COPD稳定期肾不纳气证与肺脾两虚证患者膈肌功能差异临床研究

Clinical observation of difference of diaphragm function between syndrome of kidney nonreceiving qi and deficiency of lung and spleen of patients in stable stage of COPD

目的:观察稳定期慢性阻塞性肺疾病(COPD)肾不纳气证与肺脾两虚证患者超声下膈肌功能的差异,探讨膈肌功能与肾不纳气证的关系。方法:选取COPD稳定期患者42例,其中肾不纳气证和肺脾两虚证两组各21例,另选正常组8例,比较组间膈肌收缩速度、膈肌增厚率和膈肌移动幅度(LZapp)的差异。结果:肾不纳气证组患者膈肌LZapp较肺脾两虚证组患者及正常组减小,而膈肌收缩速度、膈肌增厚率在3组间无明显统计学差异。结论:肾不纳气证COPD患者膈肌功能进一步下降,膈肌功能不全可能是COPD患者病情严重化或中医学中由肺脾及肾转变的重要因素。超声膈肌LZapp是反应肾不纳气证COPD患者膈肌功能相对敏感可靠的一个指标。

Objective:To observe the difference of ultrasonic diaphragm function between syndrome of kidney non-receiving qi and deficiency of lung and spleen of patients in stable stage of chronic obstructive pulmonary disease(COPD),and to approach the relationship between diaphragm function and kidney non-receiving qi syndrome.Methods:42 cases of selected patients in stable stage of COPD were divided into two groups,i.e.kidney non-receiving qi syndrome group and lung-spleen deficiency group,21 cases in each group.In addition,8 cases were selected as normal group.The differences of diaphragm contraction velocity,diaphragm thickening rate and LZapp were compared between two groups.Results:Diaphragm LZapp of patients in kidney non-receiving qi syndrome group was reduced compared with lung-spleen deficiency group and normal group,but there was no significant statistical difference in diaphragm contraction velocity and diaphragm thickening rate among three groups.Conclusion:The diaphragm function of COPD patients with kidney non-receiving qi syndrome is declined further.Diaphragm injury may be an important factor of severity of pathogenetic condition of COPD patients or transformation from lung,spleen and kidney in traditional Chinese medicine.Ultrasonic diaphragm LZapp is a relatively sensitive and reliable index which reflects the diaphragm function of COPD patients with kidney non-receiving qi syndrome.