小儿支气管哮喘100例体质与发病因素研究
摘要
目的:本课题针对小儿支气管哮喘体质与发病因素进行研究,探讨小儿支气管哮喘发病的危险因素,为深入认识哮喘病因及防控儿童哮喘病提供理论依据。
方法:本研究采用的研究方法是成组设计病例对照流行病学调查法,选择于2009年1月~2011年3月在长春中医药大学附属医院儿科门诊与住院诊断的哮喘患儿100例为病例组,选择同期长春中医药大学附属医院儿科门诊与住院非哮喘儿童100例为对照组,采用问卷调查法,调查与儿童哮喘发病相关的因素;收集符合纳入标准的问卷,应用SPSS13.00统计软件及相关统计方法进行统计分析。先对有关变量进行单层成组设计病例对照研究分析,再对单层成组设计病例对照研究分析有意义的因素进行配伍组设计资料的方差分析、多重比较,最后综合讨论各因素与哮喘发病的密切程度。
结果:单层成组设计病例对照研究分析结果显示有统计学意义(P<0.05)的因素有:在既往体质方面,咳嗽、易感、喉间痰鸣、体虚肥胖、面色晄白、肉松、佝偻病明显、发稀、湿疹、鼻塞;在发病病因方面,家族中有哮喘病史、家族中有其它过敏史、药物过敏史、食物过敏史、其它过敏史、反复呼吸道感染史、油漆及油烟接触史。配伍组设计资料的方差分析、多重比较:将体质因素按与哮喘发病关系的密切程度,由强到弱依次分为四级:一级因素为咳嗽之肺气虚体质;二级因素为易感之肺气虚体质,体虚肥胖、肉松之脾气虚体质,湿疹之过敏性体质;三级因素为喉间痰鸣、面色晄白之脾气虚体质,鼻塞之过敏性体质;四级因素为发稀、佝偻病明显之肾气虚体质。又将发病因素按与哮喘发病关系的密切程度,由强到弱依次分为四级:一级因素为反复呼吸道感染史之感染因素;二级因素为家族中有哮喘病史、家族中有其它过敏史之遗传因素;三级因素为油漆油烟接触史之环境因素,食物过敏史之免疫因素;四级因素为药物过敏史、其它过敏史之免疫因素。
结论:肺气虚、脾气虚、肾气虚及过敏性体质等特应质儿童较正常儿童更易发病哮喘,证实了导师王烈教授创新性理论体系之一“哮喘苗期”理论的科学性。遗传因素、感染因素、免疫因素、环境因素均是儿童哮喘发病的相关因素,儿童哮喘的防治应予以高度重视。
Purpose: This topic conducts the research in view of the young child bronchial tube asthma physique and the morbidity factor, discusses the young child bronchial tube asthma morbidity the hazard factor, prevents and controls the child asthma for the thorough understanding asthma cause of disease to provide the theory basis.
Method: This research uses the research technique is the group designs of the case to compare the epidemiology survey procedure, choices in January, 2009 to March, 2011 in Changchun Chinese medicine University affiliated hospital's department of pediatrics outpatient service and in hospital diagnosis's asthma baby 100 examples for the case group, and at same time selects the non-asthma 100 patients as control group, uses the questionnaire survey procedure, investigations with child asthma’s morbidity related factor; collections tallied integrates the standard the questionnaire, carries on the statistical analysis using the SPSS13.00 statistics software and the related statistical method. First and formost,carries on monolayer group to the related variable to design the case to compare the research analysis, The meaningful factor carries on again to the single-layer analysis in blends the group design information the variance analysis, the multiple comparisons, Finally,the synthesis discusses various factors with the asthma morbidity close degree.
Result: The single study analysis of the group designs for the case to compare shows that a statistically significant (P < 0.05) factors include: cough, susceptibility, s throat phlegm sound, body fat, complexion deficiency white, shredded meat, rachitic obvious, hair thin, eczema, stuffynose physical factors such as; Family history of asthma, family there are other history of allergies, drug allergy, food allergy, other history of allergies, repeated respiratory infections history, paint and lampblack exposure disease such as cause.Compatibility of variance analysis of design information, multiple comparison: will physical factors with asthma incidence relation by close degree, from strong to the weak into four levels: level factors in the lungs of deficiency for cough constitution; Secondary factors for the lungs of deficiency of susceptibility physique, body of virtual obesity, shredded meat on spleen-deficiency physique, eczema constitution; the allergic Level 3 factors between for throat white sputum sound, complexion on spleen-deficiency physique, blocked the the allergic constitution; Level 4 factors for hair thin, rachitic case kidney-qi is virtual constitution. Pathogenesis causes too, Level 1 factors for repeated respiratory infections history in the infection factors; In secondary factors for family history of asthma, family have other allergy history of the genetic factors; Level 3 factors of exposure to paint lampblack environmental factor, food allergy history of the immune factors; Level 4 factors for drug allergy history, other allergy history of the immune factors.
Conclusion: Lung qi difficiency and spleen qi deficiency, kidney deficiency and allergic constitution, such as qualitative children should be easier than normal children for becoming asthma, confirmed asthma seedling theory that is one of WangLie professor innovative theory system tutor. Genetic factors, infection factors, immune factors, environmental factors are the pathogenesis of childhood asthma risk factors, the prevention and control of childhood asthma should pay much attention.
方法:本研究采用的研究方法是成组设计病例对照流行病学调查法,选择于2009年1月~2011年3月在长春中医药大学附属医院儿科门诊与住院诊断的哮喘患儿100例为病例组,选择同期长春中医药大学附属医院儿科门诊与住院非哮喘儿童100例为对照组,采用问卷调查法,调查与儿童哮喘发病相关的因素;收集符合纳入标准的问卷,应用SPSS13.00统计软件及相关统计方法进行统计分析。先对有关变量进行单层成组设计病例对照研究分析,再对单层成组设计病例对照研究分析有意义的因素进行配伍组设计资料的方差分析、多重比较,最后综合讨论各因素与哮喘发病的密切程度。
结果:单层成组设计病例对照研究分析结果显示有统计学意义(P<0.05)的因素有:在既往体质方面,咳嗽、易感、喉间痰鸣、体虚肥胖、面色晄白、肉松、佝偻病明显、发稀、湿疹、鼻塞;在发病病因方面,家族中有哮喘病史、家族中有其它过敏史、药物过敏史、食物过敏史、其它过敏史、反复呼吸道感染史、油漆及油烟接触史。配伍组设计资料的方差分析、多重比较:将体质因素按与哮喘发病关系的密切程度,由强到弱依次分为四级:一级因素为咳嗽之肺气虚体质;二级因素为易感之肺气虚体质,体虚肥胖、肉松之脾气虚体质,湿疹之过敏性体质;三级因素为喉间痰鸣、面色晄白之脾气虚体质,鼻塞之过敏性体质;四级因素为发稀、佝偻病明显之肾气虚体质。又将发病因素按与哮喘发病关系的密切程度,由强到弱依次分为四级:一级因素为反复呼吸道感染史之感染因素;二级因素为家族中有哮喘病史、家族中有其它过敏史之遗传因素;三级因素为油漆油烟接触史之环境因素,食物过敏史之免疫因素;四级因素为药物过敏史、其它过敏史之免疫因素。
结论:肺气虚、脾气虚、肾气虚及过敏性体质等特应质儿童较正常儿童更易发病哮喘,证实了导师王烈教授创新性理论体系之一“哮喘苗期”理论的科学性。遗传因素、感染因素、免疫因素、环境因素均是儿童哮喘发病的相关因素,儿童哮喘的防治应予以高度重视。
Purpose: This topic conducts the research in view of the young child bronchial tube asthma physique and the morbidity factor, discusses the young child bronchial tube asthma morbidity the hazard factor, prevents and controls the child asthma for the thorough understanding asthma cause of disease to provide the theory basis.
Method: This research uses the research technique is the group designs of the case to compare the epidemiology survey procedure, choices in January, 2009 to March, 2011 in Changchun Chinese medicine University affiliated hospital's department of pediatrics outpatient service and in hospital diagnosis's asthma baby 100 examples for the case group, and at same time selects the non-asthma 100 patients as control group, uses the questionnaire survey procedure, investigations with child asthma’s morbidity related factor; collections tallied integrates the standard the questionnaire, carries on the statistical analysis using the SPSS13.00 statistics software and the related statistical method. First and formost,carries on monolayer group to the related variable to design the case to compare the research analysis, The meaningful factor carries on again to the single-layer analysis in blends the group design information the variance analysis, the multiple comparisons, Finally,the synthesis discusses various factors with the asthma morbidity close degree.
Result: The single study analysis of the group designs for the case to compare shows that a statistically significant (P < 0.05) factors include: cough, susceptibility, s throat phlegm sound, body fat, complexion deficiency white, shredded meat, rachitic obvious, hair thin, eczema, stuffynose physical factors such as; Family history of asthma, family there are other history of allergies, drug allergy, food allergy, other history of allergies, repeated respiratory infections history, paint and lampblack exposure disease such as cause.Compatibility of variance analysis of design information, multiple comparison: will physical factors with asthma incidence relation by close degree, from strong to the weak into four levels: level factors in the lungs of deficiency for cough constitution; Secondary factors for the lungs of deficiency of susceptibility physique, body of virtual obesity, shredded meat on spleen-deficiency physique, eczema constitution; the allergic Level 3 factors between for throat white sputum sound, complexion on spleen-deficiency physique, blocked the the allergic constitution; Level 4 factors for hair thin, rachitic case kidney-qi is virtual constitution. Pathogenesis causes too, Level 1 factors for repeated respiratory infections history in the infection factors; In secondary factors for family history of asthma, family have other allergy history of the genetic factors; Level 3 factors of exposure to paint lampblack environmental factor, food allergy history of the immune factors; Level 4 factors for drug allergy history, other allergy history of the immune factors.
Conclusion: Lung qi difficiency and spleen qi deficiency, kidney deficiency and allergic constitution, such as qualitative children should be easier than normal children for becoming asthma, confirmed asthma seedling theory that is one of WangLie professor innovative theory system tutor. Genetic factors, infection factors, immune factors, environmental factors are the pathogenesis of childhood asthma risk factors, the prevention and control of childhood asthma should pay much attention.
引文
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[2]全国儿童哮喘防治协作组.中国城区儿童哮喘患病率调查[J].中华儿科杂志,2003.41(2):123-127.
[3]全国儿科哮喘协作组.2000年与1990年儿童支气管哮喘患病率的调查比较[J].中华结核和呼吸杂志,2004.27( 2):112-116.
[4] Arshad M, Hamm RM, Mold JW. Does secondary smoke exposure increase the incidence and /or severity of asthma in children[J].JOK la State Med Assoc,2006.99(2):76-77.
[5] Masoli M, Fabian D, Holt S. Global Burden of Asthma, developed for the global initiative for asthma [EB/OL]. Available at: http://www.gin asthma.com (accessed Mar2004).
[6]饶兴愉,陈强.白介素基因多肤性与支气管哮喘研究现状[J].中国全科医学,2007.7.10(14):1209.
[7]侯绍辉.小儿支气管哮喘发病机制研究进展[J].中国城乡企业卫生,2006.4.(2):34.
[8]胡亚美,江载芳.诸福棠实用儿科学[M].北京:人民卫生出版社,2003.633.
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