420例肺炎支原体肺炎患儿中医证型分布及相关危险因素分析  

Distribution of Traditional Chinese Medicine Syndromes and Related Risk Factors in Children with Mycoplasma Pneumoniae Pneumonia:An Analysis of 420 Cases

作　　者：陈天柱 宋媛媛 李冉 刘传英 陈亚宾 刘华[2] 许华[2] CHEN Tian-Zhu;SONG Yuan-Yuan;LI Ran;LIU Chuan-Ying;CHEN Ya-Bin;LIU Hua;XU Hua(The First Clinical Medical School of Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China;The First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China)

机构地区：[1]广州中医药大学第一临床医学院,广东广州510405 [2]广州中医药大学第一附属医院,广东广州510405

出　　处：《广州中医药大学学报》2024年第10期2704-2712,共9页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：广东省自然科学基金项目(编号:2014A030313410);广州市科技计划项目(编号:2023A04J1172)。

摘　　要：【目的】探讨肺炎支原体肺炎(MPP)患儿中医证型分布规律及其相关危险因素。【方法】收集广州中医药大学第一附属医院收治的420例MPP患儿的临床资料,包括性别、年龄、既往呼吸道疾病病史、中医证型、MPP分型、咳嗽时长、发热时长、发热峰值、实验室指标[C反应蛋白(CRP)、降钙素原(PCT)、乳酸脱氢酶(LDH)]以及是否合并感染等;运用SPSS 26.0软件进行数据统计,分析MPP患儿的中医证型分布规律及其与各项临床资料的相关性,探讨基于中医证型的不同MPP分型的相关危险因素。【结果】(1)420例MPP患儿中,轻型283例(67.4%),难治型76例(18.1%),重型61例(14.5%);风热闭肺证152例(36.2%),痰热闭肺证141例(33.6%),湿热闭肺证77例(18.3%),毒热闭肺证25例(6.0%),肺脾气虚证16例(3.8%),阴虚肺热证9例(2.1%);单纯肺炎支原体感染295例(70.2%),混合感染125例(29.8%)。(2)不同中医证型MPP患儿在年龄分层、就诊季节方面比较,差异均有统计学意义(P<0.01),而在性别、既往有无呼吸道病史、是否合并感染方面比较,差异均无统计学意义(P>0.05)。(3)不同MPP分型在就诊季节、既往有无呼吸道病史、是否合并感染比较,差异均有统计学意义(P<0.05),而在性别及年龄分层方面比较,差异均无统计学意义(P>0.05)。(4)不同中医证型的CRP、PCT等实验室指标及咳嗽时长、发热时长、热峰等症状表现比较,差异均有统计学意义(P<0.05或P<0.01)。(5)不同MPP分型的PCT、LDH等实验室指标及咳嗽时长、发热时长、峰值等症状表现比较,差异均有统计学意义(P<0.05或P<0.05)。(6)多因素Logistic回归分析结果提示:CRP≥10.5 mg/L和风热闭肺证是轻症MPP的独立危险因素(P<0.05或P<0.01);发热≥7 d、咳嗽≥12 d和痰热闭肺证是难治性MPP的独立危险因素(P<0.05或P<0.01);咳嗽≥12 d、混合感染、毒热闭肺证是重症MPP的独立危险因素(P<0.01)。【结论】该研究发现,MPP分型�Objective To investigate the distribution of traditional Chinese medicine(TCM)syndromes and related risk factors in children with mycoplasma pneumoniae pneumonia(MPP).Methods The clinical data of 420 children with MPP admitted to the First Affiliated Hospital of Guangzhou University of Chinese Medicine were collected.The clinical data included gender,age,history of respiratory tract diseases,TCM syndromes,MPP classification,cough duration,fever duration,fever peak value,laboratory indicators of C-reactive protein(CRP),procalcitonin(PCT)and lactate dehydrogenase(LDH),and the complication of infection.SPSS 26.0 software was used for data statistics,and then the distribution of TCM syndromes in children with MPP and its correlation with various clinical data,as well as the related risk factors of MPP with different classification and various TCM syndromes were explored.Results(1)Among the 420 children with MPP,there were 283 cases(67.4%)of mild MPP,76 cases(18.1%)of refractory MPP,and 61 cases(14.5%)of severe MPP.For the distribution of TCM syndromes,there were 152 cases(36.2%)of wind-heat obstructing the lung syndrome,141 cases(33.6%)of phlegm-heat obstructing the lung syndrome,77 cases(18.3%)of damp-heat obstructing the lung syndrome,25 cases(6.0%)of toxin-heat obstructing the lung syndrome,16 cases(3.8%)of lung-spleen qi deficiency syndrome,and 9 cases(2.1%)of yin deficiency and lung heat syndrome.For the classification of infection,there were 295 cases(70.2%)of simple mycoplasma pneumoniae(MP)infection and 125 cases(29.8%)of mixed infection.(2)There were statistically significant differences in age stratification and visit season among MPP children with different TCM syndromes(P<0.01),while no significant differences were shown in the gender,history of respiratory tract diseases,and the complication of infection(P>0.05).(3)There were statistically significant differences in the visit season,history of respiratory tract diseases,and the complication of infection among the children with various MPP types(P<0.05),w

关 键 词：肺炎支原体肺炎 儿童 中医证型 相关性分析 危险因素 风热闭肺证 痰热闭肺证 毒热闭肺证 

分 类 号：R259.631[医药卫生—中西医结合]