铜绿假单胞菌肺炎中医证候特点研究

TCM Syndrome Characteristics of Pseudomonas Aeruginosa Pneumonia

目的调查铜绿假单胞菌肺炎临床确诊病例,归纳铜绿假单胞菌肺炎的中医证候学特点,区分耐药菌株与敏感菌株的证候表现。方法采取回顾性研究方法,收集北京中医药大学东直门医院铜绿假单胞菌肺炎患者的基本信息、病原菌耐药特征及中医四诊资料,分析铜绿假单胞菌肺炎患者的证候学特点。结果共纳入研究病例133例,耐药菌株69例,敏感菌株64例,铜绿假单胞菌肺炎患者在75~84岁年龄段人数最多,常合并多种慢性基础疾病,痰热壅肺证为多见,热陷心包、气阴两虚证凶险,患者的中医证型和转归具有相关性,差异有统计学意义(P<0.05);铜绿假单胞菌耐药与否与患者的年龄、某些症状具有相关性,差异有统计学意义(P<0.05)。结论铜绿假单胞菌肺炎常合并多种慢性基础疾病,基本证型是风热犯肺、痰热壅肺、肺胃热盛、热陷心包、气阴两虚,其中痰热壅肺证最多见,热陷心包、气阴两虚证凶险,耐药铜绿假单胞菌肺炎病机突出正气亏虚的特点,敏感铜绿假单胞菌肺炎病机突出痰热壅肺的特点。

Objective To investigate the clinical confirmed cases of Pseudomonas aeruginosa pneumonia,and to summarize its TCM syndrome characteristics and distinguish the syndrome manifestations of drug-resistant strains and sensitive strains in such cases.Methods A retrospective study was conducted to collect essential information,drug resistance characteristics of pathogens and traditional Chinese medical four diagnostic information of patients with Pseudomonas aeruginosa pneumonia at Dongzhimen Hospital of Beijing University of Chinese Medicine,and to analyze the syndrome characteristics of Pseudomonas aeruginosa pneumonia.Results A total of 133 cases were involved in the study,69 cases with resistant strains and 64 cases with sensitive strains,and patients with pseudomonas aeruginosa pneumonia were the most common between the age of 75 and 84.Pseudomonas aeruginosa pneumonia,often combined with a variety of chronic underlying diseases,were most often seen in lung phlegm heat syndrome,whereas heat invading the pericardium syndrome and qi-yin deficiency syndrome were dangerous.The TCM syndrome type was correlated with the outcome in such patients,and the difference was statistically significant(P<0.05).Morever,the drug resistance of pseudomonas aeruginosa was correlated with the age and certain symptoms of the patients,and the difference was statistically significant(P<0.05).Conclusion The clinical syndrome types of pseudomonas aeruginosa pneumonia patients mainly include wind-heat invading the lung,lung phlegm heat,heat exuberance in the lung and stomach,heat invading the pericardium and qi-yin deficiency syndromes.The most common syndrome type was lung phlegm heat syndrome,heat invading the pericardium syndrome and qi-yin deficiency syndrome are dangerous.The pathogenesis of drug-resistant pseudomonas aeruginosa pneumonia highlightes the characteristics of deficient healthy qi,whereas the pathogenesis of sensitive pseudomonas aeruginosa pneumonia is characterized by phlegm heat in the lung.