慢性呼吸衰竭中医证候诊断的研究

Diagnosis of TCM syndromes of chronic respiratory failure

目的探讨建立慢性呼吸衰竭证候诊断的方法与思路。方法在文献研究的基础上,综合临床调查研究及专家咨询问卷分析结果,采用医学统计方法、自适应模糊推理系统技术及德尔菲法建立证候诊断。结果慢性呼吸衰竭常见证候有痰热壅肺证、痰湿阻肺证、阳虚水泛证、痰蒙神窍证、心肺气虚证、肺肾气虚证、肺肾气阴两虚证和血瘀证,并研究了证候特征及建立了证候诊断。结论慢性呼吸衰竭常见证候包括实证类4种,虚证类3种,兼证为血瘀证,证候诊断可作为临床辨证的依据。

Objective To explore the methods and thinking train of syndrome diagnosis of chronic respiratory failure.Methods On the base of literature research and combining complicated clinical investigation and result analysis of expert consultation questionnaire,the method for syndrome diagnosis was established by using medical statistical method,technique of adaptive neuro-fuzzy inference system（ANFIS） and Delphi method.Results The common syndromes of chronic respiratory failure included the syndromes of phlegm-heat accumulating in lung,phlegm-damp obstructing lung,yang deficiency with water flood,phlegm covering mental orifice,heart-lung qi deficiency,lung-kidney qi deficiency,dual deficiency of qi and yin of lung and kidney and blood stasis.Conclusion The common syndromes of chronic respiratory failure include 4 excess syndromes and 3 deficient syndromes,and a combined syndrome is blood stasis syndrome.The syndrome diagnosis can be used as the base of clinical syndrome differentiation.