不同分期肺间质纤维化中医证型与CRP及圣乔治评分相关分析  

Clinical analysis of TCM syndrome types,CRP and St.George scores of pulmonary interstitial fibrosis in different stagings

作　　者：赵阳[1] 何海浪[1] 肖娜[1] 周贤梅[1] ZHAO Yang;HE Hai-lang;XIAO Na(Jiangsu Hospital of Traditional Chinese Medicine,Nanjing 210000,China)

机构地区：[1]江苏省中医院,南京210000

出　　处：《山西中医》2020年第11期47-49,共3页Shanxi Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(编号:81673936)。

摘　　要：目的:观察肺间质纤维化急性加重期与稳定期对中医证型分布、CRP临床部分及圣乔治评分的影响。方法:收集肺间质纤维化患者63例,分为住院组(急性加重期)29例、门诊组(稳定期)34例。比较两组患者在CRP临床部分、中医证型分布、圣乔治评分方面的情况。结果:①63例患者中呼吸困难43例(68.25%),咳嗽54例(85.71%),咯痰39例(61.9%),胸痛19例(30.15%),Velcro啰音28例(44.44%),杵状指16例(25.39%),紫绀10例(15.87%);两组比较,住院组在呼吸困难、咳嗽、咯痰、胸痛及Velcro啰音方面发生率明显高于门诊组(P<0.05);②住院组CRP(临床、影像、生理)临床定量评分明显高于门诊组,(P<0.05);③门诊组中医证型以气阴两虚、痰瘀为主,占31例(49.20%),住院组以气阴两虚,痰热为主,占27例(42.85%);④住院组圣乔治症状部分、总分部分评分均高于门诊组(P<0.05)。结论:①中医证型方面:肺间质纤维化在急性加重期及稳定期,本虚均为气阴两虚为主,急性加重期标实为痰热,稳定期为痰瘀;②肺间质纤维化急性加重期症状加重,与稳定期相比,在呼吸困难、咳嗽、咯痰、胸痛及Velcro啰音方面发生率增加,CRP临床定量评分增加,圣乔治症状评分增高,进而影响圣乔治总分增高。患者圣乔治评分越高,生活质量越差,预后不佳。Objective:To observe the effects of acute exacerbation staging and stable staging of pulmonary interstitial fibrosis on TCM syndrome types distribution,CRP clinical part and St.George scores.Methods:63 cases of collected patients with pulmonary interstitial fibrosis were divided into inpatient group(acute exacerbation staging)with 29 cases and outpatient group(stable staging)with 34 cases.CRP clinical part,TCM syndrome types distribution and St.George scores of patients were compared between two groups.Results:1.Among 63 cases of patients,there were 43 cases with dyspnea(68.25%),54 cases with cough(85.71%),39 cases with expectoration(61.9%),19 cases with chest pain(30.15%),28 cases with Velcro rales(44.44%),16 cases with clubbing finger(25.39%),10 cases with cyanosis(15.87%).The incidence of dyspnea,cough,expectoration,chest pain and Velcro rales in inpatient group was significantly higher than that in outpatient group(P﹤0.05).2.CRP(clinical-radiographic-physiologic)clinical quantitative score of inpatient group was significantly higher than that of outpatient group(P﹤0.05).3.TCM syndrome types of outpatient group were mainly characterized by qi-yin deficiency and phlegm and blood-stasis,accounting for 31 cases(49.20%);while TCM syndrome types of inpatient group were mainly characterized by qi-yin deficiency and phlegm-heat,accounting for 27 cases(42.85%).4.The scores of St.George symptom part and total score part of inpatient group were higher than those of outpatient group(P﹤0.05).Conlusion:①In TCM syndrome types:In the acute exacerbation staging and stable staging of pulmonary interstitial fibrosis,the deficiency in originis is mainly characterized by qi-yin deficiency.The excess in superficiality of acute exacerbation staging is phlegm-heat,while the excess in superficiality of stable staging is phlegm and blood-stasis.②In the acute exacerbation staging,the symptoms of pulmonary interstitial fibrosis are aggravated;compared with stable staging,the incidence of dyspnea,cough,expectoration,chest pain

关 键 词：肺间质纤维化 急性加重期 稳定期 证型分布 圣乔治评分 

分 类 号：R563.13[医药卫生—呼吸系统]