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目的探讨儿童病毒性心肌炎气阴两虚证证候要素的分布规律。方法将200例病毒性心肌炎患儿分为气阴两虚证组、风热犯心证组、湿热侵心证组、心阳虚弱证组,进行证候要素分布调查,采用因子分析,二项分类、多因素非条件Logistic回归分析等方法进行分析。结果因子分析结果提示儿童病毒性心肌炎气阴两虚证并非单纯的心系的气阴两虚,其病机涉及多个脏腑,是一个综合的脏腑病机演变过程。二项分类回归分析显示,气阴两虚证组与非气阴两虚证组(包括风热犯心证组、湿热侵心证组、心阳虚弱证组)证候要素比较,在胸闷或胸痛、面色苍白、心律改变、心音低钝、心烦、寐差、乏力、头晕、纳差、完谷不化、善太息、默默不语、手足热方面比较差异有统计学意义(P<0.05)。多因素非条件Logistic回归分析结果提示心律改变、心音低钝、头晕、完谷不化、善太息、默默不语等6项证候要素对儿童病毒性心肌炎气阴两虚证具有诊断意义。结论儿童病毒性心肌炎气阴两虚证的病机演变过程中,肝脾两脏起重要作用。
Objective To investigate the distribution of syndromes of Qi and Yin Deficiency Syndrome in children with viral myocarditis. Methods 200 cases of children with viral myocarditis were divided into Qi and Yin Deficiency Syndrome group, Fengrenshexin syndrome group, Damp-heat Invasion syndrome group and Xinyang weak syndrome group. The distribution of syndrome elements was investigated. Factor analysis, Classification, multivariate non-conditional Logistic regression analysis and other methods. Results The results of factor analysis suggested that Qi-Yin Deficiency Syndrome in children with viral myocarditis is not purely Yin-Yin deficiency of heart system. Its pathogenesis involves multiple organs and is an integrated process of organ pathogenesis. The results of two-item regression analysis showed that the two syndromes of qi and yin deficiency syndrome and non-qi and yin deficiency syndrome group (including Fengrenshenxinzheng group, Damp-heat invading syndrome group, Xin Yang weak syndrome group) Chest pain, pale, change of heart rhythm, low heart sound blunt, upset, poor sleep, weakness, dizziness, anorexia, complete diarrhea, good sleep, silent, hand and foot heat were statistically significant differences (P <0.05) . Multivariate non-conditional logistic regression analysis showed that the six syndromes of heart rhythm change, low heart sound dullness, dizziness, complete diarrhea, good rest, silence, etc. have diagnostic value in children with viral myocarditis. Conclusions The pathogenesis of Qi-Yin Deficiency Syndrome in children with viral myocarditis plays an important role in pathogenesis of liver and spleen.