慢性阻塞性肺疾病中医体质与证型的相关性研究

Correlation between TCM constitution and syndrome type in chronic obstructive pulmonary disease

目的探讨慢性阻塞性肺疾病(COPD)患者中医体质与证型的相关性,为“辨体-辨病-辨证”论治COPD提供参考。方法采用横断面调查方法,选取2015年2月—2019年6月广东省中医院呼吸与危重症学科收治的COPD患者416例,采用《中医体质分类与判定》量表对患者体质进行判定,采集患者四诊资料以进行中医证型判定,并收集患者的一般资料,分析中医体质与COPD证型、COPD分级、体质量指数、年龄的相关性。结果COPD患者体质以气虚质、阳虚质、痰湿质、血瘀质为主;COPD证型以肺肾气虚证、痰浊阻肺证、痰热郁肺证为主;气虚质、阳虚质与肺肾气虚证相关,气虚质、痰湿质与痰浊阻肺证相关,湿热质与痰热郁肺证相关,阳虚质与阳虚水泛证相关;不同病情、体质量指数、年龄患者体质分布具有明显差异。结论COPD患者体质以气虚质、阳虚质、痰湿质、血瘀质为主,证型以肺肾气虚证、痰浊阻肺证、痰热郁肺证为主,体质与证型密切相关,同时受病情、体质量指数、年龄的影响。

Objective It is to explore the correlation between TCM constitution and syndrome type in patients with chronic obstructive pulmonary disease(COPD),and to provide reference for the treatment of COPD in“body differentiation-disease differentiation-syndrome differentiation”.Methods A cross-sectional survey method was used to select 416 patients with COPD who were admitted to the Department of Respiratory and Critical Care Medicine of Guangdong Provincial Hospital of Traditional Chinese Medicine from February 2015 to June 2019.The constitution of these patients was identified by the scale of‘TCM Constitution Classification and Judgment’,the data of the four clinics were collected to identify the TCM syndrome type,and the general data of the patients were collected to analyze the correlation between TCM constitution and COPD syndrome type,COPD classification,body mass index and age.Results The constitution of COPD patients were mainly Qi deficiency constitution,Yang deficiency constitution,phlegm-dampness constitution and blood stasis constitution;COPD syndromes were mainly syndrome of lung and kidney Qi deficiency,syndrome of phlegm-turbidity obstructing in the lung,syndrome of phlegm-heat congesting in the lung;qi deficiency and yang deficiency were related to syndrome of lung and kidney Qi deficiency,qi deficiency constitution,phlegm-dampness constitution were related to syndrome of phlegm-turbidity obstructing in the lung;dampness-heat constitution was related to syndrome of phlegm-heat congesting in the lung,Yang deficiency constitution were related to syndrome of Yang deficiency with water flooding.There was a significant difference in the distribution of constitution among the patients with different disease status,body mass index and age.Conclusion The constitution of COPD patients were mainly Qi deficiency constitution,Yang deficiency constitution,phlegm-dampness constitution and blood stasis constitution;COPD syndromes were mainly syndrome of lung and kidney Qi deficiency,syndrome of phlegm-turbidity obstructing in the lung,syndrome of phlegm-heat congesting in the lung.The constitution was closed with syndrome,affected by the condition,body mass index and age.