手足口病中医证型特点及其相关因素分析

目的 探讨小儿手足口病中医证型的分布特点及其相关影响因素。方法 收集298例手足口病患儿的中医四诊资料，分析其中医证型分布特点及其与性别、年龄、病程、主要实验室指标的相关性。结果 298例手足口病患儿的中医证型以湿热郁蒸证多见，其次是肺脾湿热证，毒热动风证最少。3种证型患儿的性别、病程比较，差异具有统计学意义（P<0.05），毒热动风证多见于男性患儿，肺脾湿热证多见于发病后5～6 d，湿热郁蒸证多见于发病后5～7 d，毒热动风证多见于发病后7～8 d。3种证型患儿年龄比较，差异无统计学意义（P>0.05）。3种证型患儿感染病原体的类型比较，差异具有统计学意义（P<0.05），肺脾湿热证以感染CoxA16为主，而湿热郁蒸、毒热动风证以感染EV71为主。毒热动风证患儿白细胞计数、血糖、肌酸激酶-MB、血清白细胞介素-6、降钙素原和C反应蛋白水平均明显高于肺脾湿热证和湿热郁蒸证患儿（P＜0.05）。结论 小儿手足口病中医证型的分布具有一定的特点，其与性别、病程及主要实验室指标具有明显的相关性。

Distribution Characteristics of Traditional Chinese Medicine Syndrome Types in Hand, Foot and Mouth Disease and Related Influencing Factors

Objective To investigate the distribution characteristics of TCM syndrome types in hand, foot and mouth disease and related influencing factors. Methods The clinical data of 298 children with hand, foot and mouth disease who were diagnosed with the four diagnostic methods in traditional Chinese medicine (TCM) were collected to analyze the distribution characteristics of TCM syndrome types and their association with sex, age, course of the disease, and major laboratory markers. Results In the 298 children with hand, foot and mouth disease, the most common TCM syndrome type was stagnation and steaming of damp-heat, followed by the syndrome of damp-heat of lung and spleen and the syndrome of stirring wind due to toxic heat. There were significant differences in sex and course of the disease between the children with the three syndrome types (P<0.05). The syndrome of stirring wind due to toxic heat was commonly seen in boys. The syndrome of damp-heat of lung and spleen was commonly seen at 5-6 days after onset, the syndrome of stagnation and steaming of damp-heat was commonly seen at 5-7 days after onset, and the syndrome of stirring wind due to toxic heat was commonly seen at 7-8 days after onset. There was no significant difference in age between the children with the three syndrome types (P>0.05). There was a significant difference in the type of pathogen between the children with the three syndrome types (P<0.05); the children with the syndrome of damp-heat of lung and spleen were mainly infected with coxsackie virus A-16, while those with the syndromes of stagnation and steaming of damp-heat and stirring wind due to toxic heat were mainly infected with enter ovirus 71. Compared with those with the syndromes of damp-heat of lung and spleen and stagnation and steaming of damp-heat, the children with the syndrome of stirring wind due to toxic heat had significantly higher leukocyte count and levels of blood glucose, creatine kinase-MB, serum interleukin-6, procalcitonin, and C-reactive protein (P<0.05). Conclusion The distribution of TCM syndrome types of hand, foot and mouth disease have certain characteristics, which are significantly associated with sex, course of the disease, and major laboratory markers.