AECOPD呼吸衰竭中医证素、证候的分布及与胃肠功能障碍相关研究

目的:通过对AECOPD呼吸衰竭临床病例症状、体征等的横断面调查研究,得出该病证素、证候的分布,并分析其证候与胃肠功能障碍之间的相关性。方法:对符合纳入标准的临床病例资料进行横断面调查研究。以选用的症状、体征辨证素表,症状、体征对证素贡献度(权值)表为基准,计算症状、体征对相关证素的贡献度,根据标准选用达到或超过20的证素,得出常见证素;根据证素组合证候规律及临床实际组合证候,确定AECOPD呼吸衰竭临床常见证候,进一步分析中医证候与胃肠功能障碍的相关性。采用SPSS 20.0统计软件包,进行统计描述和分析等。结果:1)AECOPD呼吸衰竭病位证素以肺出现频率最高(100%),其次为脾(81.32%)、心(72.29%)、肾(71.08%)等;虚性病性证素气虚出现频率最高(92.17%),其次为阳虚(72.29%)、阴虚(58.43%)等;实性病性证素痰出现频率最高(100%)、热(48.8%)、饮(48.19%)、血瘀(47.59%)等。AECOPD呼吸衰竭的主要证候为肺脾气虚痰浊阻肺证(21.69%),肺肾气阴两虚痰热壅肺证(16.27%),肺脾肾阳虚痰饮停肺证(15.06%)等。2)AECOPD呼吸衰竭中医证候间胃肠功能障碍的发生率及严重程度有统计学意义(P0.05),其中肺脾肾不足痰蒙神窍证发生率最高(100%),且胃肠功能障碍评分整体偏高(9.7±3.3),病情严重。结论:AECOPD呼吸衰竭的证素以痰、气虚、阳虚、阴虚、热、饮、血瘀等为主,期间常互相联合,易侵袭肺、脾、心、肾等脏,主要证候表现为肺脾气虚痰浊阻肺证,肺肾气阴两虚痰热壅肺证,肺脾肾阳虚痰饮停肺证等,其各证候间胃肠功能障碍的发生率及严重程度有统计学意义。

Study about Syndrome Elements and TCM Syndromes and the Correlation between the TCM Syndromes and Gastrointestinal Dysfunction of AECOPD with Respiratory Failure

Objective：By cross-sectional survey study of clinical cases of AECOPD with respiratory failure ,come to the Syndrome ele-ments,TCM syndromes,then further analysis the correlation between the TCM syndromes and gastrointestinal dysfunction .Methods：Try selection symptoms contribution to Syndrome elements dialectic table ,Calculate the contribution of each patient＆#39;s clinical symptoms of the Syndrome elements,selected the Syndrome elements as standard to meet or exceed 20,frequency statistics of Syndrome elements ,come to the common Syndrome elements;according to the Syndrome elements combination TCM syndromes.Last analysis the correlations between TCM syndromes and gastrointestinal dysfunction.Results：1） Aspects of Syndrome elements ,Syndrome elements of disease location：Lung （100%）,spleen（81.32%）,heart（72.29%）,kidney（71.08%）;Deficiency Syndrome elements of disease nature：Qi deficiency （92.17%）,Yang deficiency（72.29%）,Yin deficiency（58.43%）.Excess Syndrome elements of disease nature：phlegm（100%）,heat （48.8%）,fluid-retention（48.19%）,blood stasis（47.59%）,etc.Aspects of TCM syndromes：syndrome of lung spleen Qi deficiency and turbid phlegm obstructing lung （ 21.69%） , syndrome of lung kidney Qi and Yin deficiency and phlegm-heat obstructing lung （16.27%）,syndrome of lung spleen kidney Yang deficiency and phlegm remain in lung （15.06%）,which are the major TCM syn-dromes of AECOPD with respiratory failure.2）There are significant differences of major TCM syndromes in the incidence and severity of the gastrointestinal dysfunction （P〈0.05）.Syndrome of lung spleen kidney deficiency and heart spirit confused by phlegm which has the highest incidence （100%） and highest gastrointestinal dysfunction score （9.7 ±3.3）.Conclusion：Phlegm ,Qi deficiency,Yang defi-ciency,Yin deficiency,heat,fluid-retention,blood stasis,which are the major Syndrome elements.Lung,spleen,heart,kidney,which are the major disease location.Syndrome of lung spleen Qi deficiency and turbid phlegm obstructing lung ,syndrome of lung kidney Qi and Yin deficiency and phlegm-heat obstructing lung ,syndrome of lung spleen kidney Yang deficiency and phlegm remain in lung ,which are the major TCM syndromes.There are significant differences of major TCM syndromes in the incidence and severity of the gastrointestinaldysfunction.