无反应社区获得性肺炎的中医证型及相关蛋白初步研究

发布时间：2018-05-25 23:17

本文选题：无反应社区获得肺炎 + 中医证型　；参考：《广州中医药大学》2016年硕士论文

【摘要】：目的经过多年的临床研究,现代医学对于无反应社区获得性肺炎已经形成一定的概念,本课题旨在探讨无反应社区获得性肺炎中医证型及相关蛋白标志,了解无反应肺炎的特征及发生规律,为无反应社区获得性肺炎的辨证及防治提供理论依据。方法通过查阅2013年2月至2015年2月广州中医药大学呼吸科收治的CAP病人的电子病历资料,分为观察组(无反应肺炎)及对照组(普通肺炎),收集患者的信息(包括个人一般情况、临床表现、四诊信息、中西医诊断)、病原学检测及相关蛋白水平,筛选性别、年龄、吸烟史、酗酒史、合并基础疾病、病情轻重、中医证候诊断等指标,应用SPSS20.0医学统计分析软件包进行数据统计。结果1.无反应社区获得肺炎相关因素有：年老、烟酒不节、慢性基础疾病、临床症状、真菌感染,多耐药菌、混合感染。2.在病原体检测中,相对于普通肺炎患者,无反应社区获得肺炎患者真菌感染比例明显增高,细菌感染、支原体感染在两组中比例相当。提示临床治疗中对于无反应社区获得性肺炎患者抗真菌治疗及有效覆盖病原体治疗非常重要。3.无反应社区获得肺炎患者中痰热壅肺证型较多见,不同证型的及相关蛋白水平CRP, PA值存在差异(P0.05),并有一定的变化规律。结论无反应社区获得肺炎不同证型与特种蛋白(CRP, PA)之间存在相关性,并有一定的变化规律。其中CRP与毒邪正弱呈正相关,可作为炎症指标,标志邪实程度；PA与正气强弱呈正相关,可作为正虚指标,标志正气盛衰。无反应社区获得肺炎患者的相关蛋白水平与其中医证型之间有相关性,相关蛋白可作为无反应肺炎中医辨证分型的客观指标。
[Abstract]:Objective after many years of clinical research, modern medicine has formed a certain concept of non-reactive community-acquired pneumonia. The purpose of this study is to explore the TCM syndromes and related protein markers of non-reactive community-acquired pneumonia. To understand the characteristics and occurrence of non-reactive pneumonia and to provide theoretical basis for syndrome differentiation and prevention and treatment of non-reactive community acquired pneumonia. Methods from February 2013 to February 2015, the data of electronic medical records of CAP patients admitted to Department of Respiratory, Guangzhou University of traditional Chinese Medicine were reviewed. The patients were divided into observation group (non-reactive pneumonia) and control group (common pneumonia group). The patients' information (including individual general condition, clinical manifestation, four diagnosis information, traditional Chinese and western medicine diagnosis, etiological examination and related protein level, screening sex, age, etc.) were collected. The history of smoking, alcoholism, combined basic diseases, severity of illness, diagnosis of TCM syndromes, and so on, were analyzed by SPSS20.0 medical statistical analysis software package. Result 1. Factors associated with acquiring pneumonia in non-response communities are: old age, alcohol and tobacco, chronic underlying diseases, clinical symptoms, fungal infections, multidrug resistant bacteria, and mixed infections. 2. In pathogen detection, the proportion of fungal infection in patients with pneumonia in non-response community was significantly higher than that in patients with common pneumonia. The proportion of bacterial infection and mycoplasma infection was the same in the two groups. The results suggest that antifungal therapy and effective coverage of pathogens are very important in clinical treatment of nonreactive community-acquired pneumonia patients. The type of phlegm heat obstruction of lung was more common in non-response community. There were differences in CRP and PA between different syndrome types and related protein levels, and there was a certain change rule. Conclusion there is a correlation between different syndrome types of pneumonia and special protein CRP (PAA) in non-response community. Among them, CRP was positively correlated with toxic evil, and could be used as an index of inflammation, a positive correlation between PA and the strength of positive qi, a positive correlation between PA and the strength of qi, and a sign of prosperity and decline of positive qi. There was a correlation between the level of related proteins and TCM syndromes of patients with pneumonia in non-response community, and the related proteins could be used as an objective index of TCM syndrome differentiation and classification of non-reactive pneumonia.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

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