192例过敏性紫癜患儿临床特点及中医证候分析  

Clinical Characteristics and TCM Syndromes of 192 Children with Henoch-Schonlein Purpura

作　　者：宋均亚 袭雷鸣[2] 金喻 潘月丽[2] SONG Jun-ya;XI Lei-ming;JIN Yu;PAN Yue-li(Shandong University of Chinese Medicine, Ji'nan Shandong 250014, China;The Affiliated Hospital of Shandong University of Chinese Medicine, Ji'nan Shandong 250011, China)

机构地区：[1]山东中医药大学,山东济南250014 [2]山东中医药大学附属医院,山东济南250011

出　　处：《中医药导报》2019年第13期13-15,21,共4页Guiding Journal of Traditional Chinese Medicine and Pharmacy

摘　　要：目的:探讨儿童过敏性紫癜(HSP)临床特点与中医证型的关系。方法:对192例HSP患儿临床资料行回顾性分析,总结其证候分布规律,并比较患儿发病特点等在各证型分布上的差异。结果:(1)192例患儿中,7岁以上儿童108例,男女之比为1.88∶1,冬春两季多发,农村患儿多见,感染为主要诱因。(2)辨证分型上,风热伤络证27例(14.06%)、血热妄行证47例(24.48%)、湿热内蕴证104例(54.17%)、阴虚火旺证9例(4.69%)及气不摄血证5例(2.60%)。(3)各证型患儿在性别、年龄、居住地、白细胞计数、超敏C反应蛋白、纤维蛋白(原)降解产物水平分布上差异均无统计学意义(P>0.05);在发病季节、肾损害、血小板计数、血清白蛋白、血浆D-二聚体水平分布上差异有统计学意义(P<0.05)。结论:HSP中医辨证分型以风热伤络证、血热妄行证、湿热内蕴证为主,其中风热伤络证以皮肤紫癜为主;血热妄行证、湿热内蕴证多并见腹痛、关节痛表现,且多伴有低蛋白及高凝表现,更易出现肾损害。Objective: To analyze the relationship between clinical features and TCM syndrome types of Henoch-Schonlein purpura (HSP) in children. Methods: A total of 159 cases with HSP hospitalized in our hospital were enrolled and TCM syndrome types were retrospectively studied, the patterns of onset, clinical manifestations, assistant examinations outcomes and related risk factors were compared in different syndrome types. Results:(1) Of the 192 children, 108 cases were over 7 years old, the male and female ratio was 1.88:1, spring and winter are the peak season, more in rural area than in urban area, and the inducing factors were infections.(2) There were 27 cases (14.06%) of wind-heat damaging collaterals syndrome, 47 cases (24.48%) of blood-heat damaging collaterals syndrome, 104 cases (54.17%) of damp-heat damaging collaterals syndrome, 9 cases (4.69%) of yin-deficiency fire-hyperactivity syndrome, 5 cases (2.60%) of qi failing to control blood syndrome.(3) There were no significant difference between various syndrome types in gender, age, area, levels of white blood cells, high sensitive C-reaction, and fibrinogen (P>0.05). There were significant difference between various syndrome types in seasonal incidence, levels of blood platelet counts, serum albumin, and D-2 dimer (P<0.05). Conclusion: The common TCM syndrome types of HSP are wind-heat damaging collaterals syndrome, blood -heat damaging collaterals syndrome and damp-heat damaging collaterals syndrome. Dermal purpura manifestions were mainly in wind-heat damaging collaterals syndrome type, and gastrointestinal or joint manifestions were mainly in bloodheat and damp-heat damaging collaterals syndrome types, hypoproteinemia and hypercoagulable performance are common which are more likely to suffer renal injury.

关 键 词：过敏性紫癜 儿童 中医证型 临床特点 肾损害 

分 类 号：R272.6[医药卫生—中医儿科学]