慢性阻塞性肺疾病急性加重期中医证候与APACHEⅡ评分、肺功能的相关性分析  

An Analysis of Correlation Between TCM Syndromes and APACHE Ⅱ Score and Pulmonary Function in Acute Exacerbation of Chronic Obstructive Pulmonary Disease

作　　者：王昭[1] 徐震[1] 帖永新[1] WANG Zhao;XU Zhen;TIE Yong-xin(Xinxiang Central Hospital,Xinxiang,Henan,China ,453000)

机构地区：[1]新乡市中心医院

出　　处：《河南中医》2019年第7期1076-1079,共4页Henan Traditional Chinese Medicine

摘　　要：目的:探讨慢性阻塞性肺疾病急性加重期(acute exacerbation of chronic obstructive pulmonary disease,AECOPD)中医证候与急性生理学-慢性健康状况评分系统Ⅱ(APACHEⅡ)及肺功能的相关性。方法:将81例AECOPD患者进行中医证候分型,比较各证型APACHEⅡ评分、第一秒末用力呼气容积(forced expiratory volume in one second,FEV1)、用力呼吸肺活量(forced vital capacity,FVC)、二氧化碳分压(Pa CO2)、氧分压(Pa O2)以及血清超敏C反应蛋白(hs-C reactive protein,hs-CRP)及血清降钙素原(procalcitonin,PCT)水平。结果:病程从短到长依次为痰浊阻肺证、痰热壅肺证、痰瘀阻肺证、肺肾两虚证,差异具有统计学意义(P <0. 05);FEV1、FEV1/FVC、Pa O2由高到低依次为痰浊阻肺证、痰热壅肺证、痰瘀阻肺证、肺肾两虚证,Pa CO2由低到高依次为痰浊阻肺证、痰热壅肺证、痰瘀阻肺证、肺肾两虚证,差异具有统计学意义(P <0. 05);APACHEⅡ评分由低到高依次为痰浊阻肺证、痰热壅肺证、痰瘀阻肺证、肺肾两虚证,差异具有统计学意义(P <0. 05);痰热壅肺证的PCT、hs-CRP水平明显高于痰浊阻肺证、痰瘀阻肺证及肺肾两虚证(P <0. 05)。结论:AECOPD中医证候与APACHEⅡ评分、肺功能具有一定的相关性。Objective: To explore the correlation between TCM syndromes of acute exacerbation of chronic obstructive pulmonary disease( AECOPD) and acute physiology,chronic health score system Ⅱ( APACHE Ⅱ) and pulmonary function. Methods: A total of 81 patients with AECOPD were classified into TCM syndromes. The APACHE Ⅱ scores,forced expiratory volume in one second( FEV1),forced vital capacity( FVC),partial pressure of carbon dioxide( Pa CO2),partial pressure of oxygen( Pa O2),serum hs-C reactive protein( hs-CRP) and serum calcitonin Procalcitonin( PCT) levels were compared. Results: The course of disease from short to long was phlegm turbidity obstructing lung syndrome,phlegm heat obstructing lung syndrome,phlegm stasis obstructing lung syndrome,lung and kidney deficiency syndrome,and the difference is statistically significant( P < 0. 05). FEV1,FEV1/FVC and Pa O2 from high to low were phlegm turbidity obstructing lung syndrome,phlegm-heat obstructing lung syndrome,phlegm-stasis obstructing lung syndrome and lung-kidney deficiency syndrome,and Pa CO2 from low to high were phlegm turbidity obstructing lung syndrome,phlegm-heat obstructing lung syndrome,phlegm-stasis obstructing lung syndrome and lung-kidney deficiency syndrome,and all the differences were statistically significant( P < 0. 05). APACHE Ⅱ scores from low to high were phlegm turbidity obstructing lung syndrome,phlegm heat obstructing lung syndrome,phlegm stasis obstructing lung syndrome,lung and kidney deficiency syndrome,and the difference was statistically significant( P < 0. 05). The PCT and hs-CRP levels of phlegm-heat obstructing lung syndrome were significantly higher than those of Phlegm-turbidity obstructing lung syndrome,phlegm-blood stasis obstructing lung syndrome and lung-kidney deficiency syndrome( P < 0. 05). Conclusion: The TCM syndromes of AECOPD are correlated with APACHE Ⅱ score and pulmonary function.

关 键 词：慢性阻塞性肺疾病 急性加重期 急性生理学-慢性健康状况评分系统Ⅱ 肺功能 第1秒末用力呼气容积 用力呼吸肺活量 

分 类 号：R259.622[医药卫生—中西医结合]