儿童病毒性肺炎中医证候特点及其与微观辨证的相关性研究OA

Objective:To explore the characteristics of traditional Chinese medicine(TCM)syndrome in pediatric viral pneumonia and their correlation with microscopic differentiation.Methods:A total of 1,066 children diagnosed with viral pneumonia were enrolled and classified into seven TCM syndrome types:wind-cold obstructing lung syndrome,wind-heat obstructing lung syndrome,phlegm-heat obstructing lung syndrome,damp-heat obstructing lung syndrome,toxic-heat obstructing lung syndrome,Yin deficiency with lung heat syndrome,and lung-spleen Qi deficiency syndrome.Clinical symptoms,tongue appearance distribution,and TCM syndrome distribution were observed.Inflammatory markers[white blood cell count(WBC),neutrophil count(N),C-reactive protein(CRP),procalcitonin(PCT)]and T lymphocyte subsets(CD3+,CD3+CD4+,CD3+CD8+)were measured.Results:The common symptoms were fever(86.59%),followed by cough(67.92%),tachypnea(52.44%),nasal flaring(41.46%),rales(35.37%),and loose stools(26.83%).Tongue colors were mainly pale red(36.59%)or red(26.83)with tongue coating of yellow and greasy(51.22%).The distribution of TCM syndromes ranked by proportion were as follows:phlegm-heat obstructing lung syndrome(42.68%),wind-cold obstructing lung syndrome(14.63%),wind-heat obstructing lung syndrome(12.20%),Yin deficiency with lung heat syndrome(9.76%),damp-heat obstructing lung syndrome(8.54%),toxic-heat obstructing lung syndrome(6.10%),and lung-spleen Qi deficiency syndrome(6.10%).There were significant differences in levels of WBC count,N count,CRP level,PCT level,and absolute counts of CD3+,CD3+CD4+,and CD3+CD8+(P<0.01 or P<0.05)among children with different syndrome types,which indicated a gradient pattern from exterior to interior syndromes and then toward recovery stage.Conclusion:The distribution of TCM syndromes in pediatric viral pneumonia follows the evolution rules from exterior to interior,from excess to deficiency.Phlegm-heat obstructing lung syndrome is the main syndrome type,with heat,phlegm,toxicity and stasis persisting throughout the disease course.Serum inflammatory markers and T lymphocyte subsets exhibit gradual differences among syndrome types,which suggest that the indexes above can be used as the key to clinical syndrome differentiation and disease assessment.