Research on the Pathogenesis and Stage Differentiation of 2 115 Cases with Hand-foot-and-mouth Disease

OBJECTIVE To explore the stage differentiation pattern for hand-foot-and-mouth disease thorough studies on the symptomatology of hand-foot-and-mouth disease.METHODS 2 115 required hospitalized cases were divided into general,severe and emergent syndromes to collect frequency of symptoms and physical signs of hand-foot-and-mouth disease so as to analyse the main syndrome and supplemented symptoms if each stage for further evidence factorscluster analysis in order to have the primary and secondary pathogenesis,thus leading to the conclusion for disease transformation and development,which provides regular pattern for stage differentiation.RESULTS Evidence factor analysis found out that dampness(87.97%,96.75%) and heat(98.66%,97.93%)are the main evidence factors for both the general and severe syndrome thorough the whole course.For general syndrome,it has pathoenic factor from the exterior,health qi deficiency from the interior(43.06%),as well as reversed qi circulation(19.22%);for severe syndrome,epidemic toxin has moved into the interior along pathway of the channel,thus having internal wind(73.26%) as main evidence factor besides excess evils,and health qi deficiency(73.26%) became more severe and the reversed qi circulation(37.07%) can also be frequently seen secondary pathogenesis;for emergent syndrome,it has yang depletion,qi escaping,fainting syndrome and internal wind as primary pathogenesis.Therefore,the main pathogenesis for exterior syndrome is pathogenic evils invading Taiyin with both dampness and heat;the main pathogenesis for interior syndrome is internal heat retention,reversed qi circulation,together with the internal movement of the liver wind,evil heat attacking the heat and spirit,and dissociation of yin and yang.CONCLUSION It is very sensible to come with stage differentiation according to the transformation and development of hand-foot-and-mouth disease at each stage,which can not only better reflect progression of it,but also better serve the clinical requirement of TCM as a higher link between Western syndrome differentiation and TCM differentiation,thus is worth further application promotion.