摘要
目的:观察慢性阻塞性肺疾病急性加重期(AECOPD)机械通气患者的中医证候特点,探讨中医证候和急性生理与慢性健康状况评分(APACHEⅡ评分)的关系。方法:采用前瞻性研究,对中国中医科学院望京医院重症监护室(ICU)于2014年6月-2016年6月收治的59例AECOPD机械通气患者,进行中医辨证和证型的确定。以入ICU24h内的最差值,行APACHEⅡ评分,进行统计学分析。结果:中医证候分布:实证类15例(25.42%),虚证类20例(33.90%),虚实夹杂类24例(40.68%)。对3组的APACHEⅡ评分进行多个独立样本的非参数检验,差异有统计学意义(P<0.05);两两比较,实证组与虚证组、虚实夹杂组与虚证组比较,均有显著差异(P<0.05);实证组与虚实夹杂组比较,无显著差异。结论:虚实夹杂证最多,虚证次之,实证最少。虚实夹杂类以肺脾气虚,痰蒙神窍居多;虚证类与虚实夹杂类均有肺气虚;实证类以痰蒙神窍和兼瘀证者占多数。实证组与虚实夹杂组APACHEⅡ评分均数在22分以上,而虚证组均数在14分以下,说明实证组与虚实夹杂组病情重于虚证组。
Objective: To observe TCM syndromes characteristics with mechanical ventilation cases in acute exacerbation of chronic obstructive pulmonary disease(AECOPD), and to study the relationship between TCM syndromes and APACHE Ⅱscores. Methods: A prospective study was conducted to evaluate the TCM syndrome differentiation. A total of 59 patients with AECOPD mechanical ventilation from June 2014 to June 2016 in Wangjing Hospital were collected to identify the TCM syndrome. Meanwhile, based on the worst indicators in the first 24 hours in ICU APACHE Ⅱ score of every case was statistically analyzed by software. Results: Distribution of TCM syndromes was as follows: there were 15 cases(25.42%) belonged to excess syndrome, 20 cases(33.90%) belonged to deficiency syndrome, and 24 cases(40.68%) belonged to syndrome of intermingled deficiency and excess. A multiple independent samples nonparametric test showed that APACHE Ⅱ scores among three different TCM syndrome groups were statistically significant(P<0.05); pairwise comparison showed there were significant differences between excess syndrome group and deficiency syndrome group, between intermingled deficiency and excess syndrome group and deficiency syndrome group(P<0.05); but no significant difference between excess syndrome group and intermingled deficiency and excess syndrome group. Conclusion: The cases with syndrome of intermingled deficiency and excess is the most, followed by the syndrome of deficiency, and the cases with excess syndrome is the least one. The syndrome of qi deficiency of lung and spleen and syndrome of orifices confused by phlegm are the majority in syndrome of intermingled deficiency and excess. Deficiency of lung qi is common in syndrome of intermingled deficiency and excess and syndrome of deficiency. The excess syndrome group contains mainly syndrome of orifices confused by phlegm and stasis syndrome. The means of APACHE Ⅱ score in excess syndrome group and intermingled deficiency and excess syndrome group are all above 22 points, while
出处
《中华中医药杂志》
CAS
CSCD
北大核心
2017年第10期4370-4372,共3页
China Journal of Traditional Chinese Medicine and Pharmacy
