脓毒症肺损伤患者中医证型分布状况与肺损伤相关指标及SOFA、APACHEⅡ评分的相关性分析  

Distribution of TCM Syndromes in Patients with Sepsis-Induced Lung Injury and Related Indicators of Lung Injury,SOFA and APACHEⅡScore

作　　者：闫云[1] 赵璟[1] 范风江[1] 包建颖 史晶心 李博 左远航 冯丽霞[1] YAN Yun;ZHAO Jing;FAN Fengjiang;BAO Jianying;SHI Jingxin;LI Bo;ZUO Yuanhang;FENG Lixia(Nanyang Key Laboratory of Sepsis Transformation Medicine of The First People's Hospital of Nanyang,Nanyang 473000,Henan,China)

机构地区：[1]南阳市第一人民医院脓毒症转化医学重点实验室,河南南阳473000

出　　处：《中华中医药学刊》2025年第3期175-178,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：国家中医药管理局中医药科学技术研究专项(2019ZX7822)。

摘　　要：目的分析脓毒症肺损伤患者中医证型分布状况与肺损伤相关指标及序贯性器官衰竭评分(sequential organ failure assessment,SOFA)、急性生理和慢性健康状况Ⅱ(Acute Physiology and Chronic Health EvaluationⅡ,APACHEⅡ)评分的相关性。方法选取2022年1月—2023年1月医院收治的脓毒症肺损伤患者80例,收集患者的一般资料、肺损伤相关指标[动脉血氧合指数(ratio of partial pressure of O_(2) in arterial blood to fraction of inspired oxygen,PaO_(2)/FiO_(2))、肺泡动脉氧分压差(alveolar-arterial oxygen gradient,P(A-a)O_(2))]及SOFA、APACHEⅡ评分情况,根据中医分型标准对脓毒症肺损伤患者进行分型,比较不同分型的脓毒症肺损伤患者以上各观察指标情况并分析相关性。结果脓毒症肺损伤患者以肺热壅痹证型占比最高、35.00%(28/80),其次为瘀血阻肺型27.50%(22/80),肺塞腑实型23.75%(19/80),水饮郁肺型13.75%(11/80)。不同证型的患者在性别、年龄方面差异均无统计学意义(P>0.05);不同证型的患者肺损伤指标PaO_(2)/FiO_(2)、P(A-a)O_(2)差异均有统计学意义(P<0.05);不同证型的患者SOFA、APACHEⅡ评分差异均有统计学意义(P<0.05)。肺热壅痹、瘀血阻肺、肺塞腑实、水饮郁肺证型与PaO_(2)/FiO_(2)呈显著负相关(P<0.05),与P(A-a)O_(2)、SOFA评分、APACHEⅡ评分呈显著正相关(P<0.05)。结论脓毒症肺损伤患者中医证型主要为肺热壅痹、瘀血阻肺、肺塞腑实、水饮郁肺,与肺损伤相关指标及SOFA、APACHEⅡ评分密切相关,掌握脓毒症肺损伤辨证分型特点并观察患者肺损伤相关指标及SOFA、APACHEⅡ评分变化,对疾病诊治及预后评估具有较高价值。Objective To analyze the correlation of the distribution of TCM syndromes in patients with sepsis-induced lung in-jury and lung injury-related indicators and sequential organ failure assessment(SOFA),acute physiology and chronic health e-valuationⅡ(APACHEⅡ)score.Methods Eighty patients with sepsis-induced lung injury admitted to the hospital from Janu-ary 2022 to January 2023 were selected.The general data,lung injury-related indicators{arterial oxygenation index(PaO_(2)/FiO 2),alveolar arterial oxygen partial pressure difference[P(A-a)O_(2)]}and SOFA and APACHEⅡscores of the patients were collected.The patients with sepsis-induced lung injury were classified according to the classification criteria of traditional Chi-nese medicine.The above observation indexes of patients with sepsis-induced lung injury of different types were compared and the correlation was analyzed.Results Among the patients with sepsis-induced lung injury,the lung heat obstruction type accoun-ted for the highest proportion[35.00%(28/80)],followed by the blood stasis type[27.50%(22/80)],the lung obstruction type[23.75%(19/80)],and the water retention type[13.75%(11/80)].There was no significant difference in gender or age a-mong patients with different syndromes(P>0.05).There were statistically significant differences in PaO_(2)/FiO_(2) and P(A-a)O_(2) among patients with different syndromes(P<0.05).There were significant differences in SOFA and APACHEⅡscores among patients with different syndromes(P<0.05).There was a significant negative correlation of PaO_(2)/FiO_(2) and lung heat obstruc-tion,blood stasis obstructing lung,lung congestion and Fu-organ excess,water retention and lung depression(P<0.05),and a significant positive correlation with P(A-a)O_(2),SOFA score and APACHEⅡscore(P<0.05).Conclusion The TCM syndromes of patients with sepsis-induced lung injury are mainly lung heat obstruction,blood stasis obstructing lung,lung conges-tion and Fu-organ excess,water retention obstructing lung,which are closely related to lung inj

关 键 词：脓毒症 肺损伤 中医证型 动脉血氧合指数 肺泡动脉氧分压差 序贯性器官衰竭评分 急性生理和慢性健康状况Ⅱ 

分 类 号：R256.1[医药卫生—中医内科学]