小儿病毒性肺炎的病原体及中医证型分布特点的临床研究
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摘要
目的：回顾性研究小儿病毒性肺炎病原体及中医证型分布特点。
方法：采用回顾性的研究方法,对2002年6月～2007年6月在黑龙江中医药大学附属第一医院儿科病房住院的4937例急性肺炎患儿,进行病原学检测,从中筛选出108例病毒性肺炎患儿,进行中医辨证分型,探讨小儿病毒性肺炎不同病原体在不同的中医证型、发病年龄、发病季节的分布情况,中医证型在不同发病季节的分布情况。
结果：本次研究的108例病毒性肺炎患儿病原学检测中,已知病毒72例,占66.7%,其中呼吸道合胞病毒21例,占19.4%,腺病毒14例,占13.0%,流感病毒37例,占34.3%；未知病毒36例,占33.3%；在已知病毒中流感病毒占首位。研究结果显示：小儿病毒性肺炎常见病原体的分布与发病年龄虽无相关性,但有其特点,1～3岁的婴幼儿76例,占70.4%,其中呼吸道合胞病毒、腺病毒、流感病毒、未知病毒分别占76.2%、71.4%、64.9%、72.2%,说明病毒性肺炎在1-3岁的患儿中发病率最高。小儿病毒性肺炎常见病原体的分布与发病季节虽无相关性,但也有其特点,呼吸道合胞病毒肺炎21例,春季发病16例,占76.2%；腺病毒肺炎14例,春季发病6例,占42.9%,夏季发病4例,占28.6%；流感病毒肺炎37例,春季发病23例,占62.2%,冬季发病8例,占21.6%；说明病毒性肺炎多见于春季,冬季次之。本次观察小儿病毒性肺炎病原体与中医证型分布无相关性,但也有其特点,毒热闭肺型肺炎5例,其中2例是由腺病毒感染所引起,3例是由未知病毒感染所引起,说明毒热闭肺证多由腺病毒和未知病毒引起。本次研究病毒性肺炎108例,其中风热闭肺证60例,占55.6%；痰热闭肺证42例,占38.9%；风热闭肺证加痰热闭肺证总计102例占总中医证型的94.5%；说明小儿病毒性肺炎主要见于风热闭肺证和痰热闭肺证。本次观察显示：风热闭肺证60例,春季发病41例,占68.3%,冬季发病13例,占21.7%；痰热闭肺证42例,春季发病20例,占47.6%,夏季发病10例,占23.8%。说明风热闭肺多见于冬春两季,痰热闭肺证多见于春夏季节。
结论：1.小儿病毒性肺炎病原体与发病年龄无相关性。
2.小儿病毒性肺炎病原体与发病季节无相关性。
3.小儿病毒性肺炎病原体与中医证型分布无相关性。
4.小儿病毒性肺炎中医证型分布与发病季节有相关性。
Objective:retrospective study of children with viral pneumonia pathogens, TCM distribution.
Method:A retrospective research methods, on the June 2002-June 2007 in the Heilongjiang University of Chinese Medicine First Affiliated Hospital pediatric ward of 4937cases of acute pneumonia in hospitalized patients, detection of etiology,108 cases of the virus selected from pneumonia in children, for TCM Syndrome type of viral pneumonia in children of different pathogens in different syndromes, age, seasonal distribution of disease, disease syndromes in different seasons of the distribution.
Results:The study of 108 cases of viral pathogen detection in children with pneumonia,72 cases of known virus, accounting for 66.7%, of which 21 cases of respiratory syncytial virus, accounting for 19.4%, adenovirus in 14 cases,13.0%, influenza virus 37 cases, accounting for 34.3%; unknown virus in 36 cases,33.3%; in the known viruses of influenza viruses top the list. The results showed that:children with viral pneumonia in the distribution of pathogens While no correlation with age of onset, but its characteristics,1 to 3 years 76 cases of infants, accounting for 70.4%, of which respiratory syncytial virus, adenovirus, influenza virus, unknown viruses accounted for 76.2%、71.4%、64.9%、72.2%, indicating that viral pneumonia in children with 1 to 3, the highest incidence. Children with viral pneumonia in the distribution of pathogens associated with the incidence of substance though not in season, but also has its characteristics, respiratory syncytial virus pneumonia in 21 cases,16 cases of disease in spring, accounting for 76.2%; adenovirus pneumonia in 14 cases,6 cases of disease in spring, accounting for 42.9% incidence of 4 cases in summer, accounting for 28.6%; influenza virus pneumonia in 37 cases,23 cases of disease in spring, accounting for 62.2%,8 cases of disease in winter, accounting for 21.6%; shows viral pneumonia more common in spring and winter. The observation of children with viral pneumonia pathogens and of syndromes not related to sex, but also has its characteristics, drug fever closed lung-acquired pneumonia in 5 cases,2 of which were made by the adeno virus infection induced in 3 patients by unknown virus infection cause, indicating more toxic heat closed the lung by the adenovirus and unknown viruses. In this study,108 cases of viral pneumonia, which closed the lung air heat 60 cases,55.6%; phlegm closed 42 cases of the lung, accounting for 38.9%; wind heat closed closed the lung increases the lung phlegm heat total of 102 cases were TCM 94.5%; shows mainly seen in children with viral pneumonia, wind-heat and phlegm closed the lung closed the lung. The observations:wind-heat closed the lung 60 cases, 41 cases of disease in spring,accounting for 68.3%, winter disease in 13 cases, 21.7%; phlegm closed the lung 42, Spring onset in 20 cases,47.6%, incidence in summer 10 cases, accounting for 23.8%. Note wind-heat common in winter and spring closed lung, phlegm closed the lung more common in spring and summer.
Conclusion:1. Children with viral pneumonia pathogens not associated with age.
'2. Pathogens in children with viral pneumonia not associated with the incidence of the season.
3. Children with viral pneumonia, the distribution of pathogens and syndromes not related.
4. Children with viral pneumonia of syndromes associated with the onset season
方法：采用回顾性的研究方法,对2002年6月～2007年6月在黑龙江中医药大学附属第一医院儿科病房住院的4937例急性肺炎患儿,进行病原学检测,从中筛选出108例病毒性肺炎患儿,进行中医辨证分型,探讨小儿病毒性肺炎不同病原体在不同的中医证型、发病年龄、发病季节的分布情况,中医证型在不同发病季节的分布情况。
结果：本次研究的108例病毒性肺炎患儿病原学检测中,已知病毒72例,占66.7%,其中呼吸道合胞病毒21例,占19.4%,腺病毒14例,占13.0%,流感病毒37例,占34.3%；未知病毒36例,占33.3%；在已知病毒中流感病毒占首位。研究结果显示：小儿病毒性肺炎常见病原体的分布与发病年龄虽无相关性,但有其特点,1～3岁的婴幼儿76例,占70.4%,其中呼吸道合胞病毒、腺病毒、流感病毒、未知病毒分别占76.2%、71.4%、64.9%、72.2%,说明病毒性肺炎在1-3岁的患儿中发病率最高。小儿病毒性肺炎常见病原体的分布与发病季节虽无相关性,但也有其特点,呼吸道合胞病毒肺炎21例,春季发病16例,占76.2%；腺病毒肺炎14例,春季发病6例,占42.9%,夏季发病4例,占28.6%；流感病毒肺炎37例,春季发病23例,占62.2%,冬季发病8例,占21.6%；说明病毒性肺炎多见于春季,冬季次之。本次观察小儿病毒性肺炎病原体与中医证型分布无相关性,但也有其特点,毒热闭肺型肺炎5例,其中2例是由腺病毒感染所引起,3例是由未知病毒感染所引起,说明毒热闭肺证多由腺病毒和未知病毒引起。本次研究病毒性肺炎108例,其中风热闭肺证60例,占55.6%；痰热闭肺证42例,占38.9%；风热闭肺证加痰热闭肺证总计102例占总中医证型的94.5%；说明小儿病毒性肺炎主要见于风热闭肺证和痰热闭肺证。本次观察显示：风热闭肺证60例,春季发病41例,占68.3%,冬季发病13例,占21.7%；痰热闭肺证42例,春季发病20例,占47.6%,夏季发病10例,占23.8%。说明风热闭肺多见于冬春两季,痰热闭肺证多见于春夏季节。
结论：1.小儿病毒性肺炎病原体与发病年龄无相关性。
2.小儿病毒性肺炎病原体与发病季节无相关性。
3.小儿病毒性肺炎病原体与中医证型分布无相关性。
4.小儿病毒性肺炎中医证型分布与发病季节有相关性。
Objective:retrospective study of children with viral pneumonia pathogens, TCM distribution.
Method:A retrospective research methods, on the June 2002-June 2007 in the Heilongjiang University of Chinese Medicine First Affiliated Hospital pediatric ward of 4937cases of acute pneumonia in hospitalized patients, detection of etiology,108 cases of the virus selected from pneumonia in children, for TCM Syndrome type of viral pneumonia in children of different pathogens in different syndromes, age, seasonal distribution of disease, disease syndromes in different seasons of the distribution.
Results:The study of 108 cases of viral pathogen detection in children with pneumonia,72 cases of known virus, accounting for 66.7%, of which 21 cases of respiratory syncytial virus, accounting for 19.4%, adenovirus in 14 cases,13.0%, influenza virus 37 cases, accounting for 34.3%; unknown virus in 36 cases,33.3%; in the known viruses of influenza viruses top the list. The results showed that:children with viral pneumonia in the distribution of pathogens While no correlation with age of onset, but its characteristics,1 to 3 years 76 cases of infants, accounting for 70.4%, of which respiratory syncytial virus, adenovirus, influenza virus, unknown viruses accounted for 76.2%、71.4%、64.9%、72.2%, indicating that viral pneumonia in children with 1 to 3, the highest incidence. Children with viral pneumonia in the distribution of pathogens associated with the incidence of substance though not in season, but also has its characteristics, respiratory syncytial virus pneumonia in 21 cases,16 cases of disease in spring, accounting for 76.2%; adenovirus pneumonia in 14 cases,6 cases of disease in spring, accounting for 42.9% incidence of 4 cases in summer, accounting for 28.6%; influenza virus pneumonia in 37 cases,23 cases of disease in spring, accounting for 62.2%,8 cases of disease in winter, accounting for 21.6%; shows viral pneumonia more common in spring and winter. The observation of children with viral pneumonia pathogens and of syndromes not related to sex, but also has its characteristics, drug fever closed lung-acquired pneumonia in 5 cases,2 of which were made by the adeno virus infection induced in 3 patients by unknown virus infection cause, indicating more toxic heat closed the lung by the adenovirus and unknown viruses. In this study,108 cases of viral pneumonia, which closed the lung air heat 60 cases,55.6%; phlegm closed 42 cases of the lung, accounting for 38.9%; wind heat closed closed the lung increases the lung phlegm heat total of 102 cases were TCM 94.5%; shows mainly seen in children with viral pneumonia, wind-heat and phlegm closed the lung closed the lung. The observations:wind-heat closed the lung 60 cases, 41 cases of disease in spring,accounting for 68.3%, winter disease in 13 cases, 21.7%; phlegm closed the lung 42, Spring onset in 20 cases,47.6%, incidence in summer 10 cases, accounting for 23.8%. Note wind-heat common in winter and spring closed lung, phlegm closed the lung more common in spring and summer.
Conclusion:1. Children with viral pneumonia pathogens not associated with age.
'2. Pathogens in children with viral pneumonia not associated with the incidence of the season.
3. Children with viral pneumonia, the distribution of pathogens and syndromes not related.
4. Children with viral pneumonia of syndromes associated with the onset season
引文
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[3]汪受传.新世纪全国高等中医药院校七年制规划教材.中医儿科学.中国中医药出版社,2004,103～104.
[4]谢崇杰.刘弼臣从胃论治小儿咳喘经验摄要.江西中医药,1993,24(3)：15.
[5]李江全.汪受传教授治疗小儿病毒性肺炎经验.中医药学刊,2003,21(1)：44.
[6]艾军,汪受传.清热解郁涤痰化瘀法治疗小儿病毒性肺炎研究.江苏中医药,2009,41(5)：54.
[7]夏树华.开肺化痰法治疗小儿肺炎喘嗽50例.中医药理论与应用研究,514～515.
[8]刘浩.益气解毒法治疗小儿吸道合胞病毒肺炎36例疗效观察.新中医,2007,37(5)：28～29.
[9]杨端芬.增液承气汤治疗小儿病毒性肺炎88例.四川中医,2001,19(3)：60.
[10]王红亮,李居智.二陈汤合兰子养亲汤治疗肺炎喘嗽63例.内蒙古中医药,2009,28(6)：9.
[11]李惠群.咳儿宁治疗肺炎喘嗽痰热证59例.中医杂志,2007,48(3)：205.
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