儿童抽动障碍的中医证型分布规律及其相关因素分析-distribution of tcm syndrome types and analysis of related factors in children with tic disorders.docx

中文摘要目的：对儿童抽动障碍的中医证型进行调查研究，观察其分布规律，了解各 种相关因素对证型分布的影响，分析探讨各证型的发病特点及证型分布的影响因 素。方法: 根据对本病近十年的相关文献研究，结合本病临床特点，参照《现代 中医儿科学》[1]关于儿童抽动障碍的有关章节内容及其它相关文献，在导师指导 下，设定本病辨证分型及其辨证标准。收集符合纳入标准的患儿 108 例，对入选 的病例，如实填写《儿童抽动障碍调查表》，记录其一般情况、发病时间、临床 表现、出生体重等，并判定其中医证型。随后将收集到的资料进行统计学处理， 分析和探讨各个中医证型的分布规律及证型分布与发病年龄、发病季节、出生方 式、性格情况等因素的相关性。结果：本病综合众多医家之言，儿童抽动障碍五脏相关，大多数认为本病多 责于肝风，亦与心、脾、肺、肾相关。因外感之邪、饮食、情志刺激等均可引发 本病，病机关键在于外邪侵袭，情志不遂，脾胃失和，郁而生热、生痰、动风而 使抽动发作。主要证型及其所占比重为：痰火攻心，心火内扰(35%)、脾虚肝旺， 虚风内动(23%)、肝郁化火，肝风内动(20%)、外感风邪，引动肝风(17%)、肝肾 阴虚，风阳内扰(5%)。结论：本病的发病男性明显多于女性，并且有一定的年龄特点；观察小儿大 多数是剖腹产;小儿性格急躁表现者对肝郁化火，肝风内动、痰火攻心，心火内 扰证型分布影响明显；病程长短对证型分布有一定影响，发病前期以实证为主， 主要表现为，外感风邪，引动肝风、肝郁化火，肝风内动、痰火攻心，心火内扰 等证型为主，中、后期则多伴发虚证或虚实夹杂证，表现为脾虚肝旺，虚风内动、 肝肾阴虚，风阳内扰等证型；在季节上春夏之季肝郁化火，肝风内动、痰火攻心， 心火内扰的发病率相对高。本病的诱发因素有一定特点，我们可以在调查中看出 感冒、积滞、 情志刺激与本病的发作有相关性。 关键词：儿童 抽动障碍 中医证型 Abstract Objective: The Chinese medicine certificate type that takes out to move an obstacle to the child carries on a survey research, observation it distributes regulation,understand various influence that the related factor distributes to the certificate type, impact factor for distributing of outbreak characteristics and certificate type of analysis each certificate of study type. Methods:According to combining this disease clinical characteristics to the collection research in this disease decade,according to 《the modern Chinese medicine pediatrics learn 》the teaching material take out to move an obstacle concerning the child of relevant c hapter contents and other collection , under the tutors instruction, set the dialectics cent type and its dialectics standard of this disease.collections matching to bring into suffering from of standard son is 108, to the case for selecting, such as actually fill in《 the child take out to move an obstacle survey form 》 ,record its general circumstance, be taken bad time, clinical performance and be born weight etc., and judge to cure a certificate type among them.The data that will collect later on carries on a statistics to l