COPD急性发作期中医证型相关因素研究

Factors associated with the traditional Chinese medicine syndrome types of acute exacerbation of chronic obstructive pulmonary disease

目的:探究急性发作期慢性阻塞性肺疾病(COPD)中医证型的相关因素。方法:将200例急性发作期COPD患者分为痰浊壅肺证、痰热蕴肺证、痰瘀阻肺证、肺肾气虚证,记录患者性别、年龄、病程等信息,进行肺功能等相关检查,并由患者本人填写COPD评估测试(CAT),根据所收集的资料分析中医证型与年龄、病程的关系,CAT评分与第1秒用力呼气容积(FEV1)、FEV1/用力肺活量(FVC)的关系、中医证型与CAT评分的关系。结果:在患者平均年龄、平均病程、CAT评分方面,痰浊壅肺证、痰热蕴肺证与痰瘀阻肺证、肺肾气虚证比较,差异均有统计学意义(P<0.001)。CAT评分与第1秒用力呼气容积占预计值百分比(FEV1%pred)、FEV1/FVC%之间存在负相关。结论:急性发作期COPD患者的年龄、病程、CAT评分以及肺功能在各中医证型中存在差异,CAT评分可为中医辨证分型提供依据。

Objective:To investigate the factors associated with the traditional Chinese medicine(TCM)syndrome types of acute exacerbation of chronic obstructive pulmonary disease(COPD).Methods:A total of 200 patients with acute exacerbation of COPD were divided into groups based on the TCM syndromes types of turbid phlegm obstructing the lung,phlegm-heat accumulated in the lung,phlegm and blood stasis obstructing the lung,and lung-kidney Qi deficiency.The information including sex,age,and course of disease was recorded,related examinations including pulmonary function were performed,and the patients were asked to undergo COPD assessment test(CAT).The association of TCM syndrome type with age and course of disease was analyzed,as well as the association of CAT score with forced expiratory volume in the first second(FEV1)and FEV1/forced vital capacity(FVC)ratio and the association of TCM syndrome type with CAT score.Results:There were significant differences in mean age,mean course of disease,and CAT score between the patients with turbid phlegm obstructing the lung/phlegm-heat accumulated in the lung and those with phlegm and blood stasis obstructing the lung/lung-kidney Qi deficiency(P<0.001).CAT score was negatively correlated with predicted percentage of forced expiratory volume in 1 second and FEV1/FVC%ratio.Conclusion:There are differences in age,course of disease,CAT score,and pulmonary function between the patients with acute exacerbation of COPD with different TCM syndrome types.