958例慢性阻塞性肺疾病高危人群中医证素与危险因素的相关性分析  

Analysis of the correlation between TCM syndrome elements and risk factors in 958 cases of chronic obstructive pulmonary disease in high-risk groups

作　　者：尤巧云 田玉丽 张西安 慈慧敏 周童 王新汝 查震球[3] 李乔 卢家胜 李泽庚[1,2] 童佳兵[1,2,6] You Qiaoyun;Tian Yuli;Zhang Xi′an;Ci Huimin;Zhou Tong;Wang Xinru;Zha Zhenqiu;Li Qiao;Lu Jiasheng;Li Zegeng;Tong Jiabing(Anhui University of Chinese Medicine,Hefei Anhui 230038;First Affiliated Hospital of Anhui University of Chinese Medicine,Hefei Anhui 230031;Anhui Center for Disease Control and Prevention,Hefei Anhui 230601;Jieshou Hospital of Traditional Chinese Medicine,Fuyang Anhui 236504;Taihe Hospital of Traditional Chinese Medicine,Fuyang Anhui 236699;Institute of Xin′an Medicine and Modernization of Traditional Chinese Medicine,First Affiliated Hospital of Anhui University of Chinese Medicine,Hefei Anhui 230012;Bengbu Hospital of Traditional Chinese Medicine,Bengbu Anhui 233000)

机构地区：[1]安徽中医药大学,安徽合肥230038 [2]安徽中医药大学第一附属医院,安徽合肥230031 [3]安徽省疾病预防控制中心,安徽合肥230601 [4]界首市中医院,安徽阜阳236504 [5]太和县中医院,安徽阜阳236699 [6]安徽中医药大学第一附属医院新安医学与中医药现代化研究所,安徽合肥230012 [7]蚌埠市中医医院,安徽蚌埠233000

出　　处：《山西中医药大学学报》2024年第7期794-801,共8页Journal of Shanxi University of Chinese Medicine

基　　金：国家自然科学基金区域创新发展联合基金重点支持项目(U20A20398);安徽省重点研究与开发计划(202104j07020013);安徽高校自然科学研究项目(KJ2021ZD0063)。

摘　　要：目的:探讨慢性阻塞性肺疾病(COPD)高危人群中医证素与危险因素的相关性。方法:随机调查958例COPD高危人群的基线资料、中医证候及相关危险因素,探讨中医证素分布特点,并通过二元Logistic回归分析法分析中医证素与危险因素的相关性。结果:无证型184例,有证型774例,其主要证型中前3位为肺肾气虚证、肺气虚证、痰湿阻肺证。涉及病性证素分布依次为气虚>痰>湿>阴虚>血瘀>热>阳虚;病位证素依次为肺>肾>脾>神。男性674例,女性284例。40~49岁,73例;50~59岁,361例;60~69岁,390例;70~79岁,134例,即发病年龄以50~69岁多见。不同性别主要年龄段COPD高危人群常见证素均集中于气虚、痰、湿、肺、肾等。证素与危险因素Logistic回归显示,女性为痰、湿、肺的独立保护因素(P<0.05);年龄为气虚的独立危险因素(P<0.05);吸烟为气虚、痰、湿、阴虚、血瘀、热、肺、肾、脾的独立危险因素(P<0.05);二手烟接触史是气虚、痰、湿、肺的独立危险因素(P<0.05);直系亲属患哮喘、慢支、肺气肿为气虚、痰、阴虚、热、肺、肾的独立危险因素(P<0.05);慢性呼吸系统疾病史为气虚、痰、湿、肺、肾的独立危险因素(P<0.05);COPD家族史是痰的独立危险因素(P<0.05);幼时反复下呼吸道感染是血瘀、热、神的独立危险因素(P<0.05)。结论:COPD高危人群中病性证素主要为气虚、痰、湿,病位证素主要为肺、肾、脾。COPD高危人群中男性更易出现痰、湿、肺的病理变化,年龄越大越易出现气虚的病理变化,有吸烟史更易出现气虚、痰、湿、阴虚、血瘀、肺、肾、脾、热的病理变化,有二手烟接触史更易出现气虚、痰、湿、肺的病理变化,直系亲属患哮喘、慢性支气管炎、肺气肿更易出现气虚、痰、阴虚、热、肺、肾的病理变化,有慢性呼吸系统疾病更易出现气虚、痰、湿、肺、肾的病理变化,有COPD家族史更易出现痰�Objective:To investigate the correlation between TCM syndrome elements and risk factors in a high-risk population for chronic obstructive pulmonary disease(COPD).Methods:Baseline data,TCM syndromes,and related risk factors were randomly surveyed in 958 individuals at high risk for COPD.The distribution of TCM syndrome elements was explored,and the correlation between TCM syndrome elements and risk factors was analyzed using binary logistic regression.Results:Out of 958 subjects,184 had no syndrome,and 774 had one or more syndromes.The three most common syndromes were lung-kidney Qi deficiency,lung-Qi deficiency,and phlegm-dampness obstructing the lung.The distribution of pathological syndrome elements was as follows:Qi deficiency>phlegm>dampness>Yin deficiency>blood stasis>heat>Yang deficiency.The distribution of location-related syndrome elements was:lung>kidney>spleen>spirit.There were 674 males and 284 females.Age distribution:40-49 years(73 cases),50-59 years(361 cases),60-69 years(390 cases),and 70-79 years(134 cases),with the highest prevalence in the 50-69 age group.In both genders,the most common syndrome elements in the main age groups were Qi deficiency,phlegm,dampness,lung,and kidney.Logistic regression analysis showed that female gender was an independent protective factor for phlegm,dampness,and lung(P<0.05);age was an independent risk factor for Qi deficiency(P<0.05);smoking history was an independent risk factor for Qi deficiency,phlegm,dampness,Yin deficiency,blood stasis,heat,lung,kidney,spleen(P<0.05);secondhand smoke exposure was an independent risk factor for Qi deficiency,phlegm,dampness,and lung(P<0.05);a family history of asthma,chronic bronchitis,or emphysema was an independent risk factor for Qi deficiency,phlegm,Yin deficiency,heat,lung,and kidney(P<0.05);a history of chronic respiratory disease was an independent risk factor for Qi deficiency,phlegm,dampness,lung,and kidney(P<0.05);a family history of COPD was an independent risk factor for phlegm(P<0.05);repeated lower respiratory trac

关 键 词：COPD高危人群 病性证素 病位证素 危险因素 

分 类 号：R563.9[医药卫生—呼吸系统]