学位论文0-14岁 儿童哮喘（成都片区）的中医发病相关因素的流行病学调查研究Epidemicological Study for Asthma in 0-14 years old (ChengduArea) of The Pathogenesis Relevant Factors of TCM吴玲玲指导教师姓名：申请学位级别：刘 小 凡 硕 士 专业名称： 中医儿科学论文提交时间： 2011年 4月 论文答辩时间： 2011年 5月二 一一年四月 成都中医药大学 2008级硕士学位论文中文摘要目的探讨成都市0-14岁儿童哮喘中医发病的相关因素，为深入认识哮喘中医病因及预防与控制儿童哮喘病提供理论依据。方法本研究采用成组病例对照研究。根据流行病学研究的特点，在成都市随机整群抽取约 12000名 0-14岁儿童，对照组则来自上述整群抽样中非哮喘、无慢性呼吸系统炎症的儿童。对照的选择要求与病例儿童的年龄、性别及民族相匹配，性别及民族应与病例儿童相同，年龄要求相差1岁，如果病例儿童的年龄3岁，则对照儿童的年龄也必须3岁，年龄3岁的儿童一般也要求以年龄3岁的儿童为对照。主要方法是将与儿童哮喘发病有关的因素制定成调查表，以问卷调查的方式，调查分析儿童哮喘发病的相关因素。需先将回收的问卷进行核对检查，除去填写不规范或内容不合格的问卷，再将合格的问卷的结果依次录入计算机，并通过 SPSS17.0统计软件对所录数据进行统计分析，以估计各种中医发病相关因素对儿童哮喘发病的综合效应。成都市本次的流行病学调查分成两组，由于时间等各种原因，本研究仅完成了一组的病例的搜集，即完成了对成都市机关一幼、军区一幼、文翁实验幼儿园、文翁实验小学、草堂小学、苏坡小学、川师大实验外国语学校，这 7所学校及部分散居儿童共 6100人的病例收集。结果在本研究中，病例组 288例哮喘儿童，对照组 124例非哮喘儿童，病例组中男孩 184例，女孩 104例，对照组中男孩 75例，女孩 49例，在单因素分析中，母孕时的饮食寒凉生冷、辛辣燥热偏嗜、五味中对酸、甜偏嗜、特应性体质、儿童平素体质瘦弱、易感冒、腹胀纳差、便溏、畏寒肢冷、动则气短、夜间盗汗及夜尿频多等、家具使用模压板、家中饲养宠物，家中有霉斑现象、房子在孩子出生前后至目前有装修过以及儿童出生前后至目前有被动吸烟、儿童平素易感觉疲劳、平素易动怒、儿童的饮食寒凉生冷、辛辣燥热偏嗜、五味中对酸、甜、咸偏嗜、人工喂养、生产方式中剖宫产以及儿童被褥使用的棉质材料均提示差异有显著性。经多因素非条件 Logistic回归分析，表明有儿童哮喘的中医发病主要相关因1 成都中医药大学 2008级硕士学位论文素有家族史、母孕时饮食辛辣燥热偏嗜、儿童平素易疲劳、儿童饮食的辛辣燥热偏嗜、五味中对酸、甜、咸味偏嗜、儿童平素易感冒、腹胀纳差、畏寒肢冷、过敏性鼻炎、湿疹、人工喂养及目前家中有人吸烟等。结论根据多因素非条件 Logistic回归分析显示：家族史、母孕时饮食辛辣燥热偏嗜、儿童平素易疲劳、儿童饮食的辛辣燥热偏嗜、五味中对酸、甜、咸味偏嗜、儿童平素易感冒、腹胀纳差、畏寒肢冷、过敏性鼻炎、湿疹、人工喂养及目前家中有人吸烟是儿童哮喘中医发病主要相关因素。提示如果平时能及时控制及纠正或从中医方面调理这些主要相关因素，对预防控制儿童哮喘具有重要意义。关键词：儿童哮喘中医发病相关因素流行病调查研究2 成都中医药大学 2008级硕士学位论文AbstractObjectiveTo explore pathogenesis relevant factor in TCM for asthma in 0-14-year-olds,andto provide evidence to preventing children asthma in TCM,so as to shed light on theclinic practice.MethodsThis study adopts group case-control study, According to the characteristics ofepidemiology research in chengdu random cluster extraction about 12,000-14-year-olds,followed from the cluster sampling china-africa asthma, chronic respirator inflammationwithout children. Controls the choice requirements and cases children age, sex ationalmatch, gender and national should with children, age requirement same case differs oneyears old, if the cases are less than 3 years old children age, the contrast the age of thechild must also be less than or equal to three years old, the age is more than 3 years oldchildren generally also requires greater than or equal to three years by age children ascontrols. The main methods are associated with children asthma formulated screen tableinto early factors in the etiology and questionnaire survey, the way was surveyed andanalysised of childhood asthma in reason. Must first was recoveryed a questionnaire,remove complete checking non-standard or content unqualified questionnaire, and thenqualified questionnaire resulted in turn, and through inputting computer statisticssoftware SPSS17.0 to recorded data, to estimate the statistical analysis of relevantfactors of traditional Chinese medicine of childhood asthma relative risk. Because ofinsufficient time, this study did not complete random sampling questionnaire survey ofchengdu in all areas of asthma and the asthma cases achieved only collect, in chengduthe first authorities kindergarten, the military area commands kindergarten, wen-wengexperimemal kindergarten, wen-weng experiment elementary school, cao-tangelementary school, Su-Po elementary school, sichuan normal university experimentforeign language school, this seven schools and some scattered cases of children whowere producing 6,100 collection.3 成都中医药大学 2008级硕士学位论文ResultsIn this study,The matched case-control study was performed in 288 children withasthma and 124 cases of the control group, in cases of asthma children,boy was 184cases andgirl was 104 cases, in the control group, boy was 75 cases and girl was 49cases, in the single factor analysis, mother when progesterone eating cold, spicy hot ofeosinophilic, partial tastes sour, sweet partial eosinophilia and atopic physique, childrenlearn physique emaciated, easy to colds, abdominal distension NaCha, loose stools,chills limb cold and dynamic is shortness of breath, night sweats and a night urinationwait, furniture USES die-pressed sheet, pets, home family has mildew spot phenomenon,house before and after birth to children and children currently has repair before and afterbirth to currently have passive smoking, children learn easy feeling fatigue, practicedmovability anger, childrens eating spicy hot cold, cold of partial eosinophils, tastes sour,sweet and salty partial eosinophils, artificial feeding, mode of production and in use ofcesarean delivery children bedding materials are hint cotton greup. IN the multi-factorregression analysis, Logistic unconditional indicated that there are children asthma ofrelated factors have family history, mother when eating spicy hot progestin eosinophilic,chi