类风湿关节炎相关肺间质病变的中医证素分布及组合规律研究  

Research on distribution and combination rules of TCM syndrome elements of interstitial lung disease caused by rheumatoid arthritis

作　　者：左艇[1] 李桓[1,2] 李松伟[2] 井澎博 林婷婷[1] 兰鹏[1] 

机构地区：[1]河南中医学院,郑州450046 [2]河南中医学院第一附属医院,郑州450000 [3]南通大学医学院,南通226019

出　　处：《中华中医药杂志》2015年第8期2942-2944,共3页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家自然科学基金(No.U1204828);河南省中医药科技攻关项目(No.2014ZY02028);河南中医学院大学生创新学习项目(No.CXXM201312)~~

摘　　要：目的:通过对临床病例的回顾性调查,探讨类风湿关节炎相关肺间质病变的中医证素分布与组合规律,指导中医辨证。方法:选取2008年1月-2012年4月在河南中医学院第一附属医院、河南省中医院就诊的类风湿关节炎肺间质病变患者136例,对其中医证候诊断、中医证候要素等进行统计分析,探讨类风湿关节炎相关肺间质病变的中医证素分布及组合规律。结果:证素分布:共提取证素18个,其中病因/病性证素10个,病位证素8个。证素组合情况:1单一证素构成的有血瘀及湿浊两种。2两证素组合情况:多为气阴两虚、阴阳俱虚、气虚血虚和气虚血瘀。3三证素组合情况:两病性证素与单一靶点组合中,痰+热和痰+瘀出现的频率较高;单一病性证素与两靶点组合中,气虚与肺+肾出现的频率较高。4四证素组合情况:肺肾气阴两虚所所占比例较高。5其他组合情况:尚有风痰入里证。结论:类风湿关节炎相关肺间质疾病以痰、热、瘀血、湿(浊)等为实证最常见的病理因素,虚证多以气虚、阴虚等为主,病位在肺为常见,最常累及脾肾。Objective： To investigate the distribution and combination rules of traditional Chinese medicine （TCM） syndrome elements of interstitial lung disease associated with rheumatoid arthritis （RA） by retrospective surveying on clinical cases and guide syndrome differentiation of TCM. Methods： 136 cases of patients with interstitial lung disease caused by RA in The First Affiliate Hospital of Henan University of TCM and Henan Province Hospital of TCM from January 2008 to April 2012 were included. The syndrome diagnosis, syndrome elements and so on were analyzed in order to investigate the the distribution and combinatiotl rules of TCM syndrome elements of interstitial lung disease associated with rheumatoid arthritis. Results： Distribution of syndrome elements： A total of 18 syndrome elements were extracted, in which there were 10 syndrome elements of pathogenesis and nature of disease, and 8 syndromes elements of disease location. Combination of syndromes elements： ①Combination of single syndrome elements mainly were blood stasis and damp turbidity;②Combination of two syndrome elements mainly were deficiency of both qi and yin, deficiency of both yin and yang and deficiency of both qi and blood and blood stasis due to deficient qi; ③Combination of three syndrome elements were as follows： in the combination of two syndrome elements of disease nature and single target spot, the combinations of high frequency were phlegm combined with heat and phlegm combined with blood stasis, and in the combination of single syndrome elements of disease nature with two target spots, the combinations of high frequency were qi deficiency combined with kidney and lung combined with kidney; ④Combination of four syndrome elements with high frequency was both yin and qi deficiency of lung and kidney; ⑤Other combination was syndrome of wind-phlegm invading interior. Conclusion： Phlegm, heat, blood stasis and dampness are the most common pathological factors of excess syndrome of interstitial lung disease caused

关 键 词：类风湿关节炎 肺间质病变 证素 临床调查 

分 类 号：R259[医药卫生—中西医结合]