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1、遼寧中醫(yī)雜志2009年第36卷第12期·2109·從濕溫病論治小兒手足口病122211李偉偉,余婧,韓娟,吳要偉,覃耀真,王力寧(1.廣西中醫(yī)學(xué)院第一附醫(yī)院兒科,廣西南寧530023;2.廣西中醫(yī)學(xué)院,廣西南寧530001)摘要:目的:探討小兒手足口病(HFMD)的中醫(yī)診治方法。方法:對(duì)2008年春夏季節(jié)在我區(qū)流行的小兒手足口病患兒114例進(jìn)行臨床觀察,并按傳統(tǒng)醫(yī)學(xué)中“濕溫病”進(jìn)行論治。結(jié)果:經(jīng)臨床觀察,發(fā)現(xiàn)該病的中醫(yī)證型分布情況中,屬邪傷肺衛(wèi)者85例,占74.56%;衛(wèi)氣同病者27例,占23.68%;氣營(yíng)兩燔者2例,占1.75%。通過中藥內(nèi)外共同
2、施治,114例患兒中臨床痊愈105例,有效9例。結(jié)論:中醫(yī)藥辨證、內(nèi)外兼治本病尤其是一般病例,療效確切,值得臨床推廣運(yùn)用。關(guān)鍵詞:手足口病;兒童;中醫(yī)辨證施治中圖分類號(hào):R512.5文獻(xiàn)標(biāo)識(shí)碼:A文章編號(hào):1000-1719(2009)12-2109-02FromAmongtheEpidemicFebrileDiseasetoTreatHandFootMouthDisease122211LiWei-wei,YuJing,HanJuan,WuYao-wei,QinYao-zhen,WangLi-ning(1.TheFirstHospitalAffil
3、iatedtoGuangxiCollegeofTCM,Guangxi530023,Nanning,China;2.GuangxiCollegeofTCM,Guangxi530001,Nanning,China)Abstract:Objective:Toexplorethdchitdrenhandfootandmouthdisease(HFMD)inChinesemedicinediagnosisandtreat-ment.Methods:The2008springandstunmerinourregionofthePediatrichand,foo
4、tandmouthdiseaseepidemicof114casesofchildreninclinicalobservationsandtraditionalmedicineinthewetwarmdiseasetheoryofgovernance.Results:AfterclinicalobservationofthediseasefoundinthedistributionofTCMsyndromesareevilGuardianofthe85casesoflunginjuryaccountingfor74.56%;Wei-qiwith
5、thediseasein27casesofthetotal23.68%;gasbusinessintwocasesoftwobum1.75%ofthetotal.BytraditionalChinesemedicinewithinthegoverninglawandtheexternaltreatmentofcommonandgivingoftreatment,114casesofchildrenwithclinicalrecoveryin105cases,effectivein9cases.Conclusion:TraditionalChines
6、eMedicineSyndromeDifferenti-ation,IntemalandExternalcasesofthisdisease,especiallyingeneral,curativeeffect,Beconsideredforclinicaluse.Keywords:Hand,F(xiàn)ootandMouihDisease;children;TCMDifferentialTreatmentof手足口病(HFMD)是由多種腸道病毒引起的常見例。從以上資料可見,本病以嬰幼兒及學(xué)齡前兒童為傳染病之一,其中以71型腸道病毒引起的癥狀較重,多發(fā),男性
7、多于女性。以嬰幼兒發(fā)病為主。今年我國(guó)南方地區(qū)氣候反常,使患者中伴有發(fā)熱者54例,低熱占21例,高熱者占該病呈較大范圍流行。但大多數(shù)患者癥狀較輕微,以33例,退熱時(shí)間平均2~3天;舌質(zhì)紅,苔薄黃者52發(fā)熱,手足和口腔黏膜皰疹,破潰后形成潰瘍?yōu)橹饕R例,苔黃厚膩者62例;伴有咳嗽者30例;心率明顯增[1]床特征,對(duì)患兒危害較大。部分患兒可伴有咳嗽、流快者36例。涕、食欲不振、惡心、嘔吐、頭痛等癥狀。少數(shù)患者可并實(shí)驗(yàn)室檢查:血常規(guī)檢查白細(xì)胞增高者30例,心發(fā)無菌性腦膜炎、腦炎、急性弛緩性麻痹、呼吸道感染、肌酶升高者27例;血糖高者12例;CRP檢查均在正
8、肺水腫和心肌炎等,個(gè)別重癥患兒病情進(jìn)展快,易發(fā)生常范圍;心電圖檢查輕度異常者9例、無明顯異常者死亡。西醫(yī)治療本病尚無特效措