结核性胸膜炎客观指标与中医证型的相关性分析

Analysis of Correlation between Objective Indexes of Tuberculous Pleurisy and Traditional Chinese Medicine Syndrome Types

【目的】探讨结核性胸膜炎中医辨证分型与客观指标的相关性。【方法】收集2015年9月~2021年11月在广州中医药大学第一附属医院诊治的结核性胸膜炎的住院患者111例,根据中医辨证分型,将111例患者分为络气不和组53例和饮停胸胁组58例。观察不同证型结核性胸膜炎患者与白细胞(WBC)、中性粒细胞百分比(NEU%)、C反应蛋白(CRP)、纤维蛋白原(FIB)、D-二聚体(D-D)、白蛋白(ALB)、胸腔积液量及胸腔积液类型等指标的相关性。【结果】(1)炎症指标方面:在结核性胸膜炎的住院患者中,络气不和组患者的WBC、NEU%、CRP水平均高于饮停胸胁组,差异均有统计学意义(P<0.05或P<0.01)。(2)凝血功能方面:络气不和组结核性胸膜炎患者的D-D水平较饮停胸胁组更高,差异有统计学意义(P<0.01);而2组患者的FIB水平比较,差异无统计学意义(P>0.05)。(3)胸腔积液方面:饮停胸胁组的结核性胸膜炎患者胸水量多于络气不和组,差异有统计学意义(P<0.01);与络气不和组相比,饮停胸胁组的结核性胸膜炎患者游离型胸腔积液的发生率更高,差异有统计学意义(P<0.01)。【结论】结核性胸膜炎络气不和组患者的WBC、NEU%、CRP及D-D水平更高,而饮停胸胁组患者的胸水量更多、游离型胸腔积液的占比更高。

Objective To investigate the correlation between traditional Chinese medicine(TCM)syndrome types and objective indexes of tuberculous pleurisy(TBP).Methods A total of 111 inpatients with TBP treated in the First Affiliated Hospital of Guangzhou University of Chinese Medicine were collected from September 2015 to November 2021.The patients were divided into the Luoqi imbalance(syndrome of collateral-qi imbalance)group with 53 patients,and into the Yinting Xiongxie(syndrome of fluid retained in chest and hypochondrium)group with 58 patients.And then we explored the correlation of various syndrome types of TBP with the objective indexes of white blood cells(WBC),neutrophil percentage(NEU%),C-reactive protein(CRP),fibrinogen(FIB),Ddimer(D-D),albumin(ALB),pleural effusion volume and type of pleural effusion.Results(1)In respect of the inflammatory indexes,the WBC,NEU%and CRP levels in the Luoqi imbalance group were higher than those in the Yinting Xiongxie group,and the differences were statistically significant(P<0.05 or P<0.01).(2)In respect of the coagulation function index,the D-D level in the Luoqi imbalance group was higher than that in the Yinting Xiongxie group,and the difference was statistically significant(P<0.01).However,the difference of FIB level between the two groups was not statistically significant(P>0.05).(3)In respect of the pleural effusion,the amount of pleural effusion was larger and the incidence of free pleural effusion was higher in the Yinting Xiongxie group than those in the Luoqi imbalance group,and the differences were statistically significant(P<0.01).Conclusion The WBC,NEU%,CRP and D-D levels are higher in TBP patients with collateral-qi imbalance syndrome,while the volume of pleural effusion is larger and the proportion of free pleural effusion is higher in TBP patients with the syndrome of fluid retained in chest and hypochondrium.