高海拔环境慢性阻塞性肺疾病急性加重期降维标实主证的现况研究

The Main Excess Patterns on Exacerbation of Chronic Obstructive Pulmonary Disease:A Cross-sectional Study at High altitude

目的调查分析高海拔地域环境慢性阻塞性肺疾病急性加重期(AECOPD)患者主要标实证候的分布与关联因素。方法采用横断面调查研究方法,收集青海高海拔地区AECOPD患者资料,统计主要标实证候分布,筛选证候关联因子。结果痰饮阻肺证36/238例,暂未发现阳性关联因素;痰浊阻肺证62/238例,病程年限时程具有关联;痰热阻肺证51/238例,外周血降钙素原水平升高具有关联;痰瘀阻肺证61/238例,外周血红细胞增多或血红蛋白升高具有关联;痰湿瘀热阻肺证28/238例,呼吸困难症状、外周血红蛋白水平升高以及男性具有关联。结论青海高海拔地区AECOPD的标实主证:痰浊阻肺证>痰瘀阻肺证>痰热阻肺证>痰饮阻肺证>痰湿瘀热阻肺证,血降钙素原水平是热证的独立优势因子,红细胞增多或血红蛋白升高是瘀证的独立优势因子。

Objective:To investigate and analyze the distribution and related factors of the traditional Chinese medicine(TCM)main excess patterns in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)at high altitude environment.Methods:The data of AECOPD patients in Qinghai high altitude area were collected by cross-sectional investigation.The TCM pattern distribution and pattern related factors were analyzed.Results:There were 36/238 cases of phlegm retention pattern,and no positive related factors were found.There were 62/238 cases of phlegm turbid pattern,the longer the course of disease;51/238 cases of phlegm heat pattern,the higher the level of procalcitonin in peripheral blood;61/238 cases of phlegm stasis pattern,the higher the level of peripheral blood red blood cells;28/238 cases of phlegm dampness stasis heat pattern,dyspnea and peripheral hemoglobin was associated.Conclusions:The main excess patterns of AECOPD in Qinghai high altitude area is:phlegm turbid pattern>phlegm stasis pattern>phlegm heat pattern>phlegm retention pattern>phlegm dampness stasis heat pattern.The level of procalcitonin is the independent dominant factor of heat pattern,and the increase of red blood cells or hemoglobin is the independent dominant factor of stasis pattern.