摘要
目的探讨慢性阻塞性肺疾病(COPD)急性加重期-危险窗-稳定期中医证候演变特点。方法收集8家医院COPD急性加重期、危险窗、稳定期患者500例,制定AECOPD危险窗中医证候临床研究调查表,调查内容包括患者一般人口学资料、疾病相关指标和中医四诊信息指标,分别观察并记录COPD急性加重期、危险窗及稳定期各阶段基础证、临床证候的分布及演变情况。结果收回急性加重期、危险窗期有效调查表各406份,稳定期有效调查表370份。病性:COPD在急性加重期,病性虚实比为1∶2.86,证候以实为主;危险窗时,病性虚实比为1∶1.06,证候以虚实夹杂为主;稳定期,病性虚实比为1∶0.09,证候以虚为主。病位:痰热壅肺、痰湿阻肺、外寒内饮、痰热壅肺兼肺肾气虚、痰热壅肺兼血瘀和痰湿阻肺兼肺脾气虚为急性加重期的6个主要证候,急性加重期病位以肺为主,进入危险窗后新增病位心和脾,进入稳定期后,病位以肺肾和肺脾多见。急性加重期共出现54种证候类型,危险窗期53种,稳定期44种。结论COPD急性加重期以实证为主,病位主要在肺;危险窗虚实兼半,病位在肺、脾及肾;稳定期以虚证为主,病位在肺、脾及肾,体现了本病本虚标实的临床特点。
Objective To explore the Chinese medicine syndrome evolution characteristics of acute exacerbationrisk window-stationary phase of chronic obstructive pulmonary disease（ COPD）. Methods Totally 500 COPD patients（ acute exacerbation,risk window and stationary phase） from 8 hospitals were collected. Chinese medicine syndrome clinical research questionnaires of acute exacerbation of COPD（ AECOPD） and risk window were made.The survey included patients＇ general demographic data,disease related indexes and Chinese medicine four diagnostic information indexes. The basic syndrome,distribution of clinical syndrome and the evolution in COPD acute exacerbation,risk window and stationary phase were examined and recorded. Results Questionnaires in acute exacerbation and risk window recalled were both 406. Questionnaires in stationary phase were 370. 1） Nature of disease. In acute exacerbation of COPD,deficiency-excess ratio of disease nature was 1 ∶ 2. 86. The main syndrome was excess. In risk window,the ratio was 1 ∶ 1. 06. The main syndrome was intermingled deficiency and excess. In stationary phase,the ratio was 1 ∶ 0. 09. The main syndrome was deficiency. 2） Location of disease. Six main syndromes in acute exacerbation were phlegm-heat obstructing lung,phlegm-damp obstructing lung,external cold and internal fluid,phlegm-heat obstructing lung with Qi deficiency of lung and kidney,phlegm-heat obstructing lung with blood stasis,as well as phlegm-damp obstructing lung with Qi deficiency of lung and spleen. In acute exacerbation,the location of disease was mainly lung. After going to risk window,new disease location heart and spleen increased.After going to stationary phase,common disease locations were lung-kidney and lung-spleen. In acute exacerbation,there were 54 syndromes recorded,53 in risk window,and 44 in stationary phase. Conclusion In acute exacerbation of COPD,the main syndrome was excess syndrome; the main disease location was lung. In risk window,the syndrome was intermingled deficiency and excess; the disease locations were lung,spleen and kidney. In stationary phase,the main syndrome was deficiency syndrome; the disease locations were lung,spleen and kidney. The results reflected the clinical characteristics of asthenia in origin and asthenia in superficiality of this disease.
出处
《中医杂志》
CSCD
北大核心
2017年第9期772-776,共5页
Journal of Traditional Chinese Medicine
基金
中医药行业科研专项(201107002)
2012年度国家中医临床研究基地业务建设科研专项(JDZX2012028)
河南省高等学校重点科研项目计划(14B360026)
关键词
慢性阻塞性肺疾病
急性加重期
危险窗
稳定期
证候特点
chronic obstructive pulmonary disease
acute exacerbation phase
risk window phase
stationary phase
syndrome characteristics
作者简介
通讯作者：li_js8@163．com
