摘要
目的验证慢性阻塞性肺疾病(COPD)稳定期“肺脾为核心多脏腑虚”理论,以阴阳二纲完善COPD稳定期的辨证。方法选择2019年9月-2023年2月COPD稳定期病例,符合西医COPD稳定期诊断标准、中医COPD主要症状并含有阴阳相关的症状、体征。采集患者的一般情况、中医症状体征、检验检查结果,并进行频次分析、因子分析和聚类分析。结果共收集COPD稳定期患者337例。主症中喘息(328例,97.33%)、气短(308例,91.39%)、咳嗽(303例,89.91%)等比例较高。舌脉中苔白(252例,74.78%)、舌质黯(226例,67.06%)、脉细(195例,57.86%)等比例较高。共得到14个公因子,包括因子1口渴、口渴多饮、渴喜热饮、口干,因子2失眠、入睡难、易醒,因子3腹胀、脉沉细、脉沉等。聚类分析分为3类,类1包括咳嗽、咳痰、胸闷、气短、喘息、腰膝酸软、肢冷、乏力、苔白、脉细,类2包括痰易咳出、口干、口渴、口渴多饮、渴喜热饮、失眠、入睡难、耳鸣、舌质红,类3包括痰难咳出、鼻塞、喷嚏、心悸、腹胀、食欲减退、自汗、盗汗、畏寒、大便溏、易醒、醒后难以入睡、多梦、苔黄、脉沉、脉沉细。结论COPD稳定期“肺脾为核心多脏腑虚”的概念既能突出又能涵盖COPD稳定期脏腑功能特征,相关度较高且代表性的症状、体征与阴阳关系密切。以阴阳为纲可以分为3类证型:诸脏阳虚,阳损及阴、虚阳浮越,阴阳倶损。
Objective To verify the theory of“lung and spleen as the core of multiple zangfu deficiency”in the stable stage of chronic obstructive pulmonary disease(COPD);To improve the syndrome differentiation of COPD in the stable stage with yin and yang.Methods From September 2019 to February 2023,patients with stable COPD met the diagnostic criteria of stable COPD in Western medicine,the main symptoms of COPD in traditional Chinese medicine(TCM),and the symptoms and signs containing yin and yang.The general situation,TCM symptoms and signs,and laboratory examination results of the patients were collected.Frequency analysis,factor analysis and cluster analysis were performed.Results A total of 337 patients with stable COPD were collected.The main symptoms included wheezing(328 cases,97.33%),shortness of breath(308 cases,91.39%),and cough(303 cases,89.91%).The tongue and pulse was white fur(252 cases,74.78%),dark tongue(226 cases,67.06%),and thin pulse(195 cases,57.86%).The 14 common factors were dotained,including factor 1 of thirst,thirst and polydipsia,thirst preferring hot drinks,dry mouth;factor 2 of insomnia,difficulty in falling asleep,and easy to wake up;factor 3 of abdominal distension,thin pulse,heavy pulse,etc.Clustering analysis showed that there were three categories:1)cough,expectoration,chest tightness,shortness of breath,wheezing,waist and knee soreness,cold limbs,fatigue,white fur,and thin pulse;2)expectoration,dry mouth,thirst,thirst polydipsia,thirst preferring hot drinks,insomnia,difficulty in falling asleep,tinnitus,red tongue;3)difficult to cough phlegm,nasal congestion,sneezing,palpitation,abdominal distension,loss of appetite,spontaneous sweating,night sweats,chills,loose stool,easy to wake up,difficult to fall asleep after waking up,more dreams,yellow fur,heavy pulse,heavy and thin pulse.Conclusion The concept of“lung and spleen as the core of multiple zangfu deficiency”in stable COPD can not only highlight but also cover the functional characteristics of zangfu in stable COPD.The represent
作者
马文静
司东旭
孙会卓
李尚点
张慧婷
葛未来
吴东良
李友林
MA Wenjing;SI Dongxu;SUN Huizhuo;LI Shangdian;ZHANG Huiting;GE Weiai(WU Dongliang1,2,3,LI Youling2,31.Beijing University of Chinese Medicine,Beijing 100029,China;China-Japan Friendship Hospital,Beijing 100029,China;Key Laboratory of the State Administration of Traditional Chinese Medicine(Chronic Cough and Asthma of Pulmonary Disease),Beijing Key Laboratory of Traditional Chinese Medicine for Prevention and Treatment of Allergic Diseases,Beijing 100029,China;The Second Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510000,China)
出处
《中国中医药信息杂志》
CAS
CSCD
2024年第5期138-144,共7页
Chinese Journal of Information on Traditional Chinese Medicine
基金
2022年中央财政转移支付地方项目-肺病慢性咳喘重点研究室(BZ0321)。
关键词
慢性阻塞性肺疾病
稳定期
辨证
阴阳
chronic obstructive pulmonary disease
stable period
syndrome differentiation
yin and yang
