肺动脉高压患者中医证型与肺功能的相关性研究  

Correlation between TCM Syndrome Types and Pulmonary Function in Patients with Pulmonary Hypertension

作　　者：钟秀君[1] 方漫兮 胡芸倩[3] 王岚[4] 臧娜 姜蓉[4] 汤杰[1] Zhong Xiujun;Fang Manxi;Hu Yunqian;Wang Lan;Zang Na;Jiang Rong;Tang Jie(YueyangHospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Trditional Chinese Medicine,Shanghai 200437,China)

机构地区：[1]上海中医药大学附属岳阳中西医结合医院,上海200437 [2]上海中医药大学岳阳临床医学院,上海200437 [3]同济大学附属东方医院,上海200120 [4]上海市肺科医院,上海200433

出　　处：《中国中医急症》2023年第5期806-810,共5页Journal of Emergency in Traditional Chinese Medicine

基　　金：上海市肺科医院临床研究项目(FKLY20005);岳阳中西医结合医院专科项目管理平台建设专项(YW211.03.05.01)。

摘　　要：目的 分析探讨肺动脉高压(PH)患者的中医证素分布特征以及中医证型与肺功能等临床指标的相关性。方法 分析307例患者的中医证素分布情况以及中医证型与肺功能、血气分析、血常规等指标的相关性,评估肺功能与血气分析、血常规中证型相关指标之间的关系。结果 PH的中医辨证要素中病位证素分布呈肺>心>肾>脾>肝的趋势,其中肺、心出现频次居前两位;病性证素分布呈气虚>血瘀>阳虚>阴虚>痰浊>寒>水饮>血虚>热>气滞的趋势,其中气虚、血瘀出现频次居前两位,气虚血瘀证也是最多见的证型。肺功能、血气分析、血常规有关指标在各中医证型间有明显差异,痰热郁肺证中FVC%pred、FEV1%pred、FEV1/FVC(%)、动脉血二氧化碳分压(PaCO_(2))、LY%、MONO%最低,NEUT%最高。肺功能相关指标与PaCO_(2)、NEUT%呈负相关,与LY%呈正相关。结论 气虚、血瘀为PH的基本病机,痰热郁肺证肺功能最差,PH患者肺功能与血气分析、血常规有关指标存在一定相关性,肺功能检查有助于判定中医证型。Objective:To investigate the distribution of TCM syndrome elements in patients with pulmonary hypertension(PH),and the correlation between TCM syndrome types and lung function.Methods:A total of 307 patients were selected to analyze the distribution of medical evidence and the correlation between TCM symptom type and pulmonary function,blood gas analysis,blood routine and other indicators,and evaluate the relationship between pulmonary function and blood gas analysis and blood routine medium type related indicators.Results:The distribution of disease location and syndrome elements in the TCM syndrome differentiation elements of PH showed the trend of lung>heart>kidney>spleen>liver,and the frequency of lung and heart was significantly higher than that of other disease locations;the distribution of disease syndrome elements showed the trend of qi deficiency>blood stasis>yang deficiency>yin deficiency>phlegm turbidity>cold>fluid retention>blood deficiency>heat>qi stagnation.Among them,the frequency of qi deficiency and blood stasis were obviously higher than other syndrome elements,and the syndrome of qi deficiency and blood stasis were also the most common syndrome type.The indexes related to pulmonary function,blood gas analysis and blood routine examination were significantly different among different TCM syndrome types.FVC%pred,FEV1%pred,FEV1/FVC(%),PaCO_(2),LY%,MONO%were the lowest and NEUT%was the highest in phlegm heat stagnation lung syndrome.Pulmonary function related indexes were negatively correlated with PaCO_(2) and NEUT%,and positively correlated with LY%.Conclusion:Qi deficiency and blood stasis are the basic pathogenesis of PH,and the pulmonary function of phlegm heat stagnation syndrome is the worst.There is a certain correlation between lung function and the blood gas analysis and blood routine examination in PH patients.The lung function examination is helpful to distinguish the TCM syndrome type.

关 键 词：肺动脉高压 中医证素 中医证型 肺功能 相关性 

分 类 号：R543.2[医药卫生—心血管疾病]