从二次文献探讨慢性阻塞性肺疾病急性期中医证候类型

A Discussion on TCM Syndrome Types in the Acute Stage of Chronic Obstructive Pulmonary Disease from the Secondary Literature Review

目的分析慢性阻塞性肺疾病急性期(AECOPD)中医的辨证类型。方法以AECOPD中医辨证论治文献为研究对象,运用方剂计量学方法,通过频次分析、聚类分析、证证贴近度及本病指数分析,得出共识症状和易发证候,进而拟合精简证候,获取本病证候与旁从证候。结果 1)咳嗽、咯痰、喘息、胸闷等14种症状为AECOPD的共识症状;以痰浊阻肺、痰热壅肺等6项证候为该病易发证候。2)依据贴近度可将6项易发证候拟合精简为3项,即气虚痰阻、痰热壅肺、痰瘀阳虚。3)依据本病指数分析,该病以气虚痰阻(P=0.7332)为本病证候,而以痰瘀阳虚(P=0.5490)和痰热壅肺(P=0.2511)为旁从证候。结论通过二次文献分析,获取有关AECOPD临床表现的有效信息,掌握其证候类型结构,可为该病辨证论治提供与大样本流行病学调查相近的科学依据。

Objective： To analyze TCM syndrome types in the acute stage of chronic obstructive pulmonary disease. Methods： The literature about TCM syndrome differentiation in acute stage of chronic obstructive pulmonary disease was chosen as the research object. The formula dosimetry method was used,with the analysis of the frequency,clustering analysis,correlation analysis and the disease index analysis,to reach symptoms and certification sign,streamline syndrome and get the disease from syndrome. Results： 1）The disease symptoms had 14 symptoms,such as cough,sputum,breathing and chest tightness. The disease had six easy certification,such as lung phlegm heat resistance and lung phlegm wet resistance,and so on. 2）According to closeness degree,the six easy certification could be streamlined into three： blood stasis phlegm obstruction,lung phlegm heat resistance,yang phlegm and blood stasis. 3）The disease index analysis of the disease was based on deficiency of phlegm obstruction（P = 0.7332） for the disease syndrome,yang phlegm and blood stasis and phlegm heat resistance for lung from syndrome. Conclusion： With the secondary literature analysis,clinical effective information on chronic obstructive pulmonary disease is obtained. Mastering the syndrome type structure can provide the scientific evidence for the disease diagnosis and treatment,similar to large sample epidemiological investigation.