中医辨证分型与卒中相关性肺炎患者临床特点及现代检测指标相关性分析

Correlation Analysis Between Chinese Medicine Syndrome Differentiation and Clinical Characteristics and Modern Detection Indexes of Stroke-Associated Pneumonia Patients

目的:观察卒中相关性肺炎(SAP)患者的临床特点,总结其中医证候特征,分析中医辨证分型与SAP患者临床特点及现代检测指标的相关性。方法:选取2017年2月—2020年2月郑州市第九人民医院收治的SAP患者98例。收集患者的一般临床资料,并对该病的中医证候特征进行归纳分类,分析其血常规检查、痰培养检查结果与SAP中医证型的相关性。结果:43.9%的患者血常规白细胞计数(WBC)升高,60.2%的患者出现痰培养阳性症状。患者中医证型分布比例由高到低为热入心包证、痰热壅肺证、风热袭肺证、痰湿壅肺证、邪陷正脱证、外寒内热证、肺脾气虚证、气阴两虚证。热入心包证、痰热壅肺证和脑梗死相关性较高,风热袭肺证、痰湿壅肺证和脑出血有较高的相关性。风热袭肺证、痰热壅肺证、邪陷正脱证与WBC<4×10^(9)/L相关性较高。痰湿壅肺证和热入心包证与WBC>10×10^(9)/L相关性较高。痰培养结果显示,邪陷正脱证、风热袭肺证、痰热壅肺证和热入心包证的阳性率较高。结论:SAP最常见的证型为热入心包证、痰热壅肺证、风热袭肺证、痰湿壅肺证,且与WBC、痰培养等现代检测指标显著相关,可用于鉴别临床证候。

Objective: To observe the clinical characteristics of patients with stroke-associated pneumonia(SAP),summarize the characteristics of Chinese medicine syndromes of the disease,and analyze the correlation between Chinese medicine syndrome differentiation and clinical characteristics and modern detection indexes of patients with SAP. Methods:A total of 98 patients with SAP admitted to Ninth People’s Hospital of Zhengzhou from February 2017 to February 2020 were selected. The general clinical data of patients were collected, and characteristics of Chinese medicine syndromes of the disease were summarized and classified. The correlation between the examination results of blood routine,sputum culture and the Chinese medicine syndromes of SAP was analyzed. Results: The contents of white blood cell(WBC) in 43.9% of patients were increased,and 60.2% of patients had positive sputum culture. The Chinese medicine syndromes in patients,according to the distribution proportion from high to low,were syndromes of heat entering the pericardium,phlegm-heat obstructing the lung,wind-heat attacking the lung,phlegm-damp obstructing the lung,sinking of pathogen and healthy qi desertion,external cold and internal heat,lung-spleen qi deficiency,and deficiency of both qi and yin. There were relatively strong correlations between syndromes of heat entering the pericardium and phlegm-heat obstructing the lung and cerebral infarction,and between the syndromes of wind-heat attacking the lung and phlegm-damp obstructing the lung and cerebral hemorrhage. There were relatively strong correlations between the syndromes of wind-heat attacking the lung,phlegmheat obstructing the lung and sinking of pathogen and healthy qi desertion and WBC<4×10^(9)/L. There were relatively strong correlations between the syndromes of phlegm-damp obstructing the lung and heat entering the pericardium and WBC>×10^(9)/L.The results of sputum culture showed that there were relatively strong correlations between syndromes of sinking of pathogen and healthy qi desertion,wind-heat attacking the lung,phlegm-heat obstructing the lung and heat entering the pericardium and the positive rate. Conclusion:The most common syndromes of SAP are the syndromes of heat entering the pericardium,phlegm-heat obstructing the lung,wind-heat attacking the lung and phlegm-damp obstructing the lung,and there are strong correlations between them and modern detection indexes such as WBC and sputum culture. Therefore,modern indexes such as WBC and sputum culture can be used to differentiate the clinical syndromes.