间接测热法比较不同证型呼吸衰竭患者的静息能量消耗  

Comparison of resting energy expenditure with indirect calorimetry in the patients of respiratory failure of different TCM syndromes

作　　者：陈小刚 高红梅[2] 窦琳[2] 李寅[2] 路铃 CHEN Xiao - gang1 , GAO Hong - mei2 , DOU Lin2 , LI Yin2 , LU Ling2(1. Graduate School of Tianjin University of Traditional Chinese Medicine, Tianjin 300193 ;2. Department of Intensive Care Medicine ,Tianjin First Center Hospital,Tianjin 300192)

机构地区：[1]天津中医药大学研究生院,天津300193 [2]天津市第一中心医院重症医学科,天津300192

出　　处：《世界中西医结合杂志》2018年第1期104-107,共4页World Journal of Integrated Traditional and Western Medicine

基　　金：卫生部国家临床重点专科建设项目(2011-873);天津市中医药管理局中医;中西医结合科研专项课题(13117);天津市卫生计生委科技基金(2015KZ019);天津市卫生行业重点攻关项目(16KG106)

摘　　要：目的应用间接测热法(IC)所测得数据比较ICU病房中呼吸衰竭的患者在不同中医证型下静息能量消耗(REE)。方法选入33例ICU病房中呼吸衰竭并采用机械通气辅助呼吸的患者,将纳入研究的患者进行中医辨证分型:痰热蕴肺型11例、肺气虚耗型11例、正虚喘脱型11例。分别用间接测热法测量出3组患者入院后第1、4、7天的静息能量消耗,比较3组患者之间静息能量消耗的差异,研究呼吸衰竭中不同症候的患者对能量的需求有无差异。结果 3次测量的各证型之间静息能量比较具有统计学意义(P<0.05),其中患者入院后第1天静息能量消耗的测量值比较为:痰热蕴肺型>肺气虚耗型>正虚喘脱型(F=16.72,P<0.05),患者入院后第7天静息能量消耗测量值比较为:痰热蕴肺型>肺气虚耗型>正虚喘脱型(F=4.22,P<0.05),患者入院后第4天静息能量消耗测量值比较为:痰热蕴肺型>正虚喘脱型>肺气虚耗型(F=7.64,P<0.05)。结论呼吸衰竭的患者在不同证型中静息能量消耗差异具有统计学意义,这为营养供给的准确性提供了客观指标,也为中医学辨证分型提供了客观依据和新的研究思路。Objective To compare the resting energy expenditure（REE） with indirect calorimetry（IC） in the patients of respiratory failure of different TCM syndromes in ICU. Methods A total of 33 cases of respiratory failure in ICU was selected and was assisted with mechanical ventilation. The included cases were differentiated in TCM. There were 11 cases of accumulation of phlegm heat in the lung,11 cases of lung qi consumption and 11 cases of antipathogenic qi collapse. IC was adopted to measure REE on the 1 st,4 thand7 thdays after admission in the patients of the three groups separately. The differences in REE were compared among the three groups. The energy demands were analyzed in the patients of respiratory failure of different TCM syndrome. Results The differences in REE were significantly in comparison of three comparisons among different TCM syndromes（P〈0. 05）. The results on the 1 stday were the accumulation of phlegm heat in the lung lung qi consumption antipathogenic qi collapse（F = 16. 72,P〈0. 05）. The results on the 7 thday were the accumulation of phlegm heat in the lung lung qi consumption antipathogenic qi collapse（F = 4. 22,P〈0. 05）. The results on the 4 th day were the accumulation of phlegm heat in the lung antipathogenic qi collapse lung qi consumption（F = 7. 64,P〈0. 05）. Conclusion REE was different significantly among the different TCM syndromes in the patients of respiratory failure. It provides the objective indicator for the accurate nutrient supply and the objective evidences as well as a new study approach to TCM syndrome differentiation.

关 键 词：呼吸衰竭 中医证型 静息能量消耗 

分 类 号：R563.9[医药卫生—呼吸系统]