慢性阻塞性肺疾病稳定期中医证候与BODE指数、生活质量相关性研究  

Cross-sectional Study on the Relationship among Syndrome of TCM,BODE Index and Qulity of Life,in Patients with COPD at Stable Phase

作　　者：王华楠[1] 周维[1] 毛兵[1] 

机构地区：[1]四川大学华西医院中西医结合科,成都610041

出　　处：《四川大学学报（医学版）》2015年第4期581-585,共5页Journal of Sichuan University(Medical Sciences)

基　　金：四川省科技厅科技支撑计划项目(No.2013SZ0001)资助

摘　　要：目的通过对慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)稳定期患者中医证候及现代医学相关指标的调查研究,探讨稳定期患者中医证候的变化规律以及各证候与BODE指数(body mass index,airflow obstruction,dyspnea,and exercise capacity index,BODE index)、生活质量的关系。方法收集符合纳入标准的300例COPD稳定期患者,按病变由单一脏腑向多个脏腑的累积确立5组虚证证型:肺气虚(A组)、肺脾气虚(B组)、肺肾气虚(C组)、肺脾肾气虚(D组)及气阴两虚(E组),每种证型各60例。进行COPD生活质量相关生活问卷(COPD assessment test,CAT)调查,分析BODE指数与生存质量的相关性。结果 5组间比较,A组体质量指数(BMI)、第1s用力呼气容积占预计值的百分比(FEV1%)最高,6min步行距离最长,呼吸困难程度最低(P<0.05),BODE评分、CAT得分最低(P<0.05)。D组和E组间上述指标和评分差异无统计学意义(P>0.05),均为BMI、FEV1%最低,6min步行距离最短,呼吸困难程度最高(P<0.05)。BODE指数评分与CAT得分呈正相关(r=0.883,P<0.05)。结论随着COPD病情的发展,病变由单一脏腑逐渐累积多个脏腑,由肺气虚→肺脾气虚/肺肾气虚→肺脾肾气虚,呈现BODE指数和CAT得分逐渐升高的特征。Objective To study the syndrome of traditional Chinese medicine（TCM）and relevant indexes of conventional Western medicine for patients with chronic obstructive pulmonary disease（COPD）at stable phase,and further explore the trend of change of the deficiency syndrome of TCM,and the correlation of each syndrome with the BODE index（body mass index,airflow obstruction,dyspnea,and exercise capacity index）and quality of life.Methods 300 cases with COPD which were in line with the standard were differentiated to 5groups（60cases for each group）by the symptoms.which were Lung Qi deficiency（Group A）,Lung and Spleen Qi deficiency（Group B）,Lung and Kidney Qi deficiency（Group C）,Lung,Spleen and Kidney Qi deficiency（Group D）,and deficiency of both Qi and Yin（Group E）.Some basic details about the patients were recorded,such as body mass and height.Also BODE index and COPD assessment test were conducted.And then the differences of the indexes among groups,the relationship between the BODE index and the COPD assessment test（CAT）score were analyzed.Results Comparison in 5groups,the body mass index（BMI）and forced expiratory volume in 1sto forced vital capacity ratio（FEV1%）of Group A was the highest,the 6-min walk distance（6MWD）of Group A was the longest,but the degree of dyspnea,BODE index and CAT score of patients in Group A were the lowest（P〈 0.05）.No statistical significance of above index and score between Group D and E was observed（P〉 0.05）.In Group D and E,the BMI and FEV1% was the lowest,6MWD was the shortest,and the degree of dyspnea of patients was the highest（P〈 0.05）.A positive correlation between BODE index and CAT score was observed（r=0.883,P〈 0.05）.Conclusion With the progress of COPD,disease from single viscera gradually accumulated to multiple viscera,from Group A→Group B/Group C→Group D,with the gradually increasing of BODE index and CAT score.

关 键 词：COPD稳定期 中医证候 BODE指数 CAT评分 

分 类 号：R259[医药卫生—中西医结合]