232例成人过敏性哮喘急性发作期患者中医证候分布及特征研究

目的探讨成人过敏性哮喘急性发作期患者中医证候分布规律与证候特征。方法采用回顾性、横断面调查研究方法,收集过敏性哮喘急性发作期患者临床资料,设计中医证候调查表,将患者辨证分为外寒内饮证、痰浊阻肺证、风痰阻肺证、痰热壅肺证4个证型。运用SPSS 25.0软件建立中医临床数据库,分析不同中医证型患者主要症状、伴随过敏性疾病、过敏原IgE类型、血清总免疫球蛋白E(TIgE)水平,探讨过敏性哮喘急性发作期患者中医证候特点。结果共收集232例过敏性哮喘急性发作期患者临床资料,吸入性过敏原排名前三位为尘螨、蟑螂、矮豚草/蒿/葎草/普通豚草,食入性过敏原排名前三位为蟹、海鱼组合、鸡蛋黄(清)/虾。232例患者中以风痰阻肺证(53.88%)为主,其次分别为痰热壅肺证(28.45%)、痰浊阻肺证(9.05%)、外寒内饮证(8.62%)。不同中医证型患者性别、年龄、病程、是否伴随过敏性疾病、疾病严重程度、过敏原IgE类型在证候中的分布差异无统计学意义(P>0.05),而TIgE水平在各证候间的差异有统计学意义(H=9.21,P=0.03),外寒内饮证患者TIgE水平显著高于风痰阻肺证患者(P<0.0083)。不同证型患者主症分布差异无统计学意义(χ²=13.53,P=0.14)。结论成人过敏性哮喘急性发作期患者以风痰阻肺、痰热阻肺证为主要证候类型,外寒内饮证患者血清TIgE水平明显升高。

Distribution and Characteristics of Traditional Chinese Medicine Syndromes in 232 Adults with Acute Attack of Allergic Asthma

Objective To explore the distribution and characteristics of traditional Chinese medicine(TCM) syndromes in adults with acute attack of allergic asthma.Methods A retrospective cross-sectional study was designed to collect data in patients with acute attack of allergic asthma.The TCM syndrome questionnaire was developed,in which patients were divided into four syndromes including external cold and internal rheum syndrome,turbid phlegm obstructing the lung syndrome,wind-phlegm obstructing the lung syndrome,and phlegm-heat obstructing the lung syndrome.SPSS 25.0 software was used to establish a TCM clinical database to analyze the main symptoms,concomitant allergic diseases,allergen IgE type,serum total immunoglobulin E(TIgE)level of each TCM syndrome,and to explore the characteristics of TCM syndromes of adults with acute attack of allergic asthma.Results A total of 232 patients with acute attack of allergic asthma were included.The top three inhaled allergens were dust mites,cockroaches,and dwarf ambrosia/artemisia/humulus/common ambrosia,while the top three inhaled allergens were crab,sea fish combination,and egg yolk or whites/shrimp.Among the 232 patients,the main syndrome was windphlegm obstructing the lung(53.88%),followed by phlegm-heat obstructing the lung syndrome(28.45%),turbid phlegm obstructing the lung syndrome(9.05%)and external cold and internal rheum syndrome(8.62%).There were no significant differences in gender,age,course of disease,whether accompanied by allergic diseases,disease severity,and allergen IgE type among different TCM syndromes(P>0.05).The TIgE levels were significantly different among groups(H=9.21,P<0.05),and they were higher in patients with external cold and internal rheum syndrome than with wind-phlegm obstructing the lung syndrome(P<0.0083).There was no significant difference in the distribution of the main symptoms of patients with different TCM syndrome types(χ²=13.53,P=0.14).Conclusion The main TCM syndromes of adult patients with acute attack of allergic asthma are wind-phlegm obstructing lung syndrome and phlegm-heat obstructing lung syndrome,and higher serum TIgE level is seen in patients with external cold and internal rheum syndrome.