肺动脉高压患者307例中医证型分布规律及与临床指标相关性

Distribution characteristics of traditional Chinese medicine syndrome types and correlation with clinical indicators in 307 pulmonary hypertension patients

目的:探讨307例肺动脉高压(PH)患者的中医证型分布及与临床指标的相关性,初步推测各证型的预后。方法:选取2021年1月至2022年2月于上海市肺科医院肺循环科住院的PH患者307例,总结中医证型分布特点,分析证型与临床指标的相关性,推测预后。结果:307例PH患者中医证型频次从高到低依次为气虚血瘀证[28.99%(89/307)]、气阴两虚证[19.54%(60/307)]、痰瘀阻肺证[14.01%(43/307)]、阳虚水泛证[9.77%(30/307)]和肺肾气虚证[9.77%(30/307)]、心肾阳虚证[7.17%(22/307)]、气滞心胸证[4.23%(13/307)]、肺脾两虚证[3.26%(10/307)]、痰热郁肺证[2.28%(7/307)]、脾肾阳虚证[0.98%(3/307)]。痰热郁肺证mPAP、PVR、TNT低而TAPSE高提示预后较好;痰瘀阻肺证mPAP、PVR高;阳虚水泛证RATD、TNT高而TAPSE、6MWD低,提示这两证型预后不佳。结论:PH患者中医证型与临床相关指标存在相关性,痰热郁肺证预后可能较好,痰瘀阻肺证、阳虚水泛证预后可能较差。

Objective:To investigate the distribution of traditional Chinese medicine(TCM)syndromes,and the correlation between TCM syndromes and clinical indicators in 307 patients with pulmonary hypertension(PH),and to predict the prognosis of each syndromes.Methods:Patients with PH hospitalized in the Department of Cardio-Pulmonary Circulation,Shanghai Pulmonary Hospital from January 2021 to February 2022 were select to summarize the distribution of TCM syndrome types.The correlation between syndrome type and clinical test index was analyzed to predict the prognosis.Results:The frequency TCM syndromes in 307 patients with PH was from high to low:Qi deficiency and blood stasis syndrome[28.99%(89/307)],qi yin deficiency syndrome[19.54%(60/307)],phlegm stasis lung syndrome[14.01%(43/307)],yang deficiency and water flooding syndrome[9.77%(30/307)]and lung and kidney qi deficiency syndrome[9.77%(30/307)],heart and kidney yang deficiency syndrome[7.17%(22/307)],qi stagnating cardiothoracic syndrome[4.23%(13/307)],lung and spleen deficiency syndrome[3.26%(10/307)],phlegm heat stagnation lung syndrome[2.28%(7/307)],spleen and kidney yang deficiency syndrome[0.98%(3/307)].Low mPAP,PVR,TNT while high TAPSE indicated a better prognosis in the phlegm heat stagnation lung syndrome.The phlegm stasis lung syndrome had high mPAP and PVR,high RATD and TNT while low TAPSE and 6MWD in yang deficiency and water flooding syndrome,these suggested that the prognosis of two types of syndromes was poor.Conclusion:There is a correlation between TCM syndrome types of PH patients and clinical related indicators.The prognosis of phlegm heat stagnation lung syndrome may be better,while the prognosis of phlegm stasis lung syndrome and yang deficiency and water flooding syndrome maybeworse.