咳嗽变异性哮喘各中医证型与肺功能特征及气道反应性特点

Cough Variant Asthma Syndromes and Pulmonary Function of Each Feature and Airway Reactivity Characteristics

[主要目的]探讨咳嗽变异型哮喘(CVA)肺功能各项指标的变化与中医证型关系,了解CVA患者各中医证型气道反应性情况。[资料来源]在张家港市中医院病案室,选取2009年1月至2012年12月张家港市中医院呼吸内科咳嗽变异性哮喘住院患者病历。[选择文献量及依据]研究类型为利差能黄观察,研究对象为符合《中医病证诊断疗效标准》临床诊断的咳嗽变异性哮喘患者,采用肺功能仪、支气管激发试验,袖珍式峰流速仪分析112例咳嗽变异型哮喘与20例健康对照组的肺功能指标。比较各中医证型组的差异。[数据提炼规则及应用方法]肺功能、支气管激发试验采用美国Sensonlledics公司生产的Autobox-6200D型肺功能仪测定MEFV曲线、气道弹性阻力。FEV1,实测值/预计值≥70%,用乙酰甲胆碱(Mch)行气道反应性测定(支气管激发试验)。袖珍式峰流速仪测定PEF日内波动率。[数据综合得出结果与结论]风邪犯肺、寒饮伏肺PEF、PEV1、PEFV1/FVC、MMEF低于肺肾气虚证、肺脾气虚证、肺阴亏虚证、正常对照组(P<0.05),Raw高于肺肾气虚证、肺脾气虚证、肺阴亏虚证、正常对照组(P<0.05)。各中医证型的Mch-Pc20-FEV1低于正常对照组(P<0.05)。各中医证型的Mch-Pc20-FEV1低于正常对照组,PEFR高于正常对照组(P<0.01)。咳嗽变异型哮喘患者实证病人的通气功能有所减退,气道高反应性和气道弹性阻力是咳嗽变异性哮喘虚证的病理基础。[未来展望]咳嗽变异型哮喘患者的肺功能各项指标与中医证型存在明显的关系,通过了解各种中医证型气道反应性情况,可以指导临床诊断和治疗。

[Purpose]Investigate cough variant asthma(CVA)indicators of lung function changes the relationship between TCM,to understand each TCM CVA patient airway hyperresponsiveness situation[.Source]In Zhangjiagang City Hospital medical record room,select from January 2009 to December 2012 Zhangjiagang City Hospital Respiratory Medicine cough variant asthma hospitalized patient records.[Choose the amount and basis of the literature]Type of research is yellow spreads can observe,study subjects were in line 'TCM Syndrome Diagnostic efficacy of the standard ' clinical diagnosis of cough variant asthma patients,the use of pulmonary function,bronchial provocation test,pocket peak flow analyzed 112 cases of cough variant asthma and 20 healthy control group of lung function. Compare the TCM group differences.[Data extraction rules and application methods ]lung function,bronchial provocation test used by the U.S. Sensonlledics produced Autobox-6200D MEFV curve measured pulmonary function,airway elastic resistance.FEV1,measured value/ estimated value of ≥ 70%,with methacholine(Mch)line was measured airway responsiveness(bronchial provocation test).Pocket peak flow meter measuring PEF day volatility.[Outcome data synthesis andconclusions]Fanfei pathogenic wind,cold drink volts lung PEF,PEV1,PEFV1/FVC,MMEF lower lung and kidney qi deficiency,lung deficiency syndrome,Yin deficiency syndrome,the normal control group(P<0.05),Raw than lung and kidney qi deficiency,lung deficiency syndrome,Yin deficiency syndrome,the normal control group(P<0.05). The syndromes of Mch-Pc20-FEV1 less than the normal control group(P<0.05). The syndromes of Mch-Pc20-FEV1at the end of the normal control group,PEFR than the normal control group(P<0.01). Empirical cough variant asthma patients has diminished ventilatory function,airway hyperresponsiveness and airway elastic resistance is cough variant asthma Deficiency Syndrome pathology.[Future]Cough variant asthma indicators of lung function in patients with syndromes obvious relationships through understanding various syndromes airway hyperresponsiveness situation,you can guide clinical diagnosis and treatment.