摘要
目的观察慢性阻塞性肺疾病急性加重期(acute exacerbation of chronic obstructive pulmonary disease,AECOPD)患者不同中医证型与外周血中性粒细胞/淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)及其肺功能相关指标的变化。方法将2016年1月-2018年11月本院老年病科181例AECOPD患者按中医证型分为风寒袭肺证26例、外寒内饮证40例、痰热壅肺证48例、痰湿阻肺证48例、痰蒙神窍证19例。行血常规检测,计算NLR;行CRP、肺功能检测,进行COPD患者评估测试量表(COPD Assessment Test,CAT)、改良英国医学研究学会呼吸困难指数(Modified British Medical Research Council,mMRC)评分,测定6 min步行距离(6-minute walking Test,6MWT),进行BODE指数测定[体重指数(Body Mass Index,B)、气道阻塞程度(Airflow Obstruction,O)、呼吸困难(Dyspnea,D)、运动能力(Exercise Capacity Index,E)]及查尔森合并症指数(Charlson Comorbidity Index,CCI)评分,分析检测结果。结果外寒内饮证、痰蒙神窍证患者NLR、CRP水平高于风寒袭肺证、痰热壅肺证、痰湿阻肺证(P<0.05或P<0.01);痰蒙神窍证患者FEV1占预计值百分比低于痰湿阻肺证(P=0.024);外寒内饮证患者6MWT小于痰热壅肺证、痰湿阻肺证(P值分别为0.006、0.024);各证型间mMRC分级比较,差异有统计学意义(F=26.367,P=0.049);外寒内饮证患者BODE指数高于痰热壅肺证(P=0.015),痰蒙神窍证CCI评分高于痰湿阻肺证(P=0.012)。结论AECOPD患者不同证型间NLR、CRP、6MWT有明显差异,其中,外寒内饮证、痰蒙神窍证患者炎症程度较重,而在呼吸困难程度及预后方面,尚未出现差异。
Objective To observe the changes of neutrophil to lymphocyte ratio and lung function of patients defined by different TCM syndromes with acute exacerbation of chronic obstructive pulmonary disease.Methods A total of 181 patients with acute exacerbation of chronic obstructive pulmonary disease in our hospital from January 2016 to Novenber 2018 were included and divided into 5 groups accoding to different TCM syndromes,which were wind-cold invading lung syndrome(26),external cold and internal fluid syndrome(40),phlegm-heat obstructing lung syndrome(48),phlegm-dampness blocked syndrome(48),an heart spirit confused by phlegm syndrome(19).Then tested the blood for each group,and calculated NLR;tested c-reactive protein,and lung function,and measured with COPD Assessment Test(CAT)and Modified British Medical Research Council(mMRC);conducted 6MWT,then the BODE index and Charlson Comorbidity Index(CCI)scores were calculated.Results The NLR,CRP level in patients with external cold and internal fluid syndrome and an heart spirit confused by phlegm syndromeby phlegm were significantly higher than those of other syndrome(P<0.05 or P<0.01),and FEV1%Pred was significantly lower than that of phlegm-dampness blocked syndrome(P=0.024);the 6-minute walking distance of patients with external cold and internal fluid syndrome was significantly shorter than that of phlegm-heat obstructing lung syndrome and phlegm-dampness blocked syndrome(P=0.006,P=0.024).The comparison of mMRC grades among the syndromes was statistically significant(F=26.367,P=0.049).The BODE index of patients external cold and internal fluid syndrome was higher than that of patients phlegm-heat obstructing lung syndrome(P=0.015),and the CCI score of patients an heart spirit confused by phlegm syndrome was higher than that of patients phlegm-dampness blocked syndrome(P=0.012).The BODE index of patients with external cold internal fluid syndrome was significantly higher than that of phlegm-heat obstructing lung syndrome(P=0.015).The CCI score of patients with mental d
作者
魏睿
由丽娜
夏杰
雷丽
刘朝元
吴珍元
潘霞
Wei Rui;You Lina;Xia Jie;Lei Li;Liu Chaoyuan;Wu Zhenyuan;Pan Xia(Department of Geriatrics,Jiulongpo Traditional Chinese Medicine Hospital,Chongqing 400050,China)
出处
《国际中医中药杂志》
2020年第5期421-426,共6页
International Journal of Traditional Chinese Medicine
基金
重庆市卫生健康委员会中医药科技项目(ZY201802069)
重庆市九龙坡区科学技术委员会2017年科技计划项目(2017年)。
关键词
肺疾病
慢性阻塞性
急性病
辨证分型
炎症
中性粒细胞/淋巴细胞比
肺功能
Pulmonary disease
chronic obstructive
Acute disease
Syndrome differentiation classification
Inflammation
Neutrophil to lymphocyte ratio
Lung function
