中医证型在儿童幽门螺杆菌感染致上消化道黏膜病变中的分布特点及与中医体质的关系分析  

Distribution characteristics of traditional Chinese medicine syndromes in upper gastrointestinal mucosal lesions caused by Helicobacter pylori infection in children and analysis of the correlation with traditional Chinese medicine constitution

作　　者：吕金芳 高利伟[1] 林健瑶 郝彤彤 颜斐斐[1] 罗文雄[1] LYU Jin-fang;GAO Li-wei;LIN Jian-yao(Department of Paediatrics,Guangdong Women and Children Hospital,Guangzhou 511400,China)

机构地区：[1]广东省妇幼保健院,广东省儿童医院儿科消化科,511400

出　　处：《中国实用医药》2024年第20期148-151,共4页China Practical Medicine

基　　金：广东省中医药局科研项目资助(项目编号:20201034)。

摘　　要：目的探讨中医证型在儿童幽门螺杆菌(Hp)感染致上消化道黏膜病变中的分布特点及与中医体质的关系。方法230例确诊为Hp感染致上消化道黏膜病变患儿为研究对象,根据患儿临床症状、舌象等资料对患儿进行中医证型和体质辨识,观察Hp感染致上消化道黏膜病变患儿的中医证型、中医体质分布情况,分析Hp感染致上消化道黏膜病变患儿中医证型在不同中医体质中的分布情况。结果①230例患儿中,脾胃湿热证最多,占25.2%,其次为肝胃气滞证、脾胃气虚证,分别占18.7%、17.4%,各中医证型占比存在差异,依次为脾胃湿热证>肝胃气滞证>脾胃气虚证>胃阴不足证>脾胃虚寒证>肝胃郁热证>胃络瘀阻证。②230例患儿中平和质60例,占26.1%;偏颇质170例,占73.9%。偏颇质中前3位体质类型依次为湿热质(21.3%)、气郁质(13.0%)、阴虚质(11.3%),其中以湿热质最多见。③湿热质中脾胃湿热证最多,占44.9%(22/49);气郁质中肝胃气滞证最多,占53.3%(16/30);痰湿质中脾胃湿热证最多,占53.3%(8/15);阴虚质中胃阴不足证最多,占65.4%(17/26);平和质中脾胃湿热证占比23.3%(14/60)、脾胃气虚证占比20.0%(12/60)、脾胃虚寒证占比18.3%(11/60)、胃阴不足证占比20.0%(12/60)、肝胃气滞证占比13.3%(8/60)占比均高于肝胃郁热证的5.0%(3/60)。④肝胃气滞证以气郁质(37.2%,16/43)和平和质(18.6%,8/43)居多;脾胃湿热证以湿热质(37.9%,22/58)、平和质(24.1%,14/58)、痰湿质(13.8%,8/58)居多;脾胃气虚证以气虚质(30.0%,12/40)和平和质(30.0%,12/40)居多。结论Hp感染致上消化道黏膜病变患儿偏颇体质多见,以湿热质、气郁质、阴虚质为主,结合体质的可调性,通过纠正或改善体质偏颇,改善疾病的临床症状,起到预防疾病的作用。Objective To explore the distribution characteristics of traditional Chinese medicine syndromes in upper gastrointestinal mucosal lesions caused by Helicobacter pylori(Hp)infection in children and analysis of the correlation with traditional Chinese medicine constitution.Methods 230 children diagnosed with upper gastrointestinal mucosal lesions caused by Helicobacter pylori infection were selected as the research subjects.Traditional Chinese medicine syndromes and constitutional identification were carried out according to clinical symptoms and tongue image of the children,and the distribution of traditional Chinese medicine syndromes in different traditional Chinese medicine constitutions of children with upper gastrointestinal mucosal lesions caused by Helicobacter pylori infection was analyzed.Results(i)Among the 230 children,spleen and stomach dampness heat syndrome was the most common,accounting for 25.2%,followed by liver and stomach qi stagnation syndrome,and spleen and stomach qi deficiency syndrome,accounting for 18.7%and 17.4%.There were differences in the percentage of traditional Chinese medicine syndromes,which were spleen and stomach dampness heat syndrome>liver and stomach Qi stagnation syndrome>spleen and stomach Qi deficiency syndrome>stomach Yin deficiency syndrome>spleen and stomach deficiency cold syndrome>liver and stomach stagnation heat syndrome>stomach collateral stasis obstruction syndrome.(ii)Among the 230 children,60 cases were peaceful constitution,accounting for 26.1%.170 cases were biased constitution,accounting for 73.9%.The top 3 biased constitution were damp-heat constitution(21.3%),Qi stagnation constitution(13.0%)and Yin deficiency constitution(11.3%),among which damp-heat constitution was the most common.(iii)Spleen and stomach dampness heat syndrome was the most common in damp-heat constitution,accounting for 44.9%(22/49);liver and stomach qi stagnation syndrome was the most common in Qi stagnation constitution,accounting for 53.3%(16/30);spleen and stomach dampness heat syndr

关 键 词：幽门螺杆菌 上消化道黏膜病变 中医体质 中医证型 

分 类 号：R272[医药卫生—中医儿科学]