204例ALI/ARDS患者中医证候分布与演变特征研究  

Study on the TCM syndrome distribution and evolution characteristic of 204 ALI/ARDS patients

作　　者：杨英伟[1] 李建[1] 刘恩顺[2] 孙增涛[2] 郑莉[3] 

机构地区：[1]天津中医药大学,天津3001932 [2]天津中医药大学第二附属医院,天津300150 [3]天津市津南区咸水沽医院,天津300350

出　　处：《中华中医药杂志》2015年第3期911-913,共3页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家重点基础研究发展计划(973计划)(No.2009CB522702)~~

摘　　要：目的:初步明确急性肺损伤/急性呼吸窘迫综合征(ALI/ARDS)脏腑证候分布及演变特征,为临床辨治提供依据。方法:制订ALI/ARDS患者中医证候调查表,对204例ALI/ARDS患者进行临床流行病学横断面调查。结果:①证候分布以肺系、肠系证候为主,同时涉及了心、脾、肝、肾系;②随着病情发展,各脏腑证候形成一定的演变特征:肺系证候中痰热壅肺证减少,肺气虚证增加,肺热炽盛证基本保持不变,肺阴虚证从无到有并逐渐增加;大肠证候中,肠热腑实证逐渐减少,肠道气滞证基本无变化,肠燥津亏证自出现后保持稳定趋势。结论:调查结果初步显示ALI/ARDS肺肠同病的临床特征,ALI/ARDS的病机特点为正气受损、气机郁滞,提示在施治时要行气兼顾益气,将通腑作为一个重要治法。Objective： To investigate the TCM syndrome distribution and evolution characteristic of patients with acute lung injury/acute respiratory distress syndrome （ALI/ARDS） in order to provide reference for syndrome differentiation and treatment in clinic. Methods： TCM syndrome questionnaire of patients with ALI/ARDS was designed to conduct a cross-sectional survey of clinical epidemiology among 204 patients with ALI/ARDS. Results： ①The distribution of TCM syndrome was concentrated in lung disease and large intestine disease and involved in the disease of heart, spleen, liver and kidney at the same time. ②With the progression of the disease, the evolution characteristics of viscera were developed as follows： Among the syndromes of lung disease, the lung phlegm heat syndrome gradually reduced, lung Qi deficiency syndrome gradually increased, lung heat syndrome remained unchanged and lung-yin deficiency syndrome appeared and gradually increased. Among the syndromes of large intestine disease, intestinal heat and fu-organ syndrome gradually decreased, Qi stagnation syndrome of large intestine remained unchanged and intestinal dryness and fluid deficiency syndrome appeared and remained stable. Conclusion： The results initially show that the clinical characteristic of ALI/ARDS involved in lung and large intestine disease. The pathogenesis of ALI/ARDS is Qi deficiency and Qi stagnation, which notices that the therapy should put emphasis on regulating Qi, nourishing Qi and purging fu-organs.

关 键 词：ALI/ARDS 证候分布 证候演变 肺肠相关 调查研究 

分 类 号：R259[医药卫生—中西医结合]