慢性阻塞性肺疾病中医证型与肺功能、CAT评分的相关性分析

Relationship between TCM Syndrome type and pulmonary function and CAT score in chronic obstructive pulmonary disease

目的探讨慢性阻塞性肺疾病(COPD)中医证型与肺功能、CAT评分的关系,为临床治疗提供参考。方法选取2015年9月至2017年9月我院呼吸内科门诊及住院患者中处于COPD稳定期的400例患者作为研究对象,按照COPD中医证型将其归类,对所有入选者进行肺功能评估、慢阻肺患者自我评估测试(COPD assessment test,CAT)和急性加重风险评估,比较不同中医证型患者的肺功能情况、CAT评分以及急性加重的风险情况。结果 (1)资料显示,痰湿阻肺型105例,痰热壅肺型108例,痰瘀阻肺型97例,肺肾气阴两虚型90例;(2)痰湿阻肺、痰热壅肺、痰瘀阻肺、肺肾气阴两虚4个证型的FEV1/FVC与FEV1%Pred依次下降,差异具有统计学意义(P <0. 05)。痰湿阻肺型的肺功能分级以GOLD 1级为主,痰热壅肺型的肺功能分级以GOLD 2级为主,痰瘀阻肺型的肺功能分级以GOLD 3级为主,肺肾气阴两虚型的肺功能分级以GOLD 4级为主;(3)痰湿阻肺、痰热壅肺、痰瘀阻肺、肺肾气阴两虚4个证型的高风险比例依次增加,低风险比例依次下降,差异具有统计学意义(P<0.05)。结论随着痰湿阻肺型、痰热壅肺型、痰瘀阻肺型和肺肾气阴两虚型的演变,肺功能逐渐降低,CAT评分依次升高。

Objective To investigate the relationship between TCM syndrome type and pulmonary function and CAT score in patients with chronic obstructive pulmonary disease (COPD) and provide a reference for clinical practice. Methods 400 patients with stable obstructive pulmonary disease in outpatients and inpatients of our hospital were selected as the research object from September 2015 to September 2017. According to TCM syndromes of chronic obstructive pulmonary disease, all patients were evaluated for pulmonary function, COPD assessment test (CAT) and acute exacerbation risk assessment. The pulmonary function, CAT score and the risk of acute exacerbation in patients with different TCM syndromes were compared. Results (1) The data showed that there were 105 cases of phlegm-damp lung type, 108 cases of phlegm-damp lung type, 97 cases of phlegm and blood stasis type, 90 cases of lung, kidney, qi and yin deficiency type.(2) The FEV 1/FVC and FEV1% Pred of phlegm and dampness obstructing lung, phlegm and phlegm lung, phlegm and blood stasis obstruction, lung and kidney Qi and Yin deficiency decreased in turn ( P < 0.05). Lung function grading showed that the type of phlegm damp lung to GOLD1 level, phlegm type lungs mainly GOLD2, phlegm and blood stasis type to GOLD3 level, lung and kidney qi and yin deficiency type to GOLD4 level.(3) The proportion of high-risk increased and low-risk decreased in turn in Phlegm blocking the lungs, phlegm and phlegm lungs, phlegm and blood stasis, lung and kidney qi and yin deficiency ( P < 0.05 ). Conclusion With the development of phlegm-damp lung type, phlegm phlegm type, phlegm-stasis lung type and lung-kidney-qi-yin deficiency type, lung function gradually decreases and CAT score increases in sequence.