734例慢性阻塞性肺疾病高危人群临床症状及中医证素分布特征  

Distribution characteristics of clinical symptoms and TCM syndrome elements in 734 patients with high risk of chronic obstructive pulmonary disease

作　　者：田玉丽 尤巧云 慈慧敏 张西安 周童 查震球[4] 童佳兵[2,3] Tian Yuli;You Qiaoyun;Ci Huimin;Zhang Xi'an;Zhou Tong;Zha Zhenqiu;Tong Jiabing(Anhui University of Chinese Medicine,Hefei Anhui 230012;The First Affiliated Hospital of Anhui University of Chinese Medicine,Hefei Anhui 230031;Institute of Health and Medicine,Hefei Comprehensive National Science Center,Xin'an Institute of Medicine and Traditional Chinese Medicine Modernization,Hefei Anhui 230012;Anhui Provincial Center for Disease Control and Prevention,Hefei Anhui 230601)

机构地区：[1]安徽中医药大学,安徽合肥230012 [2]安徽中医药大学第一附属医院,安徽合肥230031 [3]合肥综合性国家科学中心大健康研究院,新安医学与中医药现代化研究所,安徽合肥230012 [4]安徽省疾病预防控制中心,安徽合肥230601

出　　处：《山西中医药大学学报》2024年第2期161-165,共5页Journal of Shanxi University of Chinese Medicine

基　　金：安徽省重点研发项目(202104j07020013);安徽省高等学校自然科学研究项目(KJ2021ZD0063)。

摘　　要：目的:分析慢性阻塞性肺疾病(COPD)高危人群患病特点及中医证素分布特点,为COPD早期干预和诊治提供参考。方法:2022年5月—2022年11月在安徽部分地区对COPD高危人群进行横断面调查,从临床表现提取病位及病性证素。使用SPSS 21.0软件,采用频次分析和聚类分析分别对症状和证素进行分析。结果:共纳入734例COPD高危人群,咳嗽、咳痰、健忘、腰膝酸软、口干口苦、气促、乏力为高频症状,高危人群中患呼吸系统疾病的占34.74%,包括慢性支气管炎、过敏性鼻炎、支气管哮喘、咽炎、肺气肿、肺大疱、肺结节等。对734例COPD高危人群进行证素分析,得到病位证素7个,病性证素10个。病位证素降序排列为肺(49.59%)、肾(28.20%)、脾(26.70%)、肝(17.44%)、卫表(12.81%)、心(神)(7.36%)、胃(6.95%);病性证素降序排列为气虚(53.00%)、痰(26.3%)、湿(13.22%)、阴虚(11.58%)、阳虚(11.44%)、热(10.63%)、血瘀(4.77%)等。聚类分析发现6种组合规律:(1)病位证素肺、脾、胃+病性证素痰、气虚、湿;(2)病位证素肾+病性证素阴虚、阳虚;(3)病位证素血瘀;(4)病位证素肝+病性证素阳亢、热、气滞;(5)病位证素心(神);(6)病位证素卫表。结论:COPD高危人群在发展为COPD前已经有肺气虚的表现,COPD的发展以肺气虚为始,进一步损伤脾、肾,逐步演变为虚实夹杂。Objective:To analyze the characteristics of chronic obstructive pulmonary disease(COPD)in high-risk population and the distribution characteristics of TCM syndrome elements,and provide reference for early intervention,diagnosis and treatment of COPD.Methods:From May 2022 to November 2022,a cross-sectional study of high-risk COPD population was conducted in some areas of Anhui Province to extract disease location and disease syndrome elements from clinical manifestations.SPSS 21.0 software was used to analyze the symptoms and syndrome elements respectively by frequency analysis and cluster analysis.Results:A total of 734 subjects with high risk of COPD were included.Cough,expectoration,forgetfulness,soreness and weakness of waist and knees,dry mouth and bitter mouth,shortness of breath and fatigue were the high frequency symptoms.34.74%of the high-risk population suffered from respiratory system diseases,including chronic bronchitis,allergic rhinitis,bronchial asthma,pharyngitis,emphysema,pulmonary bullae,pulmonary nodules,etc.Syndrome elements analysis of 734 patients with high risk of COPD were conducted.7 syndrome elements of disease location and 10 syndrome elements of disease nature were obtained.The descending order of disease location syndrome elements was lung(49.59%),kidney(28.20%),spleen(26.70%),liver(17.44%),defensive surface(12.81%),heart spirit(7.36%),and stomach(6.95%).The descending order of disease nature syndrome elements was Qi deficiency(53.00%),phlegm(26.3%),dampness(13.22%),Yin deficiency(11.58%),Yang deficiency(11.44%),heat(10.63%),blood stasis(4.77%),etc.Six combination rules were found by cluster analysis:(1)disease location syndrome elements lung,spleen,stomach+disease nature syndrome elements phlegm,Qi deficiency and dampness;(2)disease location syndrome element kidney+disease nature syndrome elements Yin deficiency and Yang deficiency;(3)disease location syndrome element blood stasis;(4)disease location syndrome element liver+disease nature syndrome elements hyperactivity of Yang,heat an

关 键 词：COPD高危人群 临床症状 病性证素 病位证素 

分 类 号：R563.3[医药卫生—呼吸系统]