影响慢性阻塞性肺疾病急性加重期痰热郁肺证患者治疗疗效相关因素的回顾性分析

Factors Affecting Therapeutic Effect on Acute Exacerbation of Chronic Obstructive Pulmonary Disease in Patients with Syndrome of Phlegm-heat Obstructing Lung:A Retrospective Analysis

目的:分析影响慢性阻塞性肺疾病急性加重期(AECOPD)痰热郁肺证患者治疗效果的相关因素。方法:收集100例AECOPD患者的一般资料[性别、年龄、烟酒史、慢性阻塞性肺疾病(COPD)病程],实验室检查结果,既往病史,改良版英国医学研究委员会呼吸困难问卷(mMRC)调查,COPD患者自我评估测试问卷(CAT)评分,6 min步行距离,中医证候量表评分,是否服用中药,发病日期。采用独立样本t检验、χ^(2)检验或者单因素Logistic回归分析进行分析,采用多因素Logistic回归分析来确定影响治疗效果的主要因素。结果:共纳入患者100例,显著有效组47例,非显著有效组53例,两组患者年龄,身体质量指数(BMI),红细胞计数,血红蛋白水平,尿素氮(BUN),mMRC评分,服用中药,发病节气差异具有统计学意义(P<0.05)。两组患者在发病主运、主气、客主加临方面差异具有统计学意义(P<0.05)。两组患者发病节气统计结果显示显效组大多处于春夏发病。多因素Logistic回归显示两组BMI、BUN、服用中药、主气少阴君火(相对于厥阴风木)差异具有统计学意义(P<0.05)。结论:提高BMI指数、降低BUN水平、服用中药均可提高治疗效果,在主气少阴君火(相对于厥阴风木)时治疗效果较好。

Objective:To analyze the factors affecting the therapeutic effect on acute exacerbation of chronic obstructive pulmonary disease(AECOPD)in the patients with the syndrome of phlegm-heat obstructing lung.Method:The general information(gender,age,history of smoking and alcohol,and duration of COPD)of 100 AECOPD patients was collected.In addition,the data of laboratory test results,past medical history,modified Medical Research Council(mMRC)scale score,COPD assessment test(CAT)score,six-minute walk distance(6MWD),traditional Chinese medicine(TCM)symptom scores,whether or not taking traditional Chinese medicine,and the date of disease onset were collected.The independent samples t-test,χ^(2) test or univariate Logistic regression analysis was performed to analyze the data,and multivariate Logistic regression analysis was employed to determine the main factors affecting the therapeutic effect.Result:A total of 100 patients were enrolled in this study,including 47 patients in the significant remission group and 53 patients in the non-significant remission group.The two groups showed differences in age,body mass index(BMI),red blood cell count(RBC),haemoglobin,blood urea nitrogen(BUN),mMRC scale score,taking traditional Chinese medicine,and onset season(P<0.05).In addition,there were significant differences in terms of the domination in circuit by element Qi,dominant Qi,and join of subordinate Qi to dominant Qi between the two groups(P<0.05).The disease in the significant remission group mainly occurred in spring and summer.Multivariate Logistic regression showed that there were differences in the BMI,BUN,taking traditional Chinese medicine,and dominant Qi being lesser Yin and sovereign fire(relative to reverting Yin and wind-wood)between the two groups(P<0.05).Conclusion:Increasing the BMI,lowering the BUN level,and taking traditional Chinese medicine can improve the therapeutic effect,which is better when the dominant Qi is lesser Yin and sovereign fire relative to reverting Yin and wind-wood.