脓毒症胃肠功能障碍中医证候分布规律探讨  

Discussion on differentiation laws of traditional Chinese medicine syndromes of patients with sepsis and gastrointestinal dysfunction

作　　者：孔立[1] 郭琪钰 赵浩[1] 

机构地区：[1]山东中医药大学附属医院,山东济南250014 [2]即墨市中医医院,山东即墨266200

出　　处：《中国中西医结合急救杂志》2013年第3期134-137,共4页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：山东省自然科学基金项目（ZR2010HL062）

摘　　要：目的观察脓毒症胃肠功能障碍中医证候分布规律。方法选择2009年11月至2011年2月山东中医药大学附属医院收治的脓毒症胃肠功能障碍患者80例，观察患者的临床症状和体征，采集中医四诊信息，对患者症状和体征分布采用频次描述方法，对证候分布运用聚类分析的方法。结果80例患者中症状分布特点前5位依次为腹胀63例（78．7％）、纳呆43例（53．7％）、便秘40例（50．0％）、泄泻37例（46．2％）、脘痞35例（43．7％）；体征分布特点舌象分布特点前5位依次为黄苔52例（65．0％）、舌淡红30例（37．5％）、薄苔29例（36．2％）、舌红24例（30．0％）、厚苔24例（30．0％）；脉象分布特点前5位依次为脉数40例（50．O％）、脉沉21例（26．2％）、脉弱17例（21．2％）、脉滑14例（17．5％）、脉弦12例（15．0％）。结合聚类分析结果及患者的临床表现，脓毒症胃肠功能障碍患者的主要证型分布为实证63例（占78．8％），分别为肠热腑实证、胃热气滞证、痰湿蕴脾证、瘀滞胃肠证；虚证主要为脾胃气虚证17例（占21．3％）。结论脓毒症胃肠功能障碍的中医证候特点是实证与虚证并见，以实证为主。实证以肠热腑实证、胃热气滞证、痰湿蕴脾证、瘀滞胃肠证多见；虚证以脾胃气虚证多见。Objective To observe the differentiation laws of traditional Chinese medicine （TCM）syndromes of patients with sepsis and gastrointestinal dysfunction. Methods Eighty cases with sepsis and gastrointestinal dysfunction paid visits to the Affiliated Hospital of Shandong University of TCM in a period from November 2009 to February 2011. According to the four diagnostic methods of TCM, we gathered all patients＇ information about their clinical symptoms and signs, frequency describing methods were used to explore the distribution of patients＇ symptoms and signs and the cluster analysis was applied to determine the differentiation laws of TCM syndromes of patients with sepsis and gastrointestinal dysfunction. Results In the 80 cases, the distribution of symptoms and signs, tong and pulse manifestations having higher frequency and occupying the first 5 positions were as follows ： symptoms and signs ： abdominal distension 63 cases （78.7%）, loss of appetite 43 cases （53.7%）, constipation 40 cases （50.0%）, diarrhea 37 cases （46.3%） and bloating 35 cases （43.7%） ; tongue ： yellow moss 52 cases （65.0%）, tongue reddish 30 cases （ 37.5% ）, thin moss 29 cases （ 36.2% ）, red tongue 24 cases （30.0%） and thick moss 24 cases （ 30.0% ） ; pulse ： rapid pulse 40 cases （50.0%）, sink pulse 21 cases （26.2%）, weak pulse 17 cases （21.2%）, slippery pulse 14 cases （17.5%） and string-like pulse 12 cases （15.0%） . Based on the results of cluster analysis and patients＇ clinical manifestations, the differentiation laws of syndromes of patients with sepsis and gastrointestinal dysfunction were as follows ： 63 cases with sthenia syndrome （78.8%）including solid-fu due to intestine-heat syndrome, stomach heat due to qi stagnation syndrome, accumulation of phlegm and dampness in the spleen syndrome, and blood stagnation of gastrointestinal syndrome, and 17 cases with asthenia syndrome only referring to spleen, stomach, qi asthenia syndrome （21.3%）. Conclusion The s

关 键 词：脓毒症胃肠功能障碍 中医证候分布规律 聚类分析 

分 类 号：R197.32[医药卫生—卫生事业管理]