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过敏性鼻炎合并哮喘患者的体质及中医证型分布特点OACSTPCD

Characteristics of constitution and traditional Chinese medicine syndrome distribution in patients with allergic rhinitis complicated with asthma

中文摘要英文摘要

目的 分析过敏性鼻炎合并哮喘患者的体质及中医证型分布特点,为其中西医结合治疗提供依据.方法 全部病例资料均来源于 2020 年 1 月至 2024 年 5 月在"云上三院"过敏微信小程序中经过敏中医体质辨识初筛,并于中山大学附属第三医院过敏科接受多学科诊疗的过敏性鼻炎合并哮喘等的过敏共病患者.采用回顾性分析的方法,收集患者的性别、年龄等基本信息以及中医体质、中医证型等数据.根据该院过敏科团队提出的"过敏的 5A分级诊疗"新理念,将患者分为 3 组,分别是 2A患者(过敏性鼻炎合并哮喘)、3A患者(过敏性鼻炎合并哮喘及特应性皮炎、过敏性结膜炎或食物过敏中任一疾病)和 4A或 5A患者(过敏性鼻炎合并哮喘及特应性皮炎、过敏性结膜炎或食物过敏中任意 2 种或 3 种疾病).结果 2A患者 42 例,其中男 18 例、女 24 例,年龄(26.4±16.6)岁;3A患者 40 例,其中男 19 例、女 21 例,年龄(25.0±15.5)岁;4A或 5A患者 8 例,其中男 5 例、女 3 例,年龄(15.5±13.2)岁.2A患者常见的体质依次是阳虚质(17 例)、气虚质(14 例)、特禀质(11 例),3A患者常见的体质依次是气虚质(23例)、特禀质(16 例)、阳虚质(9 例),4A或 5A患者则以气虚质(6 例)、特禀质(4 例)多见,阳虚质、气虚质在各组患者中的分布存在差异(P均<0.05).2A患者常见的中医证型依次为寒凝阳虚证(10 例)、风寒夹湿证(8 例)、肺脾气虚证(7 例),3A患者常见的中医证型依次为肺脾气虚证(12 例)、寒凝阳虚证(7 例)、脾虚湿阻证(6 例),4A或 5A患者最常见的中医证型为肺脾气虚证(5 例),3 组患者的中医证型分布存在差异(P<0.05).2A患者与 4A或 5A患者比较差异则有统计学意义(P<0.001);3A患者与 4A或 5A患者比较差异有统计学意义(P<0.001).结论 过敏性鼻炎合并哮喘患者常见的体质为阳虚质、气虚质、特禀质,常见的中医证型为寒凝阳虚证、风寒夹湿证和肺脾气虚证.过敏共病不同级别的患者体质及中医证型分布存在差异.

Objective To analyze the distribution characteristics of constitution and traditional Chinese medicine syndrome of allergic rhinitis patients complicated with asthma,aiming to provide basis for integrated traditional Chinese and western medicine treatment for allergic rhinitis complicated with asthma.Methods After preliminary screening of traditional Chinese medicine constitution identification of allergic patients in the allergic WeChat applet of Gamma on Cloud,patients with allergic rhinitis complicated with asthma or other allergic diseases receiving multi-disciplinary diagnosis and treatment of Department of Allergy of the Third Affiliated Hospital of Sun Yat-sen University from January 2020 to May 2024 were selected.General data such as gender and age,constitution of traditional Chinese medicine and traditional Chinese medicine syndrome of allergic rhinitis patients complicated with asthma were collected and retrospectively analyzed.According to the new concept of"allergic 5A grading diagnosis and treatment"proposed by the team from Department of Allergy,all patients were divided into three groups:2A patient group(allergic rhinitis complicated with asthma),3A patient group(allergic rhinitis complicated with asthma,and any of atopic dermatitis,allergic conjunctivitis or food allergy)and 4A or 5A patient group(allergic rhinitis complicated with asthma,and any two or three of atopic dermatitis,allergic conjunctivitis or food allergy).Results There were 42 patients in the 2A group,18 males and 24 females,aged(26.4±16.6)years old,40 patients in the 3A patient group,19 males and 21 females,aged(25.0±15.5)years old,and 8 patients in the 4A or 5A patient group,5 males and 3 females,aged(15.5±13.2)years old,respectively.In the 2A patient group,the most frequent constitutions were yang-deficiency constitution(n=17),qi-deficiency constitution(n=14)and inherited special constitution(n=11).In the 3A patient group,the most common constitutions were qi-deficiency constitution(n=23),inherited special constitution(n=16)and yang-deficiency constitution(n=9).In the 4A or 5A patient group,the most prevalent constitutions were qi-deficiency constitution(n=6)and inherited special constitution(n=4).Fisher's exact test found that there were differences in the distribution of yang-deficiency constitution among all groups(all P<0.05).In terms of traditional Chinese medicine syndromes,the most common traditional Chinese medicine syndromes in the 2A patient group were yang deficiency with congealing cold syndrome(n=10),wind-cold-dampness syndrome(n=8)and lung-spleen qi deficiency syndrome(n=6).The most common traditional Chinese medicine syndromes of 3A patients were lung-spleen qi deficiency syndrome(n=12),yang deficiency with congealing cold syndrome(n=7)and wind-cold-dampness syndrome(n=6).The most common traditional Chinese medicine syndrome of 4A or 5A patients was lung-spleen qi deficiency syndrome(n=5).There were differences in the distribution of traditional Chinese medicine syndromes among the three groups(all P<0.05).The difference between 2A patients and 4A or 5A patients was statistically significant(P<0.001).The difference between 3A patients and 4A or 5A patients was also statistically significant(P<0.001).Conclusions The most common constitutions of allergic rhinitis patients complicated with asthma are yang-deficiency constitution,qi-deficiency constitution and inherited special constitution.The most prevalent traditional Chinese medicine syndromes are yang deficiency with congealing cold syndrome,wind-cold-dampness syndrome and lung-spleen qi deficiency syndrome.There are differences in the distribution of constitution and traditional Chinese medicine syndrome among patients with different grades of allergic rhinitis complicated with asthma.

张晋韬;李跃;杨钦泰;杨宏志;周琪琳;陈鸿杰;柯千山;王晓鹰;戴敏

中山大学附属第三医院肇庆医院中医科,广东 肇庆 526000中山大学附属第三医院中医科,广东 广州 510630中山大学附属第三医院过敏科,广东 广州 510630中山大学附属第三医院中医科,广东 广州 510630中山大学附属第三医院过敏科,广东 广州 510630中山大学附属第三医院中医科,广东 广州 510630中山大学附属第三医院中医科,广东 广州 510630中山大学附属第三医院云上三院研发室,广东 广州 510630中山大学附属第三医院中医科,广东 广州 510630||中山大学附属第三医院过敏科,广东 广州 510630

过敏性鼻炎合并哮喘5A分级诊疗中医体质中医证型

Allergic rhinitis complicated with asthma5A grading diagnosis and treatmentTraditional Chinese medicine constitutionTraditional Chinese medicine syndrome

《新医学》 2024 (10)

810-817,8

国家自然科学基金(U20A20399)广东省中医药重点学科建设项目(20220104)全国名老中医药专家传承工作室建设项目(140000020162)

10.3969/j.issn.0253-9802.2024.10.008

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