慢性阻塞性肺病临床表型与中医体质相关性的研究

发布时间：2018-03-30 23:13

本文选题：慢性阻塞性肺疾病　切入点：临床表型　出处：《山东中医药大学》2016年硕士论文

【摘要】：目的:通过收集慢性阻塞性肺病(COPD)患者的的临床基本资料、病史、体征、辅助检查及中医体质情况,归纳慢阻肺患者的临床表型与中医体质情况,以研究不同临床表型患者中医体质的分布规律及二者的相关性,为慢性阻塞性肺疾病的诊断和个体化治疗提供依据。方法:对2015年1月至2015年12月间于山东省中医院呼吸科住院诊断为COPD的患者进行病历查阅及问卷调查,获取患者的基本情况(性别、年龄、个人史、既往史、等),临床表型要素(COPD病史、吸烟指数、每年急性加重次数、呼吸困难指数(mMRC)、症状体征、影像特征、合并症)、中医体质要素等,将COPD患者进行临床表型及中医体质的分类,应用SPSS 21进行数据统计,分析COPD患者的临床症候特点并通过对应分析法探究不同表型与中医体质之间的相关性。结果:1.纳入本研究的241例病例中,COPD表型与中医体质之间的卡方值为82.878,P=0.0000.05,说明COPD表型与中医体质之间有显著的相关性。2.不同临床表型患者中医体质的分布规律:非频繁急性加重表型患者以湿热质为最多,其次分别为阴虚质、气虚质、痰湿质,哮喘慢阻肺重叠表型患者中特禀质占大多数,其次为阳虚质及痰湿质,以肺气肿为主的频繁急性加重表型患者以气虚质为最多,其余几种主要体质的分布无明显差异,以慢支为主的频繁急性加重表型患者以湿热质最多,其次为痰湿质、阴虚质。3.不同临床表型与中医体质之间在散点图上的距离:非频繁急性加重表型与阴虚质距离最近,哮喘慢阻肺重叠表型与特禀质距离最近,以肺气肿为主的频繁急性加重表型与气虚质距离最近,以慢支为主的频繁急性加重表型距离与湿热质距离最近。结论:COPD临床表型与中医体质之间有密切的联系,非频繁急性加重表型与阴虚质关系最密切,哮喘慢阻肺重叠表型与特禀质关系最密切,以肺气肿为主的频繁急性加重表型与气虚质关系最密切,以慢支为主的频繁急性加重表型与湿热质关系最密切。
[Abstract]:Objective: to summarize the phenotype and physique of chronic obstructive pulmonary disease (COPD) patients by collecting the basic clinical data, medical history, physical signs, auxiliary examination and physique of TCM. In order to study the distribution law of TCM constitution and the correlation between them in different clinical phenotypes, Methods: from January 2015 to December 2015, the patients diagnosed as COPD in Department of Respiratory, Shandong traditional Chinese Medicine Hospital were investigated by medical records and questionnaires. To obtain the basic conditions of the patients (sex, age, personal history, past history, et al., clinical phenotypic factors such as COPD history, smoking index, acute exacerbation times per year, dyspnea index mMRC, symptoms and signs, imaging features, etc.). The clinical phenotype and TCM constitution of COPD patients were classified, and SPSS 21 was used to carry out data statistics. The clinical symptom characteristics of COPD patients were analyzed and the correlation between different phenotypes and TCM physique was explored by correspondence analysis. Results: 1. The chi-square value between phenotype of COPD and TCM constitution was 82.878P0.0000.05, which indicated that the correlation between phenotype of COPD and TCM constitution was 82.878p 0.0000.05. There was significant correlation between COPD phenotype and TCM physique. 2. The distribution of TCM constitution in different clinical phenotypes: the most frequent acute exacerbation phenotypes were dampness and heat. The second was yin deficiency, qi deficiency, phlegm and dampness. The most of the patients with superposition phenotype of asthmatic slow obstructive lung, the second were yang deficiency and phlegm dampness, and the most frequent acute exacerbation phenotypes were emphysema, and the most frequent acute exacerbation phenotypes were emphysema. There was no significant difference in the distribution of other major physiques. The most frequent acute exacerbation phenotypes were slow bronchitis, followed by phlegm, heat and heat, followed by phlegm and dampness. The distance between different clinical phenotypes and TCM physique on scatter plot: the distance between infrequent acute exacerbation phenotype and yin deficiency type, the overlap phenotype of asthmatic slow obstructive lung and the intrinsic character, The frequent acute exacerbation phenotype with emphysema is the closest to the deficiency of qi, and the frequent acute exacerbation with slow bronchitis is the closest to the moist heat and heat. Conclusion there is a close relationship between the clinical phenotype of COPD and the constitution of TCM. The phenotype of infrequent acute aggravation was most closely related to deficiency of yin, the overlap phenotype of chronic obstructive lung of asthma was most closely related to intrinsic quality, and the phenotype of frequent acute exacerbation of emphysema was most closely related to deficiency of qi. The frequent acute exacerbation phenotypes, mainly of slow bronchioles, are most closely related to heat and humidity.
【学位授予单位】：山东中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

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