慢性阻塞性肺疾病患者肺功能与中医证型关系的研究

Comparative Study on the Lung Function and Traditional Chinese Medicine Syndrome Type in 315 Cases of COPD

目的探讨慢性阻塞性肺疾病(COPD)患者肺功能分级与中医证型的关系。方法对315例COPD患者进行辨证分型和肺功能检查,比较不同肺功能分级的证型、证候属性、证型相兼之间的分布特点。结果肺功能Ⅳ级的阳虚、寒凝证型比例明显高于肺功能Ⅰ、Ⅱ、Ⅲ级,气虚证小于肺功能Ⅰ、Ⅱ、Ⅲ级,4证相兼比例高于肺功能Ⅰ、Ⅱ、Ⅲ级;肺功能Ⅲ、Ⅳ级组的痰浊证比例高于肺功能Ⅰ、Ⅱ级;肺功能I级的虚证比例高于肺功能Ⅱ、Ⅲ、Ⅳ级,虚实夹杂证比例小于肺功能Ⅱ、Ⅲ、Ⅳ级,单证比例高于肺功能Ⅱ、Ⅲ、Ⅳ级,3证、4证相兼比例小于肺功能Ⅱ、Ⅲ、Ⅳ级。结论 COPD患者的肺功能分级不同其证型特点不同,随着肺功能的加重,由气虚发展到阳虚,并逐渐表现为虚实夹杂、多证相兼等复合证型。

Objective： To investigate the relationship of TCM syndrome type of COPD and the lung function. Methods： 315 cases were diagnosed as COPD and received lung function examination,and the characteristic of TCM syndrome type in different outcome group of lung function was analyzed. Results： The patients of Yang deficiency syndrome and congealing cold pattern were significantly more in Lung function Ⅳ level than those in Lung function Ⅰ , Ⅱ, Ⅲ level. And Qi deficiency syndrome were significantly less than those in Lung function Ⅰ , Ⅱ ,Ⅲ level. And the proportion of four syndrome types were significantly more than those in Lung function Ⅰ,Ⅱ , Ⅲ level. The patients of phlegm turbid syndrome were significantly more in Lung function Ⅲ, Ⅳ level than those in Lung function Ⅰ ,Ⅱ level. The patients of Deficiency syndrome were significantly more in Lung function Ⅰ level than those in Lung function Ⅱ , Ⅲ, Ivlevel. And intermingled deficiency and excess syndrome were significantly less than those in Lung function Ⅱ, Ⅲ, Ⅳ level, and the proportion of one syndrome type were significantly more than those in Lung function Ⅱ , Ⅲ, Ⅳ level, and the proportion of three or four syndrome type were significantly less than those in Lung function Ⅱ , Ⅲ, Ⅳ level. Conclusion： Different outcome of lung function has different TCM syndrome type in COPD. As lung function is aggravating,The patients are developed form Qi deficiency syndrome to Yang deficiency syndrome, and are developed gradually to intermingled deficiency and excess syndrome type or compound syndrome type.