摘要
目的分析自主神经介导性晕厥(ANS)患儿中医辨证分型特点。方法收集2018年7月—2021年2月就诊于复旦大学附属儿科医院儿童晕厥中心的ANS患儿85例,其中经直立倾斜试验(HUTT)诊断为血管迷走性晕厥(VVS)患者60例,体位性心动过速综合征(POTS)患者25例。分析总结患儿的中医辨证分型特点。结果 85例ANS患儿平时最常见的10项症状依次为:头晕、出冷汗、神疲乏力、常不开心情绪低落、胸闷气短、面色苍白、视物模糊、紧张焦虑、多梦、胆小。中医证型归结为肝郁气滞、气阴两虚、气血亏虚、痰热内蕴4种。单一证型31例(36.47%),其中气阴两虚证20例、肝郁气滞证9例、气血亏虚证2例;复合证型54例(63.53%),均以肝郁气滞证(54例)为主证型,兼气血亏虚(29例)、气阴两虚(14例)、痰热内蕴(11例)3个证型。在85例患者中,单一证型和复合证型中诊断为肝郁气滞证的比例最高(63例,74.12%);其次为气阴两虚证(34例,40.0%)、气血亏虚证(31例,36.47%),痰热内蕴证作为兼证11例(12.94%)。60例VVS患者主要证型为肝郁气血亏虚证(20例,33.33%)、气阴两虚证(16例,26.67%)。25例POTS患者主要证型为肝郁气血亏虚证(9例,36.0%)、肝郁气阴两虚证(6例,24.0%)。结论 VVS及POTS患儿的常见症状依次为头晕、出冷汗、神疲乏力、常不开心情绪低落;肝郁气滞和气血阴阳失衡(气阴两虚证、气血亏虚证)是ANS患儿的主要中医辨证分型。
Objective To analyze the characteristics of Chinese medicine(CM)syndrome types in children with autonomic nerve-mediated syncope(ANS). Methods Totally 85 ANS children were recruited at the Pediatric Syncope Center, Children’ s Hospital of Fudan University from July 2018 to February 2021.Sixty patients with vasovagal syncope(VVS)and 25 patients with postural orthostatic tachycardia syndrome(POTS), were diagnosed by head-up tilt test(HUTT). Characteristics of CM syndrome difference within them were analyzed. Results The most common 10 symptoms of children with ANS were: dizziness, cold sweating, fatigue, frequent unhappiness and depress, chest tightness, shortness of breath, pale face, blurred vision, anxiety, dreaminess and timidity. The main CM syndrome types were Gan depression qi stagnation syndrome(GDQSS), qi-yin deficiency syndrome(QYDS), deficiency of qi and blood syndrome(DQBS), and phlegm-heat syndrome(PHS). There were 31 patients(36.47%)in single syndrome, including 20 cases of QYDS, 9 cases of GDQSS, and 2 cases of DQBS. There were 54 patients(63.53%)with complex syndromes, mainly were GDQSS, combined with three syndromes of DQBS(29 cases), QYDS(14 cases)and PHS(11 cases).Among all the patients, the commonest syndrome was GDQSS(63 cases, 74.12%);the latter in order were as follow: QYDS(34 cases, 40.0%), DQBS(31 cases, 36.47%), and PHS(11 cases,12.94%). The main syndrome types of 60 VVS patients were GDQSS and DQBS(20 cases,33.33%), QYDS(16 cases, 26.67%).The main syndrome types of 25 POTS patients were GDQSS and DQBS(9 cases, 36.0%), GDQSS and QYDS(6 cases, 24.0%). Conclusions The common symptoms of VVS and POTS children were dizziness, cold sweats, fatigue, unhappiness and depress. GDQSS, QYDS and DQBS are the main CM syndrome types of ANS in children.
作者
张亦群
韩璐
胡红
俞建
田宏
ZHANG Yi-qun;HAN Lu;HU Hong;YU Jian;TIAN Hong(Department of Integrated Traditional Chinese and Western,Children's Hospital of Fudan University,National Children's Medical Center,Shanghai,201102;Cardiovascular Center,Children's Hospital of Fudan University,National Children's Medical Center,Shanghai,201102)
出处
《中国中西医结合杂志》
CAS
CSCD
北大核心
2021年第10期1186-1191,共6页
Chinese Journal of Integrated Traditional and Western Medicine
关键词
自主神经介导性晕厥
中医证候
辨证分型
autonomic nerve-mediated syncope
Chinese medicine syndromes
syndrome differentiation
