基于多导睡眠监测的儿童阻塞性睡眠呼吸暂停低通气综合征中医证候规律研究  

Research on distribution of TCM syndromes of obstructive sleep apnea hypopnea syndrome in children based on polysomnography

作　　者：丁丽凤[1] 陈洁[2] 张静[3] DING Lifeng;CHEN Jie;ZHANG Jing(Chinese Medicine Department,Shanghai Children’s Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200127,China;Department of Otolaryngology,Shanghai Children’s Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200127,China;Respiratory Department,Shanghai Children’s Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200127,China)

机构地区：[1]上海交通大学医学院附属上海儿童医学中心中医科,上海200127 [2]上海交通大学医学院附属上海儿童医学中心耳鼻咽喉科,上海200127 [3]上海交通大学医学院附属上海儿童医学中心呼吸科,上海200127

出　　处：《上海中医药杂志》2020年第7期76-79,共4页Shanghai Journal of Traditional Chinese Medicine

基　　金：上海市科委中医引导类科研计划项目(17401931100);上海市卫计委科研计划项目(ZHYY-ZXYJHZX-2-201707)。

摘　　要：目的分析儿童阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的中医证候规律,探讨多导睡眠监测(PSG)在本病及中医证候诊断中的应用价值。方法收集90例OSAHS患儿(病例组)及30例非OSAHS儿童(对照组)的中医证候资料及PSG数据,分析儿童OSAHS中医证型、性别、年龄、病情严重程度的分布情况,比较PSG相关指标在病例组、对照组及不同中医证型患儿之间的差异。结果①90例OSAHS患儿中,出现频率位于前10位的症状或体征依次为打鼾、腺样体肿大、张口呼吸、呼吸暂停或憋醒、扁桃体肿大、白天嗜睡、易感冒、倦怠身重、多汗、纳呆。②OSAHS患儿的中医证型以痰湿互结型最为多见(42.2%),其次为肺脾气虚型(31.1%),肺经郁热型相对少见(26.7%);男性多于女性(P<0.05);3~6岁患儿数量多于7~12岁患儿(P<0.05)。③与对照组比较,肺经郁热型、痰湿互结型、肺脾气虚型OSAHS患儿阻塞性呼吸暂停指数(OAI)、呼吸暂停低通气指数(AHI)升高(P<0.05),平均氧饱和度(SM)、最低氧饱和度(SN)降低(P<0.05);与肺经郁热型、肺脾气虚型比较,痰湿互结型OSAHS患儿OAI、AHI值升高(P<0.05),SM、SN降低(P<0.05)。结论儿童OSAHS最常见的中医证型是痰湿互结型;PSG有助于儿童OSAHS中医辨证的客观化、标准化。Objective To analyze the distribution of TCM syndromes of obstructive sleep apnea hypopnea syndrome(OSAHS) in children and to explore the application value of polysomnography(PSG) in the diagnosis of OSAHS and differentiation of TCM syndromes. Methods The information of TCM syndromes and PSG data of 90 OSAHS children(case group) and 30 non-OSAHS children(control group) were collected to analyze the distribution of TCM syndromes, sex, age and disease severity of OSAHS children, and to compare the differences of PSG indexes between case group and control group as well as among cases with different TCM syndromes. Results ①Among 90 OSAHS cases, the top 10 symptoms or signs ranked by occurrence frequency were snoring, adenoid enlargement, mouth breathing, apnea or awakening due to suffocation, tonsil enlargement, daytime drowsiness, susceptibility to common cold, tiredness, hyperhidrosis and poor appetite. ②The most common TCM syndromes of OSAHS children were phlegm-dampness interaction syndrome(42.2%), followed by lung-spleen qi deficiency syndrome(31.1%) and lung meridian stagnation-heat syndrome(26.7%);Male OSAHS cases were more than female ones(P<0.05). The number of OSAHS children aged 3-6 was more than that of OSAHS children aged 7-12(P<0. 05).(3) Compared with the control group,the obstructive apnea index(OAI) and apnea hypopnea index(AHI) increased in OSAHS children with lung meridian stagnation-heat syndrome,phlegm-dampness interaction syndrome and lung-spleen qi deficiency syndrome(P<0.05),while average oxygen saturation(SM) and minimum oxygen saturation(SN)decreased(P<0.05). Compared with the cases with lung meridian-heat stagnation syndrome and spleen-lung qi deficiency syndrome,OAI and AHI increased in OSAHS children with phlegm-dampness interaction syndrome(P<0.05) while SM and SN decreased(P<0.05). Conclusion The most common TCM syndrome of OSAHS children is phlegm-dampness interaction syndrome. PSG is beneficial to the objectification and standardization of TCM syndrome differentiation in children

关 键 词：阻塞性睡眠呼吸暂停低通气综合征 儿童 中医证候 多导睡眠监测 

分 类 号：R276.1[医药卫生—中医五官科学]