慢性阻塞性肺疾病急性加重期合并贫血相关因素及中医证型分布分析

发布时间：2018-03-18 17:54

本文选题：慢性阻塞性肺疾病急性加重期　切入点：贫血　出处：《成都中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的：探讨AECOPD合并贫血的血红蛋白值分布及AECOPD合并贫血的患病率、贫血类型和贫血程度；探讨年龄、BMI、病程、急性加重时间、住院时间等指标与AECOPD合并贫血是否具有相关性；探讨AECOPD合并贫血的中医证型分布规律,从而为临床中西医结合防治AECOPD合并贫血提供一定的理论基础。方法：①记录血红蛋白值,观察血红蛋白值分布情况,并根据血红蛋白值进行分组,统计各组的患病率,分析其贫血类型及贫血程度;②记录性别、年龄、吸烟、居住地、BMI、病程、急性加重时间、住院时间等,运用SPSS 17.0软件进行统计学分析,比较上述指标在各组之间是否具有统计学差异；③记录AECOPD合并贫血患者的中医证型及舌质、舌苔、脉象等,分析其分布规律。结果：①341例AECOPD中合并贫血者70例(20.53%),合并高血红蛋白者18例(5.28%),血红蛋白正常者253例(74.19%)；②贫血类型：正细胞性贫血48例(68.57%),小细胞性低色素性贫血19例(27.14%),巨幼细胞性贫血3例(4.29%)；③贫血程度：轻度贫血58例(82.86%),中度贫血12例(17.14%),重度、极重度贫血均0例；④运用SPSS 17.0统计分析：贫血组平均年龄较高血红蛋白血症组高,贫血组BMI较高血红蛋白血症组低；贫血组平均住院时间较高血红蛋白血症组长,贫血组急性加重时间较高血红蛋白血症组短；住院时间、急性加重时间、年龄、BMI在贫血组与高血红蛋白血症组间比较,差异具有统计学意义(P0.05),而病程在贫血组与高血红蛋白血症组间比较,差异不具有统计学意义(P0.05)；住院时间、急性加重时间、病程、年龄、BMI在各贫血组间比较,差异均不具有统计学意义(P0.05);⑤70例AECOPD合并贫血证型中实证50例(71.43%),虚证12例(17.14%),虚实夹杂8例(11.43%),实证中湿证者28例(56.00%)。结论:①ECOPD合并贫血的患病率为20.53%,AECOPD合并高血红蛋白血症的患病率为5.28%；②贫血程度以轻度贫血为主,贫血类型以正细胞性贫血为主；③随着血红蛋白水平的下降,疾病急性加重时间缩短、住院时间延长;④AECOPD合并贫血的发生与年龄、营养状况有关；⑤AECOPD合并贫血的证型分布以实证为主,虚证次之,实证中以湿证多见。
[Abstract]:Objective: to investigate the distribution of hemoglobin value in AECOPD complicated with anemia, the prevalence, type and degree of anemia in AECOPD, and the correlation between age, course of disease, time of acute exacerbation, length of hospitalization and AECOPD with anemia. In order to provide a theoretical basis for the prevention and treatment of AECOPD with anemia by combining traditional Chinese medicine and western medicine, the distribution of TCM syndromes in AECOPD complicated with anemia was discussed. Methods the hemoglobin value was recorded at 1: 1 and the distribution of hemoglobin value was observed. The patients were divided into groups according to hemoglobin value, the prevalence rate of each group was counted, the type of anemia and the degree of anemia were analyzed, the sex, age, smoking, BMIs, course of disease, time of acute exacerbation, time of hospitalization, etc. SPSS 17.0 software was used to make statistical analysis, and to compare whether the above indexes had statistical difference among the groups. The TCM syndromes, tongue coating, pulse and so on were recorded in patients with AECOPD complicated with anemia. Results among 1341 cases of AECOPD, 70 cases had anemia, 18 cases had high hemoglobin, 253 cases had normal hemoglobin and 74.19 cases had anemic type: 48 cases of normal cell anemia (48 cases), 68.57% of anemia, 19 cases of small cell hypochromic anemia (27.14). 3 cases of megaloblastic anemia (4. 29%): 58 cases with mild anemia (82.86%), 12 cases with moderate anemia (17. 14%) with severe anemia, SPSS 17.0 statistical analysis showed that the average age of anemia group was higher than that of high hemoglobinemia group, the BMI of anemia group was lower than that of hyperhemoglobinemia group, the average hospitalization time of anemia group was higher than that of hyperhemoglobinemia group, and that of anemia group was higher than that of high hemoglobinemia group. The acute exacerbation time of anemia group was shorter than that of hyperhemoglobinemia group; the time of hospitalization, acute exacerbation time, age and BMI were compared between anemia group and hyperhemoglobinemia group. The difference was statistically significant (P 0.05), but there was no significant difference in the course of disease between anemia group and hyperhemoglobinemia group (P 0.05), the duration of hospitalization, acute exacerbation time, course of disease, age and BMI were compared among the anemia groups, and there was no significant difference in the course of disease between the anemia group and the hyperhemoglobinemia group. The difference was not statistically significant in 50 cases of AECOPD with anemia syndrome, 12 cases of deficiency syndrome and 17.14% of deficiency syndrome, 8 cases of deficiency syndrome and 8 cases of deficiency syndrome, and 28 cases of dampness syndrome with anemia in 28 cases. Conclusion the prevalence rate of W1 ECOPD with anemia is 20.53 AECOPD with hyperhemoglobin. The prevalence of anemia was 5.28% and mild anemia was the main anemia. With the decrease of hemoglobin level, the acute exacerbation time of the disease was shortened, and the occurrence of 4AECOPD complicated with anemia was prolonged with age, and the distribution of the syndrome type of 5AECOPD with anemia related to nutritional status was mainly positive. Deficiency syndrome followed by dampness syndrome.
【学位授予单位】：成都中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

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