哮喘-慢性阻塞性肺疾病重叠急性加重期的中医证候规律研究  

A study of TCM Syndrome Law in Acute Exacerbation of Asthma-COPD Overlap

作　　者：连乐燊[1] 詹少锋[2] 叶小汉 陈少藩[3] 宫静[4] 陶海澜 周惠仪 LIAN Le-shen;ZHAN Shao-feng;YE Xiao-han;CHEN Shao-fan;GONG Jing;TAO Hai-lan;ZHOU Hui-yi(Dongguan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Chinese Medicine,Dongguan Guangdong 523000,China;The First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou Guangdong 510080,China;Zhongshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Chinese Medicine,Zhongshan Guangdong 528400,China;The Guangdong Provincial Second Hospital of Traditional Chinese Medicine,Guangzhou Guangdong 510030,China;Graduate School of Guangzhou University of Chinese Medicine,Guangzhou Guangdong 510806,China;Dongguan Integrated Hospital of Traditional Chinese and Western Medicine,Dongguan Guangdong 523000,China)

机构地区：[1]广州中医药大学附属东莞市中医院,广东东莞523000 [2]广州中医药大学第一附属医院,广东广州510080 [3]广州中医药大学附属中山市中医院,广东中山528400 [4]广东省第二中医院,广东广州510030 [5]广州中医药大学研究生院,广东广州510806 [6]东莞市中西医结合医院,广东东莞523000

出　　处：《中医药导报》2020年第5期72-76,82,共6页Guiding Journal of Traditional Chinese Medicine and Pharmacy

基　　金：2018年广东省名中医传承工作室建设项目(粤中医办函〔2018〕5号)。

摘　　要：目的:探讨哮喘-慢性阻塞性肺疾病重叠(asthma-COPD overlap,ACO)急性加重期的中医证候规律。方法:回顾性分析330例住院的ACO急性加重期患者,制定中医证候信息采集表,提取患者的一般资料、中医证候因子等信息资料,统计及描述中医证候因子的分布规律,并对中医证候因子进行因子分析和聚类分析,探讨中医证候规律。结果:330例患者中出现了51个中医证候因子,频率较高的中医证候因子是气促、咯痰、咳嗽、痰多、喘粗息高;因子分析共提取11个公因子,涵盖69.5%的中医证候因子信息。结合聚类分析结果,ACO急性加重期常见证候有4种,分别为痰热壅肺;风袭肺卫、内引痰浊;肺脾气虚;阳虚水饮;分布占比为32.4%、24.6%、23.5%、19.6%。病位主要在肺,涉及脾肾、肺卫;病性为实证及虚实夹杂;证候因子以痰饮证为主。结论:ACO急性加重期中医证候规律兼有哮喘和COPD的特征,更接近于AECOPD,但其风邪表证较AECOPD更为常见,虚证、表里同病较哮喘急性发作更为常见。临证应抓住ACO肺虚痰饮的主要病机,同时注意表里同治。Objective:To investigate the TCM Syndrome law in acute exacerbation of asthma-COPD overlap(ACO).Methods:The retrospective analysis contained 330 cases of the ACO inpatients in 5 hospitals.After extracting the patient's general information such as TCM syndrome factor data,with the TCM syndrome information collection table,we statisticed and described the distribution of TCM syndrome factor,and also made a factor analysis and cluster analysis,to explore the law of TCM syndrome.Results:51 TCM syndrome factors were found in 330 patients.The TCM syndrome factors with higher frequency were wheezing,cough,phlegm,wheezing and high breath.A total of 11 common factors were extracted by factor analysis,covering 69.5%of TCM syndromes.Combined with the results of cluster analysis,it is concluded that there are four common syndromes of ACO,which were respectively phlegm heat obstructing lung;wind in the lung with phlegm turbid;lung-spleen deficiency;Yang deficiency with phlegm-water;and the distribution proportion was 32.4%,24.6%,23.5%and 19.6%respectively.Disease locatie mainly in the lung,involving the spleen and kidney;The disease was mixed with excess and deficient facts.The main syndrome factor was phlegm-water syndrome.Conclusion:The TCM syndromes of acute exacerbation of ACO have characteristics of both asthma and COPD,which are closer to AECOPD.However,its wind syndrome is more common than AECOPD,and the deficiency syndrome is more common than the asthma,which suggests that we should grasp the main pathogenesis of ACO,pulmonary deficiency and phlegm,and pay attention to the combination of exterior and interior syndromes.

关 键 词：哮喘-慢性阻塞性肺疾病重叠 急性加重期 中医证候 因子分析 聚类分析 

分 类 号：R256.12[医药卫生—中医内科学]