左心疾病相关性肺动脉高压患者中医证候分布特点临床调查研究  

Clinical investigation of TCM syndrome distribution characteristics in patients with pulmonary hypertension associated with left heart disease

作　　者：黄宏 肖珉[2] 李玉峰[2] 修晟尧 姜旭[2] 贾君迪 HUANG Hong

机构地区：[1]南京中医药大学附属医院,江苏南京210029 [2]北京中医药大学东直门医院,北京100000

出　　处：《中医临床研究》2022年第11期1-7,共7页Clinical Journal Of Chinese Medicine

摘　　要：背景:左心疾病相关性肺动脉高压患者是目前最大的肺动脉高压人群,急需新的治疗方式、药物以及针对左心疾病相关性肺动脉高压(Pulmonary Hypertension due to Left Heart Disease,PH-LHD)的临床研究,中医药已显示出一定的治疗潜力和优势。目的:本研究通过收集PH-LHD患者的中医临床证候学资料,以期了解PH-LHD的证素分布规律及与疾病严重程度指标之间的相关性,初步探索PH-LHD中医证型出现形式,明确PH-LHD优势证素及与疾病严重程度相关的证素类型,为中医药临床辨证施治提供依据。方法:采用横断面的研究方法,从2017年6月-2018年12月于北京中医药大学东直门医院住院部收集314例PH-LHD患者,排除数据不全及患者拒绝配合等因素,共收集整理293例PH-LHD患者资料,完成293份中医证候调查表,通过频数、相关性、回归分析等数据统计方法进行研究,从中得出PH-LHD的证素分布规律、证素与心肺功能等与疾病严重程度相关指标之间的相关性、证素之间的内在关系,从而得出PH-LHD常见症状、体征、证素、可能出现的证素组合形式及与疾病严重程度相关的证素。结果:本研究调查PH-LHD临床常见8个证素,按照总的出现频次各证素由高到低排列依次为血瘀>气虚>痰浊>水饮>阴虚>阳虚>气滞>血虚。出现频次最多的四种证素分别是血瘀、气虚、痰浊、水饮,其中血瘀、气虚出现频次明显高于其他证型,这也符合气血理论是心系相关疾病的重要理论基础,痰浊、水饮也是PH-LHD发展过程中出现较多的病理产物;分析提取出54种复合证素类型,其中最常见的8种复合证型出现频次由高到低排列依次为气虚+血瘀>血瘀+痰浊>气虚+血瘀+水饮>气虚+血瘀+痰浊=气虚+阴虚>气虚+阴虚+血瘀+痰浊=血瘀+气滞、阳虚+水饮,其中两证素组合形式构成比最大,两证素组合形式中气虚+血瘀出现频次最多,在三证素中出现频次最高Backgound:Patients with left heart disease-related pulmonary hypertension are currently the largest population of pulmonary hypertension.New treatments,drugs and clinical studies for PH-LHD are urgently needed.TCM has shown certain therapeutic potential and advantages.Objective:To collect the clinical syndrome data of PH-LHD patients in order to understand the distribution of syndrome elements of PH-LHD and the correlation between syndrome elements and disease severity indexes,then explore the occurrence forms of TCM syndrome types of PH-LHD,and to identify the dominant syndrome elements of PH-LHD and the types of syndrome elements related to the severity of the disease,so as to provide a basis for clinical dialectical treatment of TCM.Methods:From June 2017 to December 2018,314 patients with PH-LHD were collected from the inpatient department of Dongzhimen Hospital of Beijing University of Traditional Chinese Medicine,excluding incomplete data and patients’refusal to cooperate.The data of 293 patients with PH-LHD were collected and completed.293 TCM syndrome questionnaires were completed and studied by frequency,correlation,regression analysis and other data statistical methods.The distribution law of syndrome elements of PH-LHD,the correlation between syndrome elements,cardiopulmonary function and disease severity related indexes,and the internal relationship between syndrome elements were obtained,and the common symptoms,signs,syndrome elements,possible combination forms of syndrome elements and syndrome elements related to disease severity of PH-LHD were obtained.Results:This study investigated eight common clinical syndrome factors of PHLHD.According to the total occurrence frequency,the order of syndrome elements from high to low was as follows:blood stasis>Qi(气)deficiency>phlegm turbidity>retained fluid>Yin(阴)deficiency>Yang(阳)deficiency>Qi stagnation>blood deficiency.The four syndrome elements with the most frequent occurrence were blood stasis,Qi deficiency,phlegm turbidity and retained fluid,in

关 键 词：横断面调查研究 左心疾病相关性肺动脉高压 中医证候学 证素分布特点 

分 类 号：R256.2[医药卫生—中医内科学]