157例儿童春季甲型流感临床特点及中医证型分析  

Clinical Characteristics and TCM Syndromes of 157 Pediatric Cases with Spring Season Influenza A

作　　者：袁昕[1] 胡艳[1] 何强[1] 郝静[1] 刘畅[1] Yuan Xin;Hu Yan;He Qiang;Hao Jing;Liu Chang(Beijing Children's Hospital,Capital Medical University,Beijing 100045,China)

机构地区：[1]首都医科大学附属北京儿童医院,北京100045

出　　处：《中国中医急症》2025年第4期620-624,共5页Journal of Emergency in Traditional Chinese Medicine

基　　金：北京市属医院科研培育计划项目(PZ2023027)。

摘　　要：目的分析儿童春季甲型流感临床特点及中医证型。方法以2023年春季连续就诊于首都医科大学附属北京儿童医院中医科的157例首诊确诊为甲流的患儿为研究对象,分析患儿的症状、血常规、降钙素原(PCT)、C反应蛋白(CRP)以及中医舌象、中医辨证等信息。结果首诊甲流患儿平均年龄(6.55±3.57)岁,首发症状出现至就诊平均(1.78±1.76)d,91.72%首诊甲流患儿以“发热”为首发症状;症状组合排序,“发热+咳嗽”最多(80.89%),“发热+便秘”其次(59.87%);90.48%患儿淋巴细胞绝对值(LYM)低于正常值。随着病程进展,中性粒细胞绝对值(NEU)、中性粒细胞百分比(NEU%)、中性粒细胞与淋巴细胞计数比值(NLR)降低,LYM、LYM%升高(P<0.05);95.04%患儿舌色红。随着病程进展,舌色红、苔厚、苔色黄比例升高。中医辨证分型排序,依次为热毒袭肺证(35.03%)、风热犯卫证(33.12%)、风寒束表证(20.38%)、湿遏卫气证(11.46%),0~5岁、5~10岁患儿风热犯卫证多见,分别为32.35%、37.50%,10~16岁患儿热毒袭肺证多见,为52.00%,风热犯卫证、热毒袭肺证在甲流3~14 d多见,分别为52.94%、41.18%。结论5~10岁儿童是甲流的好发人群,发热是最常见的首发症状,合并便秘较为多见,LYM降低可能是儿童甲流早期的常见现象,随病程进展,NEU、NEU%、NLR降低,LYM、LYM%升高,风热犯卫证、热毒袭肺证是儿童春季甲流的主要证型,儿童甲流病情变化快,易夹湿夹滞,易入里化热。Objective:To analyze the clinical characteristics and TCM syndromes of pediatric influenza A during the spring season.Methods:A total of 157 children who were first diagnosed with influenza A at the Department of Traditional Chinese Medicine in Beijing Children's Hospital affliated to Capital Medical University during the spring of 2023 were included.The symptoms,blood routine tests,procalcitonin(PCT),C-reactive protein(CRP),TCM tongue appearance,and TCM syndrome differentiation were analyzed.Results:The average age of the first-diagnosed influenza A patients was(6.55+3.57)years old,and the average time from the onset of initial symptoms to medical consultation was(1.78±1.76)days."Fever"was the initial symptom in 91.72%of the cases.The most common combination of symptoms was"fever+cough"(80.89%),followed by"fever+constipation"(59.87%).Lymphocyte(LYM)counts were below normal in 90.48%of the children.As the disease progressed,neutrophil(NEU),NEU%,and neutrophil-to-lymphocyte ratio(NLR)decreased,while LYM and LYM%increased(P<0.05).Red tongue color was observed in 95.04%of the children,and as the disease progressed,the proportion of red tongue,thick coating,and yellow coating increased.Wind-heat invading weifen(33.12%)and heat-toxin attacking the lung(35.03%)were the most common TCM syndromes.Wind-heat invading weifen was more common in children aged 0~5 years(32.35%)and 5~10 years(37.50%),whereas heat-toxin attacking the lung was more prevalent in children aged 10~16 years(52.00%).Wind-heat invading weifen and heat-toxin attacking the lung were predominant during days 3~14 of the llness(52.94%and 41.18%,respectively).Conclusion:Children aged 5~10 years are at higher risk for influenza A.“Fever”is the most common initial symptom,often accompanied by“constipation"Reduced lymphocyte count may be a common phenomenon in early-stage pediatric influenza A.As the disease progresses,NEU,NEU%,and NLR decrease,while LYM and LYM%increase.Wind-heat invading weifen and heat-toxin attacking the lung are the main TCM syndrom

关 键 词：甲型流感 儿童 临床特点 中医证型 

分 类 号：R511.7[医药卫生—内科学]