老年患者脓毒症中医证型与病情相关性的临床研究

Clinical Study on the Correlation between TCM Syndrome Types and the Condition of Elderly Patients with Sepsis

目的总结长春中医药大学附属医院老年脓毒症患者中医证型分布规律及与病情的相关性,为中西医结合治疗脓毒症奠定基础。方法运用中医学临床的基本方法,收集四诊资料,归纳总结其证侯分型及APACHEII评分。结果脓毒症的中医证型可分为实证、虚证及虚实夹杂证;疾病初期以热毒内陷证、阳气暴脱以及痰热证为主;后期以气滞血瘀、腑气不通证为多见。从APACHEII评分来看,虚实夹杂患者评分较高,预后差。结论老年脓毒症患者的中医证型发展规律为早期实证较多,中期虚实夹杂,后期以虚证居多。虚实夹杂者病情较重,预后差。

Objective To summarize the correlation between TCM syndrome types and the condition of elderly patients with sepsis in affiliated hospital of Changchun University of Traditional Chinese Medicine, and to lay the foundation for the therapy of integrated medicine in the treatment of sepsis. Methods We used the basic method of clinical application of traditional Chinese medicine, collected four diagnostic data, and summarized the syndrome type and APACHEII score. Results Sepsis syndromes type can be divided into excess, deficiency and excess mixed deficiency syndrome. In the early stage, the main types are toxic heat retraction syndrome, syndrome of sudden yang collapse and phlegm-heat syndrome. Qi stagnation and blood stasis and bowel gas barrier syndrome are more common in the later stage. Patients with excess mixed deficiency syndromes got higher APACHEII score with poor prognosis. Conclusion TCM syndrome type in elderly patients with sepsis is excess in early stage, deficiency in medium-term and excess mixed deficiency in late stage. The prognosis of patients with excess mixed deficiency is poor.