2013年广州及西双版纳117例登革热患者中医证候特征分析  

Characteristics of Traditional Chinese Medical Syndrome Types of Dengue Fever Patients Admitted in Guangzhou and Xishuangbanna in the Year of 2013: An Analysis of 117 Cases

作　　者：严景妍[1] 谭行华[2] 张复春[2] 洪文昕[2] 单西云[3] 马得宏[3] 

机构地区：[1]广州中医药大学,广东广州510405 [2]广州市第八人民医院,广东广州510060 [3]云南省西双版纳傣族自治州人民医院,云南西双版纳666100

出　　处：《广州中医药大学学报》2015年第4期589-593,共5页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：国家"十二.五"科技重大专项(编号:2012ZX10004301-003)

摘　　要：【目的】观察2013年广州及西双版纳暴发流行性登革热(DF)的中医临床证候特征,探讨两地患者的病情差异、治疗情况及其病因病机。【方法】对广州市第八人民医院登革热流行期间收治的255例患者中接受中西医结合治疗的78例患者及西双版纳州医院120例患者中接受中西医结合治疗的39例患者之中医证候分型及中医证候积分进行总结,对登革热流行的时间和地点进行物候学分析,并根据温病学卫气营血辨证理论探讨登革热的病因病机。【结果】(1)2013年广州登革热流行时间约为7月上旬至11月中旬,西双版纳登革热流行时间约为8月中旬至10月上旬。广州流行时间为夏末及整个秋季,消失于冬天来临之时。西双版纳流行时间为秋季,消失于比较寒冷的深秋。(2)两医院登革热患者的中医证型均以气血两燔为主,瘀毒交结次之,再次之为气分热盛和邪伏膜原。(3)治疗前,两医院患者的发热证候积分比较,西双版纳州医院患者的发热积分更高(P<0.01);治疗3 d后,两医院患者的发热证候积分均较治疗前显著改善(P<0.05或P<0.01),但两医院患者的发热证候积分比较差异无统计学意义(P>0.05);治疗6 d后,两医院患者均无发热。(4)治疗前,西双版纳州医院患者的病情更加严重,2组中医证候积分比较差异有统计学意义(P<0.05);治疗3 d后,两医院患者的中医证候均得到显著改善(P<0.01),西双版纳州医院患者的病情较广州市第八人民医院患者仍更严重(P<0.05);治疗6 d后,患者的中医证候继续改善,与治疗3 d后比较差异有统计学意义(P<0.01)。【结论】广州及西双版纳登革热患者的中医证型均以气血两燔为主,瘀毒交结次之;广州患者总体病情比西双版纳患者轻,两地治疗效果基本一致,患者症状的缓解均需1周左右。Objective To investigate the characteristics of traditional Chinese medical syndrome types of fulminant and epidemic dengue fever patients admitted in Guangzhou and Xishuang banna in the year of 2013,and to ex plore the differences of etiology and pathogenesis, illness, and treatment for the patients in the two regions. Methods We collected the clinical data of 78 cases receiving integrative Chinese and western medicine from 255 patients admitted in Guangzhou Municipal Eighth People＇s Hospital, and the clinical data of 39 cases receiving integrative Chinese and western medicine from 120 patients admitted in the People＇s Hospital of Xishuangbanna Dai Nationality Autonomous Prefecture in the year of 2013. The traditional Chinese medical syndrome types and the syndrome scores of the total of 117 cases were investigated. The method of phenology was used for the analysis of epidemic time and epidemic region of dengue fever, and the theory of defense-qi-nutrient-blood syndrome differentiation of seasonal febrile diseases was used for the analysis of etiology and pathogenesis of dengue fever. Results（1） Dengue fever was epidemic in the first ten days of July and in the middle ten days of November of the year 2013 in Guangzhou region, and was epidemic in the middle ten days of August and the first ten days of October in Xishuangbanna region. The epidemicity of dengue fever in Guangzhou covered the end of summer and the whole autumn, and then disappeared before the coming of winter. In Xishuangbanna, the epidemicity of dengue fever was obvious in autumn, and disappeared in late autumn.（2） In the two hospitals, dengue fever patients were dominated by the syndromes of excessive heat in both Qifen and Xuefen, blood stasis blended with toxicity, excessive heat in Qifen, and lingering pathogens in order.（3） Before treatment, the scores of fever were higher in patients of Xishuangbanna hospital than those in patients of Guangzhou Eighth People＇s Hospital（P〈0.01）. After treatment for 3 days, fever scores

关 键 词：登革热 中医证候特征 

分 类 号：R259.128[医药卫生—中西医结合]