尿源性脓毒血症中医证候规律研究

Study on Syndrome Regularity of Urinary Sepsis in Traditional Chinese Medicine

目的：了解尿源性脓毒血症临床基本证候分布情况，探讨其中医证候特点。为中医辨证施治提供客观依据。方法：收集2014年9月至2017年3月广州中医药大学一附院泌尿外科及重症医学科42例尿源性脓毒血症患者中医四诊资料，进行中医辨证，确定证型，并行急性生理学及慢性健康状况评分系统（APACHEⅡ）评分。结果：尿源性脓毒血症发病早期主要表现为实证及虚实夹杂证，血瘀、热毒、湿热、阴虚是主要的临床证候要素。结论：水道不通，气机闭郁，湿、热、瘀互结内蕴于里是尿源性脓毒血症的病机特点，虚实辨证可以反映病情严重程度。

Objective：To observe the distributions of basic syndromes of urinary sepsis and to explore the syndrome characteristics of traditional Chinese medicine（TCM） so as to provide an objective basis for syn- drome differentiation and treatment. Methods：From September 2014 to March 2017,total 42 patients with urinary sepsis in urology and ICU of the first affiliated hospital of Guangzhou university of Chinese medicine were enrolled in this study to determine the syndrome patterns based on the data from the four diagnostic methods in TCM and detect the APACHE II score. Results：The initial stage of urinary sepsis mainly manifested as excess syndrome,deficiency-excess complex syndrome. Blood stasis,heat toxin,damp-heat and yin deficiency were the main clinical symptom factors of urinary sepsis. Conclusions：The blockage of waterway,obstruction of qi movement,the dampness,heat and blood stasis accumulated in the interior are the characteristic of pathogenesis of urinary sepsis,and the syndrome differentiation based on deficiency and excess can reflect the severity of the disease.