哮喘-慢性阻塞性肺疾病重叠中医证候规律及与血清胃泌素、D-二聚体和营养水平相关性研究  

Correlation of Traditional Chinese Medicine Syndrome Differentiation with Serum Gastrin,D-Dimer and Nutrition Level in Patients with Overlap of Asthma and Chronic Obstructive Pulmonary Disease

作　　者：张双胜[1] 仝金斋[2] 钟春毅[1] 余月华[1] 胡紫光[1] ZHANG Shuang-Sheng;TONG Jin-Zhai;ZHONG Chun-Yi;YU Yue-Hua;HU Zi-Guang(Dept.of Traditional Chinese Medicine,Jiangmen Central Hospital,Jiangmen 529030 Guangdong,China;Dept.of Respiratory Diseases,Jiangmen Central Hospital,Jiangmen 529030 Guangdong,China)

机构地区：[1]江门市中心医院中医科,广东江门529030 [2]江门市中心医院呼吸科,广东江门529030

出　　处：《广州中医药大学学报》2021年第1期1-5,共5页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：广东省中医药局面上项目(编号:20191371)。

摘　　要：【目的】探讨哮喘-慢性阻塞性肺疾病重叠(ACO)患者中医证候规律及与血中胃泌素(GAS)、D-二聚体(D-D)和营养状况的相关性,并与单纯慢性阻塞性肺疾病(COPD)组比较,为中医辨治ACO提供客观依据。【方法】选取符合诊断条件的ACO和单纯COPD患者各50例,比较ACO组和COPD组之间血中GAS、D-D、前白蛋白(PA)及外周血总淋巴细胞计数(PBL)的区别,并观察ACO组不同中医证型之间上述指标的差异。【结果】(1)在实验室指标方面:ACO组血中GAS、PBL水平高于单纯COPD组,差异有统计学意义(P<0.05);而PA水平有高于单纯COPD组趋势,D-D水平有低于单纯COPD组趋势,但差异均无统计学意义(P>0.05)。(2)在中医证型分布方面:ACO组患者中,痰浊蕴肺型17例(占34.0%),痰热郁肺型20例(占40.0%),肺肾亏虚型13例(占26.0%);COPD组患者中,痰浊蕴肺型18例(占36.0%),痰热郁肺型18例(占36.0%),肺肾亏虚型14例(占28.0%);组间比较,差异无统计学意义(P>0.05)。(3)在不同中医证型各项指标的差异方面:ACO组不同中医证型间GAS表达水平不同,其中痰浊蕴肺型最高,痰热郁肺型次之,肺肾亏虚型最低,差异有统计学意义(P<0.05);不同中医证型间PA表达水平也不同,痰热郁肺型低于痰浊蕴肺型及肺肾亏虚型,差异有统计学意义(P<0.05);而在PBL方面,肺肾亏虚型略高于其他2型,在反映机体纤溶水平的D-D方面,痰热郁肺型略高于其他2型,但差异均无统计学意义(P>0.05)。【结论】GAS在ACO患者和单纯COPD患者之间,以及GAS与PA在ACO不同中医证型之间表达水平不同,且PA与患者的营养免疫状况相关,GAS、PA可能是ACO中医证候物质基础之一。Objective To explore the correlation of traditional Chinese medicine(TCM)syndrome differentiation with serum gastrin(GAS),D-dimer(D-D)and nutrition level in patients with overlap of asthma and chronic obstructive pulmonary disease(COPD),and to compare with simple COPD patients,so as to provide evidence for the syndrome differentiation and treatment of asthma-COPD overlap(ACO)patients. Methods A total of 50 COPD patients served as COPD group,and a total of 50 patients with asthma-COPD overlap served as ACO group. The serum levels of GAS,D-D,and prealbumin(PA)as well as the peripheral blood lymphocyte(PBL)count in the two groups were measured. And the differences in the levels of GAS,D-D,PA and PBL among the ACO patients with different TCM syndromes were investigated. Results(1)ACO group had higher serum levels of GAS and PBL than COPD group,and the difference was statistically significant(P < 0.05). PA level showed an increasing trend and D-D showed a decreasing trend in ACO group as compared with those in COPD group,but the difference was not statistically significant(P > 0.05).(2) In ACO group,17 cases(34.0%)were differentiated as the syndrome of phlegm turbidity accumulating in the lung,20 cases(40.0%)were differentiated as the syndrome of phlegm heat obstructing the lung,and 13 cases(26.0%)were differentiated as the syndrome of lung and kidney insufficiency.In COPD group,18 cases(36.0%)were differentiated as the syndrome of phlegm turbidity accumulating in the lung,18 cases(36.0%)were differentiated as the syndrome of phlegm heat obstructing the lung,and 14 cases(28.0%)were differentiated as the syndrome of lung and kidney insufficiency. The intergroup comparison showed that the differences of TCM syndromes between the two groups were not statistically significant(P > 0.05).(3)In ACO group,GAS level varied in the syndrome of phlegm turbidity accumulating in the lung,syndrome of phlegm heat obstructing the lung,and syndrome of lung and kidney insufficiency,and the GAS level in the 3 syndrome types was in decrea

关 键 词：哮喘 慢性阻塞性肺疾病 哮喘-慢性阻塞性肺疾病重叠 胃泌素 营养状况 D-二聚体 中医证候 

分 类 号：R259.622[医药卫生—中西医结合]