CAP中医证型分布与临床指标相关性探讨

发布时间：2018-11-14 11:38

【摘要】：目的：运用统计学方法探讨CAP的证型与症状、炎症指标(如白细胞计数、C反应蛋白、降钙素原)、影像学表现和预后的相关性。方法：采用回顾性研究方法,收集2010年10月至2016年1月我院病区收治的诊断为社区获得性肺炎的患者,根据入组标准纳入合格病例,根据排除标准剔除不合格病例,总共收集241例病例,记录不同证型社区获得性肺炎的一般资料、主要临床症状(发热、咳嗽痰白、咳痰色黄、干咳无痰、胸痛等)、舌脉,以及病人入院时检查的白细胞、C-反应蛋白(CRP)、降钙素原(PCT)和X线检查的结果,并记录不同证型病例最终疾病转归及住院时间。最后使用SPSS22.0统计软件进行分析。结果：1.主要临床症状：CAP各个证型与部分症状之间相关性是有统计学意义的,其中邪犯肺卫证型的病人出现中低热症状的较多,而出现高热的54人病例中多见于痰热壅肺证型,在出现咳嗽痰白症状的患者中,以痰浊阻肺证证型的病人为多见,而出现咳痰色黄的80人病例中以痰热壅肺证型多见,在出现干咳无痰这一症状的46人中,大多数是正虚邪恋证证型的患者。2.炎症指标：肺炎证型和降钙素原异常率和白细胞计数相关性有统计学意义,而与C反应蛋白相关性无统计学意义。其中痰热壅肺证型的白细胞计数和C反应蛋白都是最高的,邪犯肺卫证和痰热壅肺证降钙素原出现异常的较多。3.影像学表现：影像学表现与证型相关性有统计学意义,但是四个证型都是以支气管炎症表现为主,间质性炎症表现最少见。而间质性炎症表现主要见于痰热壅肺证和邪犯肺卫证。4.预后：CAP证型与住院时间相关性无统计学意义,但是其中正虚邪恋证型住院天数最长。结论：社区获得性肺炎的证型分布有一定规律,其与症状、炎症指标、影像学表现有一定相关性,与住院天数相关性无统计学意义。
[Abstract]:Objective: to investigate the correlation between syndromes and symptoms, inflammatory indexes (such as leukocyte count, C-reactive protein, procalcitonin), imaging findings and prognosis of CAP. Methods: retrospective study was used to collect the patients diagnosed as community-acquired pneumonia in our hospital from October 2010 to January 2016. The eligible cases were included according to the criteria of admission, and the substandard cases were excluded according to the exclusion criteria. A total of 241 cases were collected to record the general data of community-acquired pneumonia of different syndromes, the main clinical symptoms (fever, cough, white phlegm, yellow sputum, dry cough, no phlegm, chest pain, etc.), the pulse of tongue, and the white blood cells examined on admission. C-reactive protein (CRP),) procalcitonin (PCT) and X ray examination were performed, and the final disease outcome and hospitalization time were recorded in different syndromes. Finally, SPSS22.0 statistical software is used to analyze. Results: 1. The main clinical symptoms: the correlation between each syndrome type of CAP and some symptoms was statistically significant, among which the patients with evil invasion of lung health syndrome had more moderate and low fever symptoms, while 54 cases with high fever were more commonly seen in phlegm and heat blockage of lung syndrome. Among the patients with cough and phlegm white symptoms, the type of phlegm turbid obstruction of the lung syndrome was more common, while in the 80 cases with yellow color of expectoration, phlegm heat was more common in the patients with phlegm heat obstruction of the lung syndrome, and in 46 patients with dry cough without phlegm, Most of them are the patients with syndrome of deficiency and evil. 2. Inflammation index: pneumonia syndrome type, abnormal rate of procalcitonin and white blood cell count had statistical significance, but had no statistical significance with C-reactive protein. The white blood cell count and C-reactive protein of phlegm heat blocking lung syndrome were the highest, and the abnormal procalcitonin proto appeared in the lung health syndrome and phlegm heat blocking lung syndrome were more than 3. 3%. Imaging findings: the correlation between imaging manifestations and syndromes was statistically significant, but the four syndromes were mainly bronchitis, interstitial inflammation was the most rare. The interstitial inflammatory manifestations were mainly found in phlegm and heat in the lung syndrome and evil invasion of lung health syndrome. 4. Prognosis: there was no significant correlation between CAP syndrome type and hospitalization time, but the duration of hospitalization was the longest. Conclusion: the distribution of syndromes of community-acquired pneumonia has a certain regularity, which has certain correlation with symptoms, inflammatory indexes and imaging manifestations, but has no statistical significance with the days of hospitalization.
【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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