老年与非老年社区获得性肺炎的临床及中医辨证资料比较分析

Comparativeanalysis of Clinic and TCM Syndrome Data of Community-acquired Pneumonia in Elderly and Non-elderly

目的:总结社区获得性肺炎(CAP)患者的临床表现、中医辨证分型及病原学相关资料。方法:回顾性分析2009年1月—2009年12月广东省中医院收治的成人CAP患者的临床资料,比较老年CAP患者(年龄≥60岁)与非老年CAP患者(年龄<60岁)临床特征和中医辨证分型的异同。结果:成人CAP患者448例,年龄(56±1.02)岁。老年CAP患者238例,中青年患者210例。老年CAP患者以发热(P=0.002)或咳嗽(P=0.016)为首发症状者均较中青年CAP患者少。老年患者白细胞升高者较中青年患者多(P<0.0001)。中青年CAP患者大叶性肺炎较老年CAP患者多(P=0.021),老年CAP患者多叶或双肺病变较中青年患者多(P=0.037)。老年患者真菌感染比例较中青年患者高(P=0.006)。老年与非老年CAP患者均以痰热蕴肺为最多见的证型,其次为风热袭肺证。老年CAP患者证型较为复杂,证型种类较多。老年患者表现为23种证型,非老年患者表现为16种证型,老年CAP患者里证较中非老患者多,非老年患者表证、表里兼夹证较老年患者多。非老年和老年患者均以实证为主,老年患者虚实夹杂证较中青年患者多(P=0.014)。结论:老年CAP患者发病率高,临床表现、中医辨证分型具有其特殊性,应予足够重视。

Objective： To summary clinic and TCM syndrome and etiology data of Community-acquired Pneumonia（CAP）.Method：A retrospective analysis was carried out on clinical data of 448 adult CAP patients from January 2009 to December 2009 in Guangdong provincial TCM hospital.To compare the clinical features between elderly CAP patients and non-elderly.Result：There are 448 adult CAP patients,the average age is 56±1.02.238 of them were elderly CAP patients and 210 patients were Young and Middle-aged.As compared with non-elderly CAP patients,less elderly CAP patients had fever（P=0.002） or cough（P=0.016）firstly.Elevated white blood cell in elderly CAP patients were more than in non-elderly CAP patients（P0.0001）.There are more lobar pneumonia in young and Middle-aged CAP patients than in elderly CAP patients（P=0.021）As compared with non-elderly CAP patients,elderly CAP patients had more multiple pulmonary lobes and both lungs lesion（P=0.037）.elderly CAP patients had more fungus infection（P=0.006）.Phlegm Heat Obstructing in the Lungis the most commom syndrome in both elderly and non-elderly CAP patients,in the next place is wind Heat Attacking the Lung syndrome.Syndromes in elderly CAP patients were complex and multifold.There are 23 kind of syndromes in elderly CAP patinents and 16 kind of syndromes in non-elderly CAP patinents.There are more interiorsyndromes in elderly CAP patinents and more exterior syndrome,exterior and interiorsyndrome in non-elderly CAP patinents.sthenic syndrome is the most commom syndrome in both elderly and non-elderly CAP patients,There are more asthenia and sthenic syndrome in elderly CAP patinents than in non-elderly CAP patinents（P=0.014）.Conclusion：Elderly CAP had high morbidity and special clinic feature and TCM syndrome.So it should be much accounted.