COPD稳定期患者中医证型分布与营养状况、肺功能及急性加重的关系研究  

Relationship between the distribution of traditional Chinese medicine syndrome patterns and nutritional status,lung function,acute exacerbation in patients with stable COPD

作　　者：顾燚娟 孙敏[1] 杨晔 李莎莎[2] Gu Yijuan;Sun Min;Yang Ye(Department of Respiratory Medicine,Rugao Hospital of Traditional Chinese Medicine,Nantong 226500,China)

机构地区：[1]如皋市中医院呼吸内科,南通226500 [2]徐州市中心医院新城分院急诊输液室

出　　处：《中华保健医学杂志》2025年第1期44-47,共4页Chinese Journal of Health Care and Medicine

基　　金：江苏省卫生健康委科研项目(z2021044)。

摘　　要：目的探讨慢性阻塞性肺疾病(COPD)稳定期患者中医证型分布与营养状况、肺功能及急性加重的关系。方法回顾性分析如皋市中医院2022年2月~2024年2月收治的96例COPD患者的临床资料,以规范治疗后的病情变化情况为条件进行分组,即稳定期(64例)和急性加重期(32例),收集并对比两组一般资料、中医证型,检测并对比两组营养指标、肺功能指标;以多因素logistic回归分析COPD急性加重的危险因素。结果稳定期患者体质量指数(BMI)为(25.35±1.02)kg∕m2,高于急性加重期(23.85±0.79)kg∕m2,差异有统计学意义(t=2.430,P=0.017);合并糖尿病的患者占比(20.31%)低于急性加重期(46.88%),差异有统计学意义(χ^(2)=7.286,P=0.007)。稳定期患者中医证型见肺气虚证、肺脾气虚证、肺肾气虚证,急性加重期见痰热壅肺证、痰浊阻肺证。稳定期患者血清白蛋白(ALB)、前白蛋白(PA)、转铁蛋白(Tf)(24.05±1.52)g∕L、(111.25±16.38)mg∕L、(1.80±0.32)g∕L均低于急性加重期患者患者(21.31±1.13)g∕L、(86.25±13.65)mg∕L、(1.61±0.29)g∕L,差异有统计学意义(t=9.018,7.434,2.827,P<0.05);稳定期患者第1秒用力呼气容积(FEV1)、用力肺活量(FVC)、呼吸峰值流速(PEF)水平分别为(0.78±0.30)L、(1.82±0.36)L、(3.85±0.85)L∕s,均低于急性加重期患者患者(0.63±0.26)L、(1.60±0.31)L、(3.42±0.72)L∕s,差异有统计学意义(t=2.410,2.951,2.454,P<0.05)。经多因素回归分析,BMI、营养指标、肺功能指标均是COPD患者急性加重的危险因素(P<0.05)。结论BMI、营养水平、中医证型及肺功能是COPD稳定期患者病情出现急性加重的危险因素,临床应及时评估患者营养状态及肺功能水平,对高危患者及时采取相应的措施以改善营养,提高肺功能,从而降低急性加重的风险。Objective To investigate the relationship between the distribution of traditional Chinese medicine syndrome patterns and nutritional status,lung function,acute exacerbation in patients with stable chronic obstructive pulmonary disease(COPD).Methods Retrospective analysis of clinical data of 96 COPD patients admitted to our hospital from February 2022 to February 2024.They were assigned to the stable group(64 cases)and the acute exacerbation group(32 cases).Collect and compare two sets of general information and traditional Chinese medicine syndrome types,and test and compare the nutritional indicators and lung function indicators of the two groups;Use multiple logistic regression analysis to identify risk factors for acute exacerbation of COPD.Results The body mass index(BMI)of patients in the stable phase was(25.35±1.02)kg∕m^(2),which was higher than that in the acute exacerbation phase(23.85±0.79)kg∕m2(t=2.430,P=0.017).The proportion of patients with diabetes(20.31%)was lower than that in the acute exacerbation phase(46.88%)(χ^(2)=7.286,P=0.007).The Chinese medicine syndrome types of patients in the stable phase included lung qi deficiency,lung spleen deficiency,lung kidney qi deficiency,and the acute exacerbation phase included phlegm heat obstructing the lung,and phlegm turbid obstructing the lung.The levels of serum albumin(ALB),prealbumin(PA),transferrin(Tf),forced expiratory volume in one second(FEV1),forced vital capacity(FVC),and peak expiratory flow rate(PEF)in stable phase patients were(24.05±1.52)g∕L,(111.25±16.38)mg∕L,(1.80±0.32)g∕L,(0.78±0.30)L,(1.82±0.36)L,and(3.85±0.85)L∕s,respectively,which were lower than those in acute exacerbation phase patients(21.31±1.13)g∕L,(86.25±13.65)mg∕L,(1.61±0.29)g∕L,(0.63±0.26)L,1.60±0.31)L,(3.42±0.72)L∕s(t=9.018,7.434,2.827,2.410,2.951,2.454,P<0.05).Through multiple regression analysis,BMI,nutritional indicators,and lung function indicators are all risk factors for acute exacerbation in COPD patients(P<0.05).Conclusion BMI,nutritio

关 键 词：中医证型 慢性阻塞性肺疾病 营养 肺功能 

分 类 号：R563[医药卫生—呼吸系统]