371例多重耐药菌血行感染中医证候分布特点回顾性研究  

A Retrospective Study on the Distribution Characteristics of Chinese Medicine Syndromes in 371 Cases of Multidrug-Resistant Bacteria Bloodstream Infection

作　　者：郑丹文[1] 吴炎华 ZHENG Danwen;WU Yanhua

机构地区：[1]广东省中医院,广东广州510120 [2]广州中医药大学第二临床医学院,广东广州510006

出　　处：《新中医》2018年第8期161-163,共3页New Chinese Medicine

基　　金：广东省中医药局科研课题(20162063)

摘　　要：目的:观察多重耐药菌血行感染(BSI)患者中医证候分布。方法:纳入3 7 1例多重耐药菌BSI患者,回顾性调查中医证候信息及相关临床资料,分析多重耐药菌BSI患者虚实辨证与预后的关系。结果:3 7 1例多重耐药菌BSI患者中,虚实夹杂证患者占比81.6%,单纯实证占比15.4%。实证类基本证候要素中,火热证占比最高,为6 7.1%(229例),而后依次为血瘀证、痰证、水停证。虚证类基本证候要素中,气虚证出现频率最高,达7 4.1%(27 5例),而后依次为阳虚证、阴虚证、血虚证。与非脓毒症患者相比,脓毒症患者阳虚证比例明显增多(P<0.01);脓毒症并MODS患者阳虚证比例多于脓毒症患者(P<0.01)。虚实夹杂证患者死亡率高于单纯实证患者(P<0.05),阳虚证患者死亡率高于非阳虚证患者(P<0.01)。结论:多重耐药菌BSI患者中医证候以虚实夹杂证多见,随着疾病的进展,病机演变从邪正交争逐渐演变为邪盛正衰,以阳气虚衰最为突出,且预后较差。Objective： To observe the distribution of Chinese medicine syndromes in 371 cases of multidrug-resistant bacteria bloodstream infection（BSI）. Methods： Enrolled 371 multidrug-resistant bacteria BSI patients in this study, retrospectively investigated the information of Chinese medicine syndromes and related clinical data and analyzed the relationship between deficiency and excess syndrome differentiation and prognosis of multidrug-resistant bacteria BSI patients. Results：Among the 371 multidrug-resistant bacteria BSI patients,those with syndrome of intermingled deficiency and excess accounted for 81.6% and those with simple excess syndrome accounted for 15.4%. Among the basic syndrome elements of excess syndrome, the highest proportion of heat syndromes was 67.1%（229 cases）,followed by blood stasis syndrome,phlegm syndrome and water stagnation syndrome. Among the basic syndrome elements of deficiency syndromes, qi deficiency syndrome had the highest frequency reaching 74.1%（275 cases）, followed by yang deficiency syndrome, yin deficiency syndrome and blood deficiency syndrome. Compared with patients with non-sepsis, the proportion of yang deficiency in patients with sepsis increased significantly（P〈0.01）. The proportion of yang deficiency syndrome in patients with sepsis and MODS was higher than that in sepsis patients（P〈0.01）. The mortality rate of patients with deficiency and excess inclusion syndrome was higher than that of the patients with simple excess syndrome（P〈0.05）. The mortality rate of patients with yang deficiency syndrome was higher than that of patients with non-yang deficiency syndrome（P〈0.01）. Conclusion： The Chinese medicine syndromes in multidrug-resistant bacteria BSI patients are commonly syndrome of intermingled deficiency and excess. With the progression of this disease,the pathogenesis evolve from the struggle between vital qi and pathogen to the state of evil excess and vital qi deficiency. The deficiency of yang qi is the most obvious one and th

关 键 词：多重耐药菌 血行感染(BSI) 中医证候 虚实夹杂 阳虚 

分 类 号：R515.3[医药卫生—内科学]