慢性阻塞性肺疾病中医证候演变规律研究概述
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摘要
作为一种发病率极高的疾病,慢性阻塞性肺疾病在漫长的病程中表现出规律性的中医证候演变。疾病的阶段性、共患疾病、现代医学客观指标、体重指数等多因素均能对证候的演变造成一定影响。文章通过对近年文献中慢性阻塞性肺疾病证候研究进行梳理和总结,分析疾病证候演变的规律,提高中医药辨治慢性阻塞性肺疾病水平,为今后临床诊疗过程中的精准辨证和疾病预后调摄提供借鉴与参考。
As a disease with extremely high morbidity,chronic obstructive pulmonary disease shows regular TCM syndrome evolution in the long course of disease. The stage of disease,common disease,modern medical objective index,body mass index and other factors can influence the evolution of syndrome.Based on recent literature review and the studies on chronic obstructive pulmonary disease syndrome summary,analysis of disease syndrome evolution rule,improve the level of the Chinese medicine treating COPD,for future clinical diagnosis and treatment in the process of precise offer reference for syndrome differentiation and disease prognosis cultivate.
As a disease with extremely high morbidity,chronic obstructive pulmonary disease shows regular TCM syndrome evolution in the long course of disease. The stage of disease,common disease,modern medical objective index,body mass index and other factors can influence the evolution of syndrome.Based on recent literature review and the studies on chronic obstructive pulmonary disease syndrome summary,analysis of disease syndrome evolution rule,improve the level of the Chinese medicine treating COPD,for future clinical diagnosis and treatment in the process of precise offer reference for syndrome differentiation and disease prognosis cultivate.
引文
[1]Global initiative for chronic obstructive lung disease. Global strategy for the diagnosis,management,and prevention of chronic obstructive pulmonary disease 2017 report[EB/OL]. https://doi.org/10.1164/ajrccm.163.5.2101039.2016-11-16.
[2]陈宪海,陈召华,周钦荣.《诸病源候论》论治肺胀特色及对现代临床的启示[J].中华中医药学刊,2010,28(3):503-505.
[3]李建生,王海峰.基于慢性阻塞性肺疾病急性加重危险窗的祛邪扶正序贯辨证治疗策略[J].中国中西医结合杂志,2011,31(9):1276-1280.
[4]李建生,张海龙,王海峰,等.慢性阻塞性肺疾病证候演变特点临床调查[J].中医杂志,2017,58(9):772-776.
[5]王玉光.慢性阻塞性肺病的中医证候学调查研究[D].北京:北京中医药大学,2004.
[6]林琳,胡旭贞.慢性阻塞性肺疾病急性加重期中医证候规律的初步探讨[J].广州中医药大学学报,2008(1):1-4.
[7]吴少芳.中医辨证综合疗法联合无创正压通气治疗慢性阻塞性肺疾病合并呼吸衰竭临床研究[J].中医学报,2013,28(9):1284-1286.
[8]李德科,唐荣伟,赵荣琴.中医辨证治疗慢性阻塞性肺疾病合并呼吸衰竭[J].中国实验方剂学杂志,2014,20(10):213-215.
[9]张永建,王芳,陆娟英,等.中医辨证治疗慢性阻塞性肺疾病合并呼吸衰竭[J].中医临床研究,2017,9(9):9-10.
[10]Barnes PJ,Celli BR. Systemic manifestations and comorbidities of COPD[J].Eur Respir J,2009,33(5):1165-85
[11]苗青,曹雪,樊茂蓉,等.慢性阻塞性肺疾病合并抑郁焦虑状态的中医证候学研究[J].江苏中医药,2010,42(1):21-23.
[12]曹雪.慢性阻塞性肺疾病伴抑郁或焦虑状态的中医证候研究[D].北京:北京中医药大学,2009.
[13]Roversi S,Roversi P,Spadafora G,et al. Coronary artery diseaseconcomitant with chronic obstructive pulmonary disease[J].Eur J ClinInvest,2014,44(1):93-102.
[14]刘玉金.从心肺相关论治慢性阻塞性肺疾病合并冠心病研究[D].石家庄:河北医科大学,2017.
[15]徐新毅,陈清维,葛正行,等.慢性阻塞性肺疾病合并呼吸衰竭心力衰竭的中医辩证治疗[J].贵阳中医学院学报,2011,33(2):76-77.
[16]陈阳燕.心脏指标与慢性阻塞性肺病阳虚辨证关系的临床研究[D].广州:广州中医药大学,2008.
[17]Bolton CE,Cannings-John R,Edwards PH,et al.What community measurents can be used to predict bone disease in patients with COPD?[J].Respir Med,2008,102(5):651-657.
[18]陈少藩.中山市中老年人慢性阻塞性肺疾病继发骨质疏松症中医证候研究[J].内蒙古中医药,2017,36(15):21.
[19]刘振峰,高振,艾力江·阿斯拉,等.新疆慢性阻塞性肺疾病继发骨质疏松症中医证候研究[J].中国中医药信息杂志,2012,19(11):13-15.
[20]Hurst JR,Vestbo J,Anzueto A,et al. Susceptibility to exacerbation in chronic obstructive pulmonary disease[J].N Engl J Med,2010,363(12):1128-1138.
[21]叶蔚,王小奇,张红,等.慢性阻塞性肺疾病食管pH监测与证型的相关性研究[J].中医药学刊,2004(12):2252-2253.
[22]叶蔚,王小奇,刘庆生,等.降逆和胃方治疗慢性阻塞性肺疾病伴有胃食管反流病的研究[J].中华中医药学刊,2009,27(1):84-86.
[23]Barnes PJ. Inflammatory mechanisms in patients with chronic obstructive pulmonary disease[J].J Allergy Clin Immunol,2016,138(1):16-27.
[24]季秀梅,周晓,陈菊萍,等.慢性咳嗽患儿呼出气一氧化氮与特应性体质及血清总免疫球蛋白E水平的相关性研究[J].浙江医学,2013,35(11):1013-1015.
[25]翟豫疆.COPD患者FENO与肺功能及中医辨证分型等相关性分析[D].乌鲁木齐:新疆医科大学,2013.
[26]曾繁琨.AECOPD患者呼出气一氧化氮测定与中医辨证分型等相关性分析[D].广州:广州中医药大学,2016.
[27]隆海燕,罗红,陈平,等.阻塞性肺疾病患者血清CRP和IL-18与肺功能及生活质量的相关性[J].中南大学学报:医学版,2011,36(11):1090-1096.
[28]付玲.罗玲教授学术思想与临床经验总结及慢性阻塞性肺疾病中医证型与肺功能等的相关性研究[D].成都:成都中医药大学,2016.
[29]李勇,黄振炎,卢育明,等.慢性阻塞性肺疾病急性期不同中医证型相关指标的比较及临床意义[J].中国医药指南,2015,13(16):10-11.
[30]Aaron SD,Tan WC,Bourbeau J,et al. Diagnostic instability and reversals of chronic obstructive pulmonary disease diagnosis in individuals with mild to moderate airflow obstruction[J].Am J Respir Crit Care Med,2017,196(3):306-314.
[31]李淑芳,闫国良,庞辉群.AECOPD患者凝血功能变化及中医证候特点[J].中国中医急症,2013,22(6):895-897.
[32]薛河东.慢性阻塞性肺疾病患者中医证型与凝血、纤溶指标的相关性研究[J].新中医,2018,50(1):38-40.
[33]瞿波,周维,毛兵.慢性阻塞性肺疾病稳定期中医证型与肺功能的关系探讨[J].华西医学,2015,30(10):1853-1856.
[34]王娟.慢性阻塞性肺疾病中医辨证分型与相关指标的临床研究[D].南京:南京中医药大学,2001.
[35]Celli BR,Cote CG,Marin JM,et al. The body-mass index,airflow obstruction,dyspnea,and exercise capacity index in chronic obstructive pulmonary disease[J].N Engl J Med,2004,350(10):1005-1012.
[36]苗青,樊茂蓉,安喆,等.体质量指数对慢性阻塞性肺疾病中医证候分布的影响[J].时珍国医国药,2010,21(6):1560-1562.
[37]陆学超,胡海波,韩萍,等.慢性阻塞性肺疾病急性加重期合并营养不良中医证候分布规律初探[J].中国中医药信息杂志,2013,20(10):11-13.
[38]陆学超,李莉莎,宁天芳,等.慢性阻塞性肺疾病(COPD)稳定期合并营养不良中医证候规律初探[J].中医药通报,2013,12(3):48-51,55.
[39]LIU S,ZHOU Y,LIU S,et al. Association between exposure to ambient particulate matter and chronic obstructive pulmonary disease:results from a cross-sectional study in China[J].Thorax,2017,72(9):788-795.
[40]LI MH,FAN LC,MAO B,et al. Short-term exposure to ambient fine particulate matter increases hospitalizations and mortality in COPD:A systematic review and Meta-analysis[J].Chest,2016,149(2):447-458.
[41]朱雪,李珂,陈宪海.PM2.5中医病因属性及致病特点探讨[J].中华中医药杂志,2017,32(9):3937-3939.
[2]陈宪海,陈召华,周钦荣.《诸病源候论》论治肺胀特色及对现代临床的启示[J].中华中医药学刊,2010,28(3):503-505.
[3]李建生,王海峰.基于慢性阻塞性肺疾病急性加重危险窗的祛邪扶正序贯辨证治疗策略[J].中国中西医结合杂志,2011,31(9):1276-1280.
[4]李建生,张海龙,王海峰,等.慢性阻塞性肺疾病证候演变特点临床调查[J].中医杂志,2017,58(9):772-776.
[5]王玉光.慢性阻塞性肺病的中医证候学调查研究[D].北京:北京中医药大学,2004.
[6]林琳,胡旭贞.慢性阻塞性肺疾病急性加重期中医证候规律的初步探讨[J].广州中医药大学学报,2008(1):1-4.
[7]吴少芳.中医辨证综合疗法联合无创正压通气治疗慢性阻塞性肺疾病合并呼吸衰竭临床研究[J].中医学报,2013,28(9):1284-1286.
[8]李德科,唐荣伟,赵荣琴.中医辨证治疗慢性阻塞性肺疾病合并呼吸衰竭[J].中国实验方剂学杂志,2014,20(10):213-215.
[9]张永建,王芳,陆娟英,等.中医辨证治疗慢性阻塞性肺疾病合并呼吸衰竭[J].中医临床研究,2017,9(9):9-10.
[10]Barnes PJ,Celli BR. Systemic manifestations and comorbidities of COPD[J].Eur Respir J,2009,33(5):1165-85
[11]苗青,曹雪,樊茂蓉,等.慢性阻塞性肺疾病合并抑郁焦虑状态的中医证候学研究[J].江苏中医药,2010,42(1):21-23.
[12]曹雪.慢性阻塞性肺疾病伴抑郁或焦虑状态的中医证候研究[D].北京:北京中医药大学,2009.
[13]Roversi S,Roversi P,Spadafora G,et al. Coronary artery diseaseconcomitant with chronic obstructive pulmonary disease[J].Eur J ClinInvest,2014,44(1):93-102.
[14]刘玉金.从心肺相关论治慢性阻塞性肺疾病合并冠心病研究[D].石家庄:河北医科大学,2017.
[15]徐新毅,陈清维,葛正行,等.慢性阻塞性肺疾病合并呼吸衰竭心力衰竭的中医辩证治疗[J].贵阳中医学院学报,2011,33(2):76-77.
[16]陈阳燕.心脏指标与慢性阻塞性肺病阳虚辨证关系的临床研究[D].广州:广州中医药大学,2008.
[17]Bolton CE,Cannings-John R,Edwards PH,et al.What community measurents can be used to predict bone disease in patients with COPD?[J].Respir Med,2008,102(5):651-657.
[18]陈少藩.中山市中老年人慢性阻塞性肺疾病继发骨质疏松症中医证候研究[J].内蒙古中医药,2017,36(15):21.
[19]刘振峰,高振,艾力江·阿斯拉,等.新疆慢性阻塞性肺疾病继发骨质疏松症中医证候研究[J].中国中医药信息杂志,2012,19(11):13-15.
[20]Hurst JR,Vestbo J,Anzueto A,et al. Susceptibility to exacerbation in chronic obstructive pulmonary disease[J].N Engl J Med,2010,363(12):1128-1138.
[21]叶蔚,王小奇,张红,等.慢性阻塞性肺疾病食管pH监测与证型的相关性研究[J].中医药学刊,2004(12):2252-2253.
[22]叶蔚,王小奇,刘庆生,等.降逆和胃方治疗慢性阻塞性肺疾病伴有胃食管反流病的研究[J].中华中医药学刊,2009,27(1):84-86.
[23]Barnes PJ. Inflammatory mechanisms in patients with chronic obstructive pulmonary disease[J].J Allergy Clin Immunol,2016,138(1):16-27.
[24]季秀梅,周晓,陈菊萍,等.慢性咳嗽患儿呼出气一氧化氮与特应性体质及血清总免疫球蛋白E水平的相关性研究[J].浙江医学,2013,35(11):1013-1015.
[25]翟豫疆.COPD患者FENO与肺功能及中医辨证分型等相关性分析[D].乌鲁木齐:新疆医科大学,2013.
[26]曾繁琨.AECOPD患者呼出气一氧化氮测定与中医辨证分型等相关性分析[D].广州:广州中医药大学,2016.
[27]隆海燕,罗红,陈平,等.阻塞性肺疾病患者血清CRP和IL-18与肺功能及生活质量的相关性[J].中南大学学报:医学版,2011,36(11):1090-1096.
[28]付玲.罗玲教授学术思想与临床经验总结及慢性阻塞性肺疾病中医证型与肺功能等的相关性研究[D].成都:成都中医药大学,2016.
[29]李勇,黄振炎,卢育明,等.慢性阻塞性肺疾病急性期不同中医证型相关指标的比较及临床意义[J].中国医药指南,2015,13(16):10-11.
[30]Aaron SD,Tan WC,Bourbeau J,et al. Diagnostic instability and reversals of chronic obstructive pulmonary disease diagnosis in individuals with mild to moderate airflow obstruction[J].Am J Respir Crit Care Med,2017,196(3):306-314.
[31]李淑芳,闫国良,庞辉群.AECOPD患者凝血功能变化及中医证候特点[J].中国中医急症,2013,22(6):895-897.
[32]薛河东.慢性阻塞性肺疾病患者中医证型与凝血、纤溶指标的相关性研究[J].新中医,2018,50(1):38-40.
[33]瞿波,周维,毛兵.慢性阻塞性肺疾病稳定期中医证型与肺功能的关系探讨[J].华西医学,2015,30(10):1853-1856.
[34]王娟.慢性阻塞性肺疾病中医辨证分型与相关指标的临床研究[D].南京:南京中医药大学,2001.
[35]Celli BR,Cote CG,Marin JM,et al. The body-mass index,airflow obstruction,dyspnea,and exercise capacity index in chronic obstructive pulmonary disease[J].N Engl J Med,2004,350(10):1005-1012.
[36]苗青,樊茂蓉,安喆,等.体质量指数对慢性阻塞性肺疾病中医证候分布的影响[J].时珍国医国药,2010,21(6):1560-1562.
[37]陆学超,胡海波,韩萍,等.慢性阻塞性肺疾病急性加重期合并营养不良中医证候分布规律初探[J].中国中医药信息杂志,2013,20(10):11-13.
[38]陆学超,李莉莎,宁天芳,等.慢性阻塞性肺疾病(COPD)稳定期合并营养不良中医证候规律初探[J].中医药通报,2013,12(3):48-51,55.
[39]LIU S,ZHOU Y,LIU S,et al. Association between exposure to ambient particulate matter and chronic obstructive pulmonary disease:results from a cross-sectional study in China[J].Thorax,2017,72(9):788-795.
[40]LI MH,FAN LC,MAO B,et al. Short-term exposure to ambient fine particulate matter increases hospitalizations and mortality in COPD:A systematic review and Meta-analysis[J].Chest,2016,149(2):447-458.
[41]朱雪,李珂,陈宪海.PM2.5中医病因属性及致病特点探讨[J].中华中医药杂志,2017,32(9):3937-3939.