社区获得性肺炎中医证型与CRP、NAP积分关系探讨

Clinical Study on Relation Between Differention Type of TCM Syndrome of Community-acquired Pneumonia and CRP、Integral of NAP

目的:研究CAP中医证型与炎性指标关系,探求炎性指标在各中医证型的分布规律。方法:选取CAP患者中医辨证属风热犯肺、痰热壅肺、肺胃热盛、热闭心包、气阴两虚病例各20例,正常对照组20例,检测各证型CRP、NAP积分,分析各证型炎性指标值的异同性。结果:CAP患者与对照组比较,CRP、NAP积分均有显著性差异(P<0.01)。CRP在风热犯肺型即有升高,在痰热壅肺型及肺胃热盛型进一步升高,在热闭心包时CRP到极点。在气阴两虚阶段CRP水平仍较正常人升高,提示炎症仍有残余。NAP积分在风热犯肺型升高,在邪气深入阶段(痰热壅肺、肺胃热盛、热陷心包)均有明显升高,在热闭心包时NAP升高更明显。在气阴两虚型时则基本恢复正常。结论:CAP不同的中医证型,其炎症指标有一定的变化规律。联合检测这些指标可以作为CAP辨证分型的客观依据。

Objective： To study the relationship between Differentiation-Type of TCM Syndrome of the Community-acquired pneumonia（CAP） and CRP, Integral of NAP, to explore the regularity of Traditional Chinese MedcineSyndrome Differentiation-type（TCM-SDT） and clinical indicatrix of phlegmonosis. Methods： Patients with community-acquired pneumonia were differented by adopting the TCM Syndrome Differentiation for five groups, including Syndrome of wind and heat invading the lung, Syndrome of phlegm-heat obstructing the lung, Syndrome of excessive heat at lung and stomach, Syndrome of heat sinking theca cordis and Syndrome of deficiency of both Qi and Yin. There were 20 patients in each group. Otherwise, 20 healthy adults were added for control group. CRP, Integral of NAP were detected in every person. Then analysis the relationship between indicatrix of phlegmonosis and TCM Syndrome Differentiation. Results： The levels of CRP, Integral of NAP in patients with community-acquired pneumonia are significantly different from those in control group （ P 〈 0.01 ）. CRP was high in Syndrome of wind and heat invading the lung group, higher in Syndrome of phlegm-heat obstructing the lung and Syndrome of excessive heat at lung and stomach, and come to a boil in Syndrome of heat sinking theca cordis. The level of CRP in Syndrome of deficiency of both Qi and Yin was still higher than normal group, which suggests that there were still remnants of the inflammation. Integral of NAP increased in the Syndrome of wind and heat invading the lung group, and increased significantly in depth phase of evil （Syndrome of phlegm-heat obstructing the lung,Syndrome of excessive heat at lung and stomach,Syndrome of heat sinking theca cordis）. Integral of NAP increased significantly in Syndrome of heat sinking theca cordis, and returned to normal in Syndrome of deficiency of both Qi and Yin. Conclusion： There is specified regularity of inflammatory indicators in different TCM-SDT of CAP. Combination of these indicatrix of phlegmonosis is worth of can be used as objective indicatrix for TCM Syndrome Differentiation of CAP.