114例多器官功能障碍综合征患者中医证型临床分析

Analysis of Traditional Chinese Medicine( TCM) Syndromes of 114 Multiple Organ Dysfunction Syndrome Patients

目的:回顾分析重症医学科MODS患者中医证型及其诱发因素,为中西医结合方法治疗MODS提供科学依据。方法:本研究对2011年9月—2012年9月期间,在西安交通大学第二附属医院重症医学科诊治的114例多器官功能障碍综合征患者进行临床回顾研究,分析MODS的诱因、特点及其中医证型特点。结果:1多器官功能障碍中以循环、呼吸、凝血和胃肠道功能障碍发生率最高,四者占功能障碍器官总数的78.4%,其次为肝脏功能障碍,占10.5%。2MODS诱因中以感染为主,占总诱因54.7%,其中肺部感染占76.6%;其次为手术或创伤,占总诱因34.9%;3本研究中MODS的中医辨证分型主要分为实热证、血瘀证、腑气不通证、厥脱证四个证型,各占64.9%、74.6%、89.5%、5.3%,其中腑气不通证、实热证和血瘀证是MODS住院期间最常见三个证型。结论:1感染是MODS的最常见诱发因素;2肺、胃肠道和心功能障碍发生率最高;3实热证、血瘀证、腑气不通证是MODS入院初的最常见三个证型。

Objective： To analyze the traditional Chinese medicine（ TCM） syndromes and its predisposing factors of 114 multiple organ dysfunction syndrome（ MODS） patients to provide a scientific basis for integrative treatment of MODS. Methods： In this study,we made the retrospective analysis of TCM syndromes of MODS patients from September 2011 to September 2012,in Critical Care Medicine Department,the Second Affiliated Hospital of Xi＇ an Jiaotong University. Results： Heart dysfunction,respiratory dysfunction,coagulation dysfunction and gastrointestinal dysfunction were the most common manifestations,totally amounting to78. 4% and the second was liver dysfunction,which accounted for 10. 5%. Infection was the main predisposing factor of MODS（ 54. 7%） and pulmonary infection was ranked the first（ 76. 6%）. Excess heat syndrome,stagnancy of blood and Qi syndrome,Yangming Fu-organ syndrome,depletion of Yin and Yang syndrome,tooks up 64. 9%,74. 6%,89. 5% and 5. 3%,respectively.Exces heat syndrome,blood stasis syndrome and Yangming Fu-organ appearing were in all process of disease. Conclusion： Infection,especially pulmonary infection,is the main predisposing factor of MODS. Heart,lung and gastrointestinal dysfunctions were the most common. Excess heat syndrome,blood stasis syndrome and Yangming Fu-organ appear in all process of disease,which should be reversed in the early stage.