多重耐药菌肺部感染六经辨证体系证候规律研究  

A study on the distribution feature of TCM syndrome of pulmonary infection caused by multidrug-resistant bacteria in syndrome differentiation system of six meridians

作　　者：罗潇潇 江婷 王温欣 罗胜[2] LUO Xiaoxiao

机构地区：[1]广州中医药大学,广东广州510006 [2]广州市番禺区中医院,广东广州511408

出　　处：《中医临床研究》2024年第31期35-40,共6页Clinical Journal Of Chinese Medicine

基　　金：2019年度番禺区医疗卫生项目一般项目(2019-Z04-70);2022年广东省基础与应用基础研究基金项目(2022B1515230001)。

摘　　要：目的:总结并分析住院肺部感染多重耐药菌患者的六经辨证证候及其分布规律。方法:运用回顾性分析方法整理2018年-2021年广州市番禺区中医院住院肺部感染多重耐药菌患者的基础情况、主要临床症状、体征,判断其六经辨证证型,对证型与痰细菌培养及药敏等结果进行综合分析。结果:共纳入患者183例,涉及多重耐药菌188株,其中革兰氏阴性菌共163株,占86.70%,革兰氏阳性菌25株,占13.30%。有鲍曼不动杆菌64株、铜绿假单胞菌61株、肺炎克雷伯菌26株,3种菌株共151株,占总菌株的80.32%。六经辨证分型以阳经证型居多。其中,单经证者100例,占54.64%,主要为少阳证、少阴证及阳明证,共占六经证型的51.11%;两经合病主要为太阳阳明证、少阳阳明证及少阳少阴证。多重耐药的革兰氏阳性菌例数较少,革兰氏阴性菌以少阳证、少阴证多见,但太阳阳明合病、少阳阳明合病较其余证型多。在阳性菌证型中,同样是少阳证、少阴证阳性菌株占比较大,其次是阳明证及太阳阳明合病。铜绿假单胞菌感染以太阳、阳明证型为主,鲍曼不动杆菌感染以少阳、少阴证型为主,此两者在不同证型上的差异有统计学意义(P<0.01);大肠埃希菌感染以少阳证为主,差异有一定统计学意义(P<0.05);金黄色葡萄球菌、肺炎克雷伯菌在中医证型上未见明显统计学差异(P>0.05)。结论:住院肺部多重耐药菌感染患者的六经辨证证型与感染菌株有一定的相关性,总体上以三个阳经证型为主。建议诊治上重视阳经证型。Objective:To summarize and analyze the six meridians syndrome differentiation and distribution of hospitalized Opulmonary infection patients with multidrug-resistant bacteria.Methods:Using the method of retrospective analysis,this study sorted out the basic situation,main clinical symptoms and signs of patients with pulmonary infection with multidrug-resistant bacteria hospitalized in Panyu District traditional Chinese medicine hospital from 2018 to 2021,and judged their six meridians syndrome differentiation.The syndrome types,sputum bacterial culture and drug sensitivity were comprehensively analyzed.Results:A total of 183 patients were included,with 188 strains of multidrug-resistant bacteria,among which a total of 163 strains of Gram-negative bacteria accounted for 86.70%,and 25 strains of Gram-positive bacteria accounted for 13.30%.The most common ones were Acinetobacter baumannii(64 strains),Pseudomonas aeruginosa(61strains),and Klebsiella pneumoniae(26 strains),with a total of 151 strains of the three strains,accounting for 80.32%of the total strains.The syndrome differentiation of the six meridians was mainly based on the Yang meridian(阳经)type.Among them,100 cases of single meridian syndrome accounted for 54.64%,mainly including Shaoyang(少阳)syndrome,Shaoyin(少阴)syndrome,and Yangming(阳明)syndrome,accounting for 51.11%of six meridian syndrome types.The main syndrome types of the two meridians were Taiyang(太阳)-Yangming syndrome,Shaoyang-Yangming syndrome,and Shaoyang-Shaoyin syndrome.The number of cases of multi-resistant Gram-positive bacteria was low,and Gram-negative bacteria were more common in Shaoyang and Shaoyin syndromes,but there were more cases of Taiyang-Yangming syndrome and Shaoyang-Yangming syndrome than the rest of the syndromes.In the syndrome types of positive bacteria,the positive bacteria of Shaoyang syndrome and Shaoyin syndrome accounted for a large proportion,followed by Yangming syndrome and Taiyang-Yangming syndrome.Pseudomonas aeruginosa infection mostly existed in

关 键 词：六经辨证 中医体质 多重耐药菌 肺部感染 

分 类 号：R241.5[医药卫生—中医诊断学]