肺结核中医证候规律研究

Study on the Rule of TCM Syndromes in Pulmonary Tuberculosis

目的探索初治继发性肺结核中医证候规律。方法在全国不同地域14家单位对1500例初治继发性肺结核患者进行中医四诊信息采集表的问卷调查,应用中医四诊信息采集软件,系统规范化录入肺结核中医四诊信息及各项辅助检查。建立数据库,进行统计分析。结果本研究人群证候主要集中在肺阴虚证(40.3%)、阴虚火旺证(20.4%)、气阴两虚证(19.5%);肺阴虚证的相关因素为白介素-1,阴虚火旺证的相关因素为白介素-10,气阴两虚证的相关因素为肿瘤坏死因子,阴阳两虚证的相关因素为CD4+淋巴细胞、干扰素-γ,肺脾两虚证的相关因素为肿瘤坏死因子,肺肾阴虚证无相关因素。总结出临床上常见6个证候的症状、舌、脉。结论对肺结核客观指标的研究非常必要,本课题初步总结出11个证候相关的免疫因子。初步总结出初治继发性肺结核中医证候规律。

Objective To explore the rules of Chinese medicine（ TCM） syndromes in secondary pulmonary tuberculosis（ TB） after the initial treatment. Methods In 14 organizations of different regions in China,1500 cases of initially treated secondary TB received the questionnaire on four diagnostic information collection of TCM. The software of four diagnostic information collection of TCM was adopted for the systematic and normative record of the four diagnostic information and every accessory examinations. The database was set up for statistical analysis. Results In this study,the syndromes were mainly differentiated as lung yin deficiency（ 40. 3%）,excessive fire due to yin deficiency（ 20. 4%） and deficiency of qi and yin（ 19. 5%）. The correlative factor of lung yin deficiency syndrome was IL- 1,that of excessive fire due to yin deficiency was IL- 10 and that of deficiency of qi and yin was TNF,that of yin and yang deficiency was CD4＋lymphocyte and interferon- γ,that of lung and spleen deficiency was TNF and there was no correlative factor to yin deficiency of lung and kidney. The symptoms,tongue and pulse conditions were summarized in six common syndromes in clinic. Conclusion It is very necessary to study the objective indexes of TB. This study summarizes initially 11 correlative immune factors to the syndromes.