肺炎克雷伯杆菌肺炎中医证素特征及证型分布规律和预后相关性研究

Study on Traditional Chinese Medicine Symptom Characteristics of Klebsiella Pneumonia,Its Symptom type Distribution Law and Prognosis Correlation

目的 探讨肺炎克雷伯杆菌肺炎中医证素特征和证型分布规律,为临床治疗肺炎克雷伯杆菌肺炎提供客观依据。方法 收集200例肺炎克雷伯杆菌肺炎住院患者的临床症状、中医四诊资料等信息,通过SPSS25.0软件进行统计,分析总结肺炎克雷伯杆菌肺炎患者临床特点,中医证素特征及证型分布规律及其与预后的相关性。结果 中医证素特征上,肺炎克雷伯杆菌肺炎患者的主要病位证素为肺,病性证素为痰。高龄老人组及老年组证素心与气虚的出现频率均高于中青年组,并且随着年龄的增加,证素心与气虚的出现频次增加(P <0.05)。预后与证素相关性研究发现,死亡组证素阴虚的出现频率高于存活组(P <0.05)。证型分布上,肺炎克雷伯杆菌肺炎中医证型分布主要有5类:痰浊阻肺证、痰热壅肺证、肺脾气虚证、气阴两虚证、热陷心包证。结论 肺炎克雷伯杆菌肺炎多见于基础疾病较多的老年人群,多重耐药菌株感染可致重症肺炎发生率升高。证素辨证中,肺、痰为其主要证素表现,心及气虚证素与患者年龄存在相关性;正虚证素表现越多,患者预后越差,尤其阴虚证素预后不良最为显著。肺炎克雷伯杆菌肺炎证型以痰浊阻肺证最多见,临床多见2~3种证型重叠出现。

Objective:To investigate the characteristics and distribution of traditional Chinese medicine symptoms for Klebsiella pneumonia,and to provide an objective basis for the clinical treatment of Klebsiella pneumonia.Methods:The clinical symptoms and four diagnosis data of traditional Chinese medicine in 200 hospitalized patients with Klebsiella pneumonia were collected,and the clinical characteristics,TCM symptom characteristics and distribution of TCM symptoms and their correlation with prognosis were analyzed and summarized by SPSS25.0 software.Results:In terms of TCM characteristics,the main symptom of Klebsiella pneumonia patients was lung and the pathogenic factor was phlegm.The frequency of deficiency of heart and qi in the senile elderly group and the elderly group was higher than that in the young and middle-aged group,and with the increase of age,the frequency of deficiency in heart and qi increased(P<0.05).Prognosis and syndrome element correlation studies found that the frequency of yin deficiency in the death group was higher than in the survival group(P<0.05).In terms of the distribution of symptoms,there were five main types of traditional Chinese medicine syndrome distribution of Klebsiella pneumonia:syndrome of turbid phlegm obstructing lung,syndrome of phlegmheat obstructing lung,syndrome of qi deficiency of lung and spleen,syndrome of deficiency of both qi and yin,and syndrome of invasion of pericardium by heat.Conclusion:Klebsiella pneumonia is more common in the elderly population with more underlying diseases,and multidrug-resistant strain infection can increase the incidence of severe pneumonia.In the differentiation of syndrome elements,lung and phlegm were the main manifestations,and there was a correlation between heart and qi deficiency and the age of patients.The more positive and deficiency,the worse the prognosis of patients,especially the yin deficiency syndrome.Klebsiella pneumonia is most common with syndrome of turbid phlegm obstructing lung and 2 to 3 types of symptoms may coexist clinically.