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目的:探讨重症手足口病的中医辨证分型特点。方法:统计分析113例重症手足口病患儿的性别、年龄、发病天数、舌象、病位和中医辨证分型等,其中,97例邪陷厥阴、热扰心肝;12例邪陷少阴,心阳虚衰;4例热盛动血、心肺气脱。结果:1~3岁的年龄段占总体的90.3%;85.8%的患儿是在发病4天内达到重症标准。证型以邪陷厥阴、热扰心肝为主,占85.8%,该证型病位主要在心包经和肝经,合并侵犯脾经有47.4%,舌象以舌红苔黄为主,共占52.6%;证型邪陷少阴,心阳虚衰占10.6%,该证型病位主要在心经,合并侵犯脾经有33.3%,舌象以舌淡、苔白为主,占50%。结论:重症手足口病患儿中医证型以邪陷厥阴、热扰心肝多见,临床表现主要为心包经、肝经和心经病证,常合并脾经病变;壮热,神昏,烦躁,易惊,手足抖动,四肢厥冷,呕吐,舌红、苔黄是重症患儿最常见的中医证候。
Objective: To explore the characteristics of TCM syndrome differentiation of severe hand-foot-mouth disease. Methods: Statistical analysis of 113 cases of severe hand-foot-mouth disease in children with gender, age, days of onset, tongue, disease and TCM Syndromes, etc., of which 97 cases of convulsion yue yin, heat interference heart and liver; Yin, heart Yang deficiency failure; 4 cases of hot blood, heart and lung air off. Results: The age group of 1 to 3 years accounted for 90.3% of the total; 85.8% of the children reached the critical standard within 4 days of onset. Syndromes with evil Jueyin, heat-induced liver and heart-based, accounting for 85.8%, the cardinal disease mainly in the pericardium and liver by the merger of the spleen by 47.4%, the tongue like yellow tongue-coating, a total of Accounting for 52.6%; card type evil Shaoyin, heart failure accounted for 10.6% of the heart, the cardinal disease mainly in the cardiogram, combined with violations of the spleen by 33.3% tongue tongue pale, white moss, accounting for 50% . Conclusion: TCM syndromes of children with severe hand-foot-mouth disease are characterized by evil Jueyin and thermal disturbance of heart-liver. Clinical manifestations are mainly pericardial, hepatic and cardio-cerebrovascular diseases, often complicated with splenomegaly; , Easily scared, hands and feet jitter, extremities Jueleng, vomiting, red tongue, moss yellow is the most common TCM syndrome in critically ill children.