呼吸机依赖胃肠功能障碍患者中医证候分布探讨  

Study on the Distribution of TCM Syndromes of Gastrointestinal Dysfunction in Ventilator Dependent Patients

作　　者：董妍 杨志旭[2] 李春[2] Dong Yan;Yang Zhixu;Li chun(Hebei Provincial Hospital of Traditional Chinese Medicine,Hebei,Shijiazhuang 050011,China)

机构地区：[1]河北省中医院,河北石家庄050011 [2]中国中医科学院西苑医院,北京100091

出　　处：《中国中医急症》2021年第3期447-449,453,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：河北省中医药管理局科研计划项目(2019048)。

摘　　要：目的观察呼吸机依赖患者胃肠功能障碍中医证候分布,为探讨其规律提供参考。方法选择2018年1月至2020年2月中国中医科学院西苑医院、河北省中医院收治的呼吸机依赖患者中出现胃肠功能障碍者50例,观察临床症状和体征,采集中医四诊信息,对患者症状和体征分布采用频次描述方法,对证候分布运用聚类分析的方法,病性、病位采用率的分析方法。结果50例患者中症状分布特点前5位依次为腹胀33例(66.00%)、胃潴留32例(64.00%)、便秘30例(60.00%)、发热29例(58.00%)、小便不利28例(56.00%);舌象分布特点前5位依次为腻苔22例(44.00%)、舌淡18例(36.00%)、舌红15例(30.00%)、少苔12例(24.00%)、舌红绛11例(22.00%);脉象分布特点前5位依次为沉脉20例(40.00%)、滑脉20例(40.00%)、脉弦20例(40.00%)、细脉15例(30.00%)、数脉13例(26.00%)。结合聚类分析结果及患者的临床表现,呼吸机依赖患者中胃肠功能障碍的主要证型分布:实证14例(28.00%)、虚证18例(36.00%)、虚实夹杂证18例(36.00%)。病性以脾虚、痰湿、气滞为主,病位以脾、肺、三焦为主。结论呼吸机依赖患者中胃肠功能障碍者以腹胀、便秘、胃潴留、发热、小便不利为常见症状,以虚证和虚实夹杂证为主要证型,病性要素为脾虚、痰湿、气滞为主,病位以脾、肺、三焦为主。Objective:To observe the distribution of traditional Chinese medicine(TCM)syndromes of gastrointestinal dysfunction in ventilator dependent patients.Methods:From January 2018 to February 2020,50 patients with ventilator dependent gastrointestinal dysfunction were selected from Xiyuan Hospital of China Academy of Chinese Medical Sciences and Hebei Hospital of Traditional Chinese Medicine.The clinical symptoms and signs of the patients were observed,the four-diagnostic informations of TCM were collected,the frequency description method was used for the distribution of symptoms and signs,and the cluster analysis method was used for the distribution of syndromes.The disease′s nature and location were analyzed by rate.Results:Among the 50 patients,the top 5 symptoms were as follows:abdominal distention(33 cases,66.00%),gastric retention(32 cases,64.00%),constipation(30 cases,60.00%),fever(29 cases,58.00%),and inhibited urination(28 cases,56.00%);the top 5 distribution features of tongue were as follows:thick tongue(22 cases,44.00%),pale tongue(18 cases,36.00%),red tongue(15 cases,30.00%),little coating tongue(12 cases,24.00%),deep red tongue(11 cases,22.00%);the top 5 distribution features of pulse were as follows:deep pulse(20 cases,40.00%),slippery pulse(20 cases,40.00%),taut pulse(20 cases,40.00%),thready pulse(15 cases,30.00%),and rapid pulse(13 cases,26.00%).Combined with the results of cluster analysis and clinical manifestations of patients,the main syndrome types of gastrointestinal dysfunction in ventilator dependent patients were as follows:14 cases(28.00%)of Excess syndrome;18 cases(36%.00)of Deficiency syndrome;18 cases(36.00%)of Deficiency and Excess syndrome.The disease type syndrome elements were mainly Spleen Deficiency,Phlegm Dampness and Qi Stagnation.The main location of the disease was Spleen,Lung and Triple Energizer.Conclusion:The patients with gastrointestinal dysfunction in ventilators were characterized by abdominal distention,constipation,gastric retention,fever and urina-tion disorders.The

关 键 词：胃肠功能障碍 呼吸机依赖 证素 聚类分析 

分 类 号：R574[医药卫生—消化系统]