COPD稳定期中医证型、体质分布调查及相关性探讨——对我院370人次COPD稳定期患者调查分析
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摘要
目的:通过调查COPD稳定期患者对其中医证型及体质相关性进行探讨,为COPD稳定期中医治疗提供一定的理论参考。方法:便利抽样选取2017年1月至12月期间门诊就诊的COPD稳定期患者370人次为调查对象。男270例,女100例。通过问卷调查、完成中医体质辨识量表及医师诊断评判出患者的中医证型和体质。结果:COPD稳定期患者中医证型分布以肺肾气虚证(39.73%)居多,其它依次为肺气虚证(33.51%)、肺脾气虚证(15.41%)、肺肾气阴两虚证(11.35%)。COPD稳定期患者中医体质分布以气虚质居多,即气虚质(39.19%),痰湿质(16.76%),阳虚质(14.86%),血瘀质(11.35%),阴虚质(7.84%),湿热质(7.30%),气郁质(2.70%)。COPD中医体质与证型之间有关联(P <0.05)。肺气虚与气虚质(r=0.58,P=0.029);肺肾气虚与气虚质(r=0.56,P=0.032)和阳虚质(r=0.43,P=0.044)相关;肺脾气虚证与痰湿质相关(r=0.48,P=0.038);对于肺肾气阴两虚证与阴虚质相关(r=0.37,P=0.047)。结论:COPD稳定期患者中医证型与中医体质存在相关性,中医体质影响着疾病的发生、证型,明确其相关性,对于COPD稳定期中医治疗有着重大意义。
Objective: This paper analyzes 370 patients with stable COPD and investigates the association between TCM syndrome types and body constitution. This study provides a theoretical basis for TCM treatment of stable COPD. Methods: A total of 370 patients with stable COPD who attended the outpatient service of our hospital from January to December, 2017 were enrolled as subjects by convenient sampling. In those patients, 270 were male and 100 were female. TCM syndrome types and body constitution of patients were evaluated by questionnaire survey,the TCM constitution identification scale, and diagnosis by physicians. Results: In those patients with stable COPD,the most common TCM syndrome type was lung-kidney Qi deficiency(39.73%), followed by lung-Qi deficiency(33.51%), lung-spleen Qi deficiency(15.41%), and lung-kidney Qi-Yin deficiency(11.35%); the most common TCM constitution was Qi deficiency(39.19%), followed by phlegm dampness(16.76%), Yang deficiency(14.86%),blood stasis(11.35%), Yin deficiency(7.84%), dampness heat(7.30%), and Qi depression(2.70%). TCM constitution was associated with TCM syndrome types in COPD patients(P < 0.05). Lung-Qi deficiency was associated with Qi deficiency(r = 0.58, P = 0.029); lung-kidney Qi deficiency was associated with Qi deficiency(r = 0.56, P =0.032) and Yang deficiency(r = 0.43, P = 0.044); lung-spleen Qi deficiency was associated with phlegm dampness(r = 0.48, P = 0.038); lung-kidney Qi-Yin deficiency was associated with Yin deficiency(r = 0.37, P = 0.047). Conclusion: For patients with stable COPD, TCM syndrome types are associated with TCM constitution. TCM constitution has an impact on the development of the disease and its syndrome types. Clarification of the association between them is quite important for TCM treatment of stable COPD.
Objective: This paper analyzes 370 patients with stable COPD and investigates the association between TCM syndrome types and body constitution. This study provides a theoretical basis for TCM treatment of stable COPD. Methods: A total of 370 patients with stable COPD who attended the outpatient service of our hospital from January to December, 2017 were enrolled as subjects by convenient sampling. In those patients, 270 were male and 100 were female. TCM syndrome types and body constitution of patients were evaluated by questionnaire survey,the TCM constitution identification scale, and diagnosis by physicians. Results: In those patients with stable COPD,the most common TCM syndrome type was lung-kidney Qi deficiency(39.73%), followed by lung-Qi deficiency(33.51%), lung-spleen Qi deficiency(15.41%), and lung-kidney Qi-Yin deficiency(11.35%); the most common TCM constitution was Qi deficiency(39.19%), followed by phlegm dampness(16.76%), Yang deficiency(14.86%),blood stasis(11.35%), Yin deficiency(7.84%), dampness heat(7.30%), and Qi depression(2.70%). TCM constitution was associated with TCM syndrome types in COPD patients(P < 0.05). Lung-Qi deficiency was associated with Qi deficiency(r = 0.58, P = 0.029); lung-kidney Qi deficiency was associated with Qi deficiency(r = 0.56, P =0.032) and Yang deficiency(r = 0.43, P = 0.044); lung-spleen Qi deficiency was associated with phlegm dampness(r = 0.48, P = 0.038); lung-kidney Qi-Yin deficiency was associated with Yin deficiency(r = 0.37, P = 0.047). Conclusion: For patients with stable COPD, TCM syndrome types are associated with TCM constitution. TCM constitution has an impact on the development of the disease and its syndrome types. Clarification of the association between them is quite important for TCM treatment of stable COPD.
引文
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11 .李竹英,赵仁燕.慢性阻塞性肺疾病稳定期中医体质与证候关系探析[J].中国中医急症, 2017, 26(3):440-441,447.
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13 .衣标美.丹溪学派诊治痰证的理论研究[D].北京:中国中医科学院, 2016.
14 .许瑞旭,窦思东.中医阳虚型体质现代研究概述[J].健康研究, 2015, 35(5):505-507.
15 .于佳琦.肺胀古代文献研究[D].辽宁:辽宁中医药大学, 2010.
16 .杨倩春,李思宁,毛炜.中医体质学说研究进展[J].临床医药文献电子杂志, 2017, 4(98):19 389-19 392.
17 .刘炜,葛正行,李波.慢性阻塞性肺疾病患者中医体质分布特点及其与证候的关系研究[J].中国中药杂志,2013, 38(20):3 587-3 590.
18 .李竹英,田春燕,王桂媛.中医体质学说在慢性阻塞性肺疾病稳定期中的应用及思考[J].中国中西医结合杂志, 2016, 36(8):999-1001.
19 .胡宗仁.慢性阻塞性肺疾病稳定期的古代文献研究[D].长沙:湖南中医药大学, 2017.
20 .王方维,孟静岩,马佐英,等.从脾论治肺系疾病的理论探析[J].天津中医药大学学报, 2016, 35(5):347-350.
21 .洪敏俐,郭媛媛,黄锦榕,等.慢性阻塞性肺疾病不同表型中医证型分布规律探讨[J].中华中医药杂志, 2018, 33(03):1 194-1 197.
22 .李建.补肾益肺汤在肺胀(肺肾气阴两虚证)康复治疗中的作用临床观察[J].长春中医药大学中华中医药杂志,2018, 33(03):1 194-1 197.
2 .李东,王琦.王琦教授基于“辨体论治”的三辨诊疗模式临床应用探析[J].中华中医药杂志, 2012, 27(9):2 332-2 334.
3 .宋琳,韩锋锋. 2016年版GOLD慢性阻塞性肺疾病全球倡议解读[J].世界临床药物, 2016, 37(7):437-456.
4 .中华中医药学会.肺胀诊疗指南[J].中国中医药现代远程教育, 2011, 9(12):112-113.
5 .中华中医药学会内科分会肺系病专业委员会.慢性阻塞性肺疾病中医证候诊断标准(2011版)[J].中医杂志,2012, 53(2):177-178.
6 .中华中医药学会.中医体质分类与判定[J].中华养生保健:上半月, 2009, 4(9):38-39.
7 .陈志强,蔡光先.中西医结合内科学[M].北京:中国中医药出版社, 2012,25-30.
8 .邱仕君,陈坚雄,程宾.对中医五脏相关学说的理论探讨[J].湖北民族学院学报(医学版), 2007, 24(1):1-5.
9 .刘忠达,陈海涛,李权. COPD稳定期中医体质类型分布研究:浙江省中西医结合学会呼吸病专业委员会第九次学术年会[C].浙江丽水, 2013.
10 .雷传丽.老年COPD稳定期患者肺肾气虚证型及体质类型分布特点研究[D].昆明:云南中医学院, 2015.
11 .李竹英,赵仁燕.慢性阻塞性肺疾病稳定期中医体质与证候关系探析[J].中国中医急症, 2017, 26(3):440-441,447.
12 .吴梦园,章莹,王飞,等.中医气虚体质研究进展[J].中医临床研究, 2018, 10(17):140-142.
13 .衣标美.丹溪学派诊治痰证的理论研究[D].北京:中国中医科学院, 2016.
14 .许瑞旭,窦思东.中医阳虚型体质现代研究概述[J].健康研究, 2015, 35(5):505-507.
15 .于佳琦.肺胀古代文献研究[D].辽宁:辽宁中医药大学, 2010.
16 .杨倩春,李思宁,毛炜.中医体质学说研究进展[J].临床医药文献电子杂志, 2017, 4(98):19 389-19 392.
17 .刘炜,葛正行,李波.慢性阻塞性肺疾病患者中医体质分布特点及其与证候的关系研究[J].中国中药杂志,2013, 38(20):3 587-3 590.
18 .李竹英,田春燕,王桂媛.中医体质学说在慢性阻塞性肺疾病稳定期中的应用及思考[J].中国中西医结合杂志, 2016, 36(8):999-1001.
19 .胡宗仁.慢性阻塞性肺疾病稳定期的古代文献研究[D].长沙:湖南中医药大学, 2017.
20 .王方维,孟静岩,马佐英,等.从脾论治肺系疾病的理论探析[J].天津中医药大学学报, 2016, 35(5):347-350.
21 .洪敏俐,郭媛媛,黄锦榕,等.慢性阻塞性肺疾病不同表型中医证型分布规律探讨[J].中华中医药杂志, 2018, 33(03):1 194-1 197.
22 .李建.补肾益肺汤在肺胀(肺肾气阴两虚证)康复治疗中的作用临床观察[J].长春中医药大学中华中医药杂志,2018, 33(03):1 194-1 197.