支气管哮喘缓解期不同中医证型患儿的肺功能改变情况  

Analysis of pulmonary function changes in children with different TCM syndromes during remission stage of bronchial asthma

作　　者：刘亚尊 薛征[1] 周欢 杨艳[1] 黄莉荣 LIU Ya-zun;XUE Zheng;ZHOU Huan;YANG Yan;HUANG Li-rong(Shanghai Municipal Hospital of Traditional Chinese Medicine,Shanghai 200071,China)

机构地区：[1]上海中医药大学附属市中医医院,上海200071

出　　处：《中华中医药杂志》2022年第10期6006-6009,共4页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：上海市进一步加快中医药传承创新发展三年行动计划[No.ZY(2021-2023)-0206-04]。

摘　　要：目的:通过对支气管哮喘缓解期患儿各中医证型中肺功能改变的分布情况进行研究,探讨不同中医证型中肺功能改变的特点,为支气管哮喘缓解期患儿临床诊治提供新思路。方法:收集上海中医药大学附属市中医医院、上海儿童医学中心支气管哮喘缓解期患儿291例,根据其症状、体征进行中医证素、中医证型的辨别,判定中医证型,并行肺功能检测[用力肺活量(FVC)、第1秒用力呼气量(FEV_(1))、一秒率(FEV_(1)/FVC)、用力呼出25%肺活量的呼气流量(FEF_(25))、用力呼出50%肺活量的呼气流量(FEF_(50))、用力呼出75%肺活量的呼气流量(FEF_(75))],分析不同中医证型中肺功能的改变情况。结果:291例支气管哮喘缓解期患儿中肺脾气虚120例(41.24%)、脾肾阳虚116例(39.86%)、肺肾阴虚55例(18.90%),各中医证型中肺功能相关指标FVC、FEV_(1)、FEV_(1)/FVC、FEF_(25)、FEF_(50)总体分布均在正常范围,而FEF_(75)总体分布在肺脾气虚和脾肾阳虚两证型中为轻度下降(55.10%~56.80%)。结论:支气管哮喘缓解期患儿中医证型以肺脾气虚证居多,其次为脾肾阳虚证和肺肾阴虚证,其肺功能改变以小气道功能下降为主,并与肺脾气虚证及脾肾阳虚证的关系更密切。Objective:Through the study of the distribution of pulmonary function in children with different TCM syndromes during remission stage of bronchial asthma,the characteristics of pulmonary function in different TCM syndromes were explored,for providing new ideas for the clinical diagnosis and treatment of children with bronchial asthma in remission stage.Methods:291 children with bronchial asthma in remission stage from the Shanghai Municipal Hospital of Traditional Chinese Medicine and Shanghai Children’s Medical Center were collected.According to its symptoms and signs,TCM syndrome elements and TCM syndrome types are identified,and TCM syndrome types are determined.The pulmonary function tests[forced vital capacity(FVC),forced expiratory volume in one second(FEV_(1)),forced expiratory volume in one second/forced vital capacity(FEV_(1)/FVC),forced expiratory flow at 25%of FVC exhaled(FEF_(25)),forced expiratory flow at 50%of FVC exhaled(FEF_(50))and forced expiratory flow at 75%of FVC exhaled(FEF_(75))]were performed concurrently to analyze the changes of pulmonary function in different TCM syndrome types.Results:Among the 291 children with bronchial asthma in remission stage,there were 120 cases(41.24%)of deficiency qi of lung and spleen,116 cases of deficiency yang of spleen and kidney(39.86%),and 55 cases of deficiency yin of lung and kidney(18.90%).The distribution of pulmonary function-related indicators FVC,FEV_(1),FEV_(1)/VC,FEF_(25),and FEF_(50) in each TCM syndrome types were all within the normal range,however the distribution of FEF_(75) was slightly decreased(55.10%~56.80%)in the syndromes of deficiency qi of lung and spleen and deficiency yang of spleen and kidney.Conclusion:The TCM syndromes of bronchial asthmatic children in remission stage are mainly syndrome of deficiency qi of lung and spleen followed by syndrome of deficiency yang of spleen and kidney,and deficiency yin of lung and kidney.The change of pulmonary function is mainly the impaired small airway function,which is more closely relate

关 键 词：儿童 支气管哮喘缓解期 中医证型 肺通气功能 小气道功能 

分 类 号：R272[医药卫生—中医儿科学]