasion of spleen syndrome was all less than that in damp-heat stagnating in the spleen syndrome.[Conclusion] The patients with upper respiratory tract infection after antibiotics treatment were mainly changed to damp-heat stagnating in the spleen syndrome and cold-damp invasion of spleen syndrome,suggesting using Chinese traditional medicine with corresponding antibiotics for treatment.