卫气营血辨证结合中性粒细胞/淋巴细胞比值(NLR)与脓毒症病原学的关系研究  

Study on the relationship between Traditional Chinese Medicine Syndrome Differentiation of Weifen,Qifen,Yingfen and Xuefen Combined with Neutrophil/Lymphocyte Ratio and the Etiology of Sepsis Patients

作　　者：张国鹏 程序 赵梦竹 刘梦华 魏琼 张冬梅[2] 梁腾霄[2] Zhang Guopeng;Cheng Xu;Zhao Mengzhu;Liu Menghua;Wei Qiong;Zhang Dongmei;Liang Tengxiao(Beijing Wangfu Hospital of Integrated Traditional Chinese and Western Medicine,Beijing 102209,China)

机构地区：[1]北京王府中西医结合医院,北京102209 [2]北京中医药大学东直门医院,北京100700

出　　处：《中国中医急症》2023年第8期1332-1335,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：国家重点研发计划(2018YFC1705902)。

摘　　要：目的探讨中医卫气营血辨证结合中性粒细胞/淋巴细胞比值(NLR)与脓毒症患者病原学的相关性。方法采用回顾性病例对照研究,选取2019年1月至2022年5月北京王府中西医结合医院急诊科收治的脓毒症住院患者180例,根据卫气营血辨证为气分证73例、营分证48例、血分证59例。探讨中医证型与动态演变的中性粒细胞/淋巴细胞比值(NLR)相关性,及NLR在不同病原菌感染脓毒症患者中的特异性和敏感性。收集患者基本信息和临床资料,采用SPSS 20.0软件进行统计学分析,并使用Graphpad prism8.0对分析数据进行绘图整理。结果随着脓毒症病情的进展加重,不同证型的NLR数值动态演变,血分证中NLR值显著高于其他两组(P<0.05)。且动态演变的NLR在不同病原菌感染相比较,NLR在革兰阴性菌脓毒症患者中敏感性和特异性更高(P<0.05)。结论中医卫气营血辨证结合NLR在未明确病原菌学检测结果的脓毒症中,早期预测感染病原菌类型上具有优势。本结果可指导临床合理使用抗生素及中药干预。Objective:To study the correlation between Traditional Chinese medicine(TCM)syndrome differen⁃tiation of Weifen,Qifen,Yingfen and Xuefen combined with neutrophil/lymphocyte ratio(NLR)and the etiology of sepsis patients.Methods:A retrospective case-control study was conducted to select 180 inpatients with sepsis admitted to the emergency department of Beijing Wangfu Hospital of Integrated Traditional Chinese and Western Medicine from January 2019 to May 2022.According to the syndrome differentiation of Weifen,Qifen,Yingfen and Xuefen,there were 73 cases of Qifen syndrome,48 cases of Yingfen syndrome and 59 cases of Xuefen syndrome.The correlation between TCM syndrome types and the dynamically evolving NLR,and the specificity and sensitivity of NLR in patients with sepsis caused by different pathogens were explored.Basic information and clinical data of patients were collected,and statistical analysis and mapping were carried out using SPSS 20.0 software.Results:With the aggravation of sepsis,the value of NLR in different syndrome types was dynamically evolving,and the NLR value in blood syndrome was significantly higher than that in the other two groups,the difference was statisti⁃cally significant(P<0.05).In addition,the dynamically evolving NLR was more sensitive and specific in patients with gram-negative bacterial sepsis than in patients with different pathogens(P<0.05).Conclusion:In sepsis with unclear results of pathogenic bacteria detection,the combination of TCM syndrome differentiation of Weifen,Qifen,Yingfen and Xuefen and NLR has advantages in early prediction of the type of infectious pathogens,which would guide the rational use of antibiotics and Chinese medicine intervention in clinical practice.

关 键 词：脓毒症 病原学 NLR 卫气营血辨证 

分 类 号：R631[医药卫生—外科学]