【作者】 姜玉婷；

【导师】 邢向晖；

【作者基本信息】 山东中医药大学 ， 中医儿科学， 2004， 硕士

【摘要】 目的：探讨小儿特发性血小板减少性紫癜(idiopathic thrombocytopennicpurpura，ITP)发病规律、预后相关因素并结合中医理论和古今文献分析研究小儿ITP中医证治特点。方法：采用自行设计调查表，对住院记录及随访资料进行整理登记，有关数据经统计学处理。结果：急性型发病高峰在学龄前期，冬春季节多见；慢性型发病高峰在学龄期，夏秋季节多见。两型首次发病年龄及性别构成无明显差异。病毒感染为急性型主要发病诱因，而慢性型多无明显诱因。两型均以病毒感染为主要病情反复诱因，激素减量也是病情反复的重要诱发因素。预后与起病时血红蛋白量、起病至开始治疗时间、血小板开始上升时间、血小板恢复正常时间存在相关性。中医证型以血热妄行型最多见，其次为气不摄血型。血瘀证贯穿疾病始终。表证及湿热证为常见兼证。血热妄行型病程最短，疗效最好，而脾肾阳虚型病程最长，疗效较差。犀角地黄汤应用率最高。具有清热解毒、止血散瘀作用的中药在用药中占绝对优势，补气药物也占一定比例。结论：早诊断、早治疗，积极防治感染，能提高疗效，有效改善本病预后。中医治疗应结合小儿生理病理特点，以清热、益气为主，辨证参病，分阶段治疗。更多还原

【Abstract】 Objectives: To discussing the occurring rule and factors related to prognosis on childhood ITP,and to seach for the characteristic of Chinese Traditional Medicinal syndromes and treating of suffering children..Methors:Survey by uniform questionnaires which is from in-patient medical record.the datas which are brought through statistic test.Result:The acute syndrome reached its climax chiefly in preschool-age,mainly in winter and spring ,but the chronic reached at school age,mainly in summer and autumn.The two syndrome have no distinctive difference in occurring age and sex.The acute syndrome occurred mostly after infection of virus.The Disease were induced repeatedly by the infection of virus. Subtracting of hormone was also an important inducement.The prognosis was related to quantity of hemoglobin ,the duration from onset to beginning treatment,elevating and resuming time of platelet count.Most cases show bleeding due to blood heat ane dificiency of qi.Blood stasis was incidental from begaining to ending.exterior syndrome and damp-heat syndrome are main accompanying syndromes.Blood heat syndrome is the best in curative effect ,but insufficiency of Spleen and Kidney yang syndrome is the worst one.Xi jiao di huang tang is applied most. The medicinal herbs mainly inclouded these which can clear away heat ,decrease fire, cool blood and reinforce qi to stop bleeding.Conclusions:diagnosing and treating early , preventing and cureing infection effectively can improve prognosis.When we treat this disease with Chinese traditional medicine,we must combine children’characteristic in physiology and pathology,not only differentiate syndromes,but also differentiate disease.更多还原