稳定期慢阻肺患者各影像表型的中医证型及IL-6、SP-D水平分析
发布时间：2019-05-14 18:47
【摘要】：目的:通过研究慢性阻塞性肺疾病(Chronic Obstructive Pulmonary Disease,COPD)稳定期患者胸部HRCT表型与中医证型关系、各HRCT表型患者外周血中IL-6、SP-D因子水平,为COPD表型的研究提供参考依据。方法:收集2015.1-2015.12在山西省人民医院就诊的COPD稳定期患者,记录其一般资料,选择符合诊断标准的慢阻肺稳定期患者150例,行胸部高分辩CT,根据临床HRCT表型分组方法,将150例稳定期COPD患者分为A型、E型、M型3组。对患者临床症状、舌象和脉象进行采集,进而进行中医辨证诊断,根据对患者的诊断结果将患者分为肺气虚、肺脾气虚、肺肾气虚。抽取所有患者外周血3ml,检测IL-6及SP-D浓度。对采集的资料进行统计分析,研究慢性阻塞性肺疾病稳定期患者胸部HRCT表型与中医证型、HRCT表型与外周血中IL-6和SP-D因子的相关性。结果:1)患者HRCT表型可分为A型有45例,E型有52例,M型有53例。三者进行表型比较,其结果存在统计学差异,P0.05。2)HRCT表型与慢阻肺稳定期三种证型有一定的相关性,其中肺气虚型与HRCT表型中A型关系密切,肺脾气虚型与M型关系密切,肺肾气虚型与E型关系相对密切。3)在HRCT3种表型间,M型患者外周血中IL-6平均浓度高于A型与E型,P0.05有统计学意义;SP-D外周血在3种表型间未被发现有统计学意义,P0.05无统计学意义。结论:1.HRCT作为慢性阻塞性肺疾病的一种表型有一定可靠性,HRCT可以定量分析肺气肿和支气管增厚情况,可为临床慢阻肺患者的个体化治疗提供方法和可靠依据。2.IL-6是慢阻肺有关的炎症因子,不同影像学表型的COPD患者,呈现的全身炎症严重度不相同。SP-D作为是一种抑炎因子与肺气肿有相关性,但其对慢阻肺稳定期患者意义不大。3、慢阻肺HRCT表型与慢阻肺稳定期中医证型有一定相关性,肺肾气虚型与肺气肿关系密切;支气管壁增厚型与肺脾气虚有相关性;肺气虚型属于慢阻肺初级阶段,症状较轻、急性加重少、生活质量较好的患者型。
[Abstract]:Objective: to study the relationship between chest HRCT phenotype and TCM syndrome type in patients with chronic obstructive pulmonary disease (Chronic Obstructive Pulmonary Disease,COPD) in stable stage, and the level of IL-6,SP-D factor in peripheral blood of patients with HRCT phenotype, so as to provide reference for the study of COPD phenotype. Methods: the patients with stable stage of COPD treated in Shanxi people's Hospital on May 12, 2015.1 were collected and their general data were recorded. 150 patients with stable stage of chronic obstructive pulmonary disease who met the diagnostic criteria were selected for chest high resolution CT,. According to the phenotypic grouping method of clinical HRCT, 150 patients with stable COPD were divided into three groups: type A, type E and type M. The clinical symptoms, tongue images and pulse images of the patients were collected, and then the patients were diagnosed by syndrome differentiation of traditional Chinese medicine (TCM). According to the diagnosis results of the patients, the patients were divided into deficiency of lung qi, deficiency of lung and spleen, deficiency of lung and kidney qi. The concentrations of IL-6 and SP-D were measured by taking 3 ml of peripheral blood from all patients. The data collected were statistically analyzed to study the correlation between chest HRCT phenotype and TCM syndrome type, HRCT phenotype and IL-6 and SP-D factors in peripheral blood of patients with stable chronic obstructive pulmonary disease (COPD). Results: 1) the phenotypes of HRCT were divided into A type (45 cases), E type (52 cases) and M type (53 cases). There was significant difference among the three phenotypes. P0.05.2) there was a certain correlation between HRCT phenotype and three syndromes in stable stage of chronic obstructive pulmonary disease (COPD), and the type of lung qi deficiency was closely related to type A of HRCT phenotype. The type of deficiency of lung and spleen qi was closely related to type M, and the type of deficiency of lung and kidney qi was relatively closely related to type E. 3) among the phenotypes of HRCT3, the average concentration of IL-6 in peripheral blood of patients with type M was higher than that of type A and type E, P 0.05. The peripheral blood of SP-D was not found among the three phenotypes, but there was no significant difference between the three phenotypes (P 0.05). Conclusion: 1.HRCT is reliable as a phenotype of chronic obstructive pulmonary disease. HRCT can quantitatively analyze emphysema and bronchial thickening. It can provide a method and reliable basis for individualized treatment of patients with chronic obstructive pulmonary disease. 2.IL-6 is an inflammatory factor related to chronic obstructive pulmonary disease and COPD patients with different imaging phenotypes. The severity of systemic inflammation is different. SP-D, as an anti-inflammatory factor, is correlated with emphysema, but it is of little significance to patients with stable stage of COPD. 3, the phenotype of HRCT in COPD is related to the syndrome type of TCM in stable stage of COPD. The type of deficiency of lung and kidney qi is closely related to emphysema. There is a correlation between the thickening of bronchial wall and deficiency of lung and spleen qi, and the type of deficiency of lung qi belongs to the primary stage of chronic obstructive pulmonary disease, with mild symptoms, less acute aggravation and better quality of life.
【学位授予单位】：山西中医学院
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259
本文编号：2476956
[Abstract]:Objective: to study the relationship between chest HRCT phenotype and TCM syndrome type in patients with chronic obstructive pulmonary disease (Chronic Obstructive Pulmonary Disease,COPD) in stable stage, and the level of IL-6,SP-D factor in peripheral blood of patients with HRCT phenotype, so as to provide reference for the study of COPD phenotype. Methods: the patients with stable stage of COPD treated in Shanxi people's Hospital on May 12, 2015.1 were collected and their general data were recorded. 150 patients with stable stage of chronic obstructive pulmonary disease who met the diagnostic criteria were selected for chest high resolution CT,. According to the phenotypic grouping method of clinical HRCT, 150 patients with stable COPD were divided into three groups: type A, type E and type M. The clinical symptoms, tongue images and pulse images of the patients were collected, and then the patients were diagnosed by syndrome differentiation of traditional Chinese medicine (TCM). According to the diagnosis results of the patients, the patients were divided into deficiency of lung qi, deficiency of lung and spleen, deficiency of lung and kidney qi. The concentrations of IL-6 and SP-D were measured by taking 3 ml of peripheral blood from all patients. The data collected were statistically analyzed to study the correlation between chest HRCT phenotype and TCM syndrome type, HRCT phenotype and IL-6 and SP-D factors in peripheral blood of patients with stable chronic obstructive pulmonary disease (COPD). Results: 1) the phenotypes of HRCT were divided into A type (45 cases), E type (52 cases) and M type (53 cases). There was significant difference among the three phenotypes. P0.05.2) there was a certain correlation between HRCT phenotype and three syndromes in stable stage of chronic obstructive pulmonary disease (COPD), and the type of lung qi deficiency was closely related to type A of HRCT phenotype. The type of deficiency of lung and spleen qi was closely related to type M, and the type of deficiency of lung and kidney qi was relatively closely related to type E. 3) among the phenotypes of HRCT3, the average concentration of IL-6 in peripheral blood of patients with type M was higher than that of type A and type E, P 0.05. The peripheral blood of SP-D was not found among the three phenotypes, but there was no significant difference between the three phenotypes (P 0.05). Conclusion: 1.HRCT is reliable as a phenotype of chronic obstructive pulmonary disease. HRCT can quantitatively analyze emphysema and bronchial thickening. It can provide a method and reliable basis for individualized treatment of patients with chronic obstructive pulmonary disease. 2.IL-6 is an inflammatory factor related to chronic obstructive pulmonary disease and COPD patients with different imaging phenotypes. The severity of systemic inflammation is different. SP-D, as an anti-inflammatory factor, is correlated with emphysema, but it is of little significance to patients with stable stage of COPD. 3, the phenotype of HRCT in COPD is related to the syndrome type of TCM in stable stage of COPD. The type of deficiency of lung and kidney qi is closely related to emphysema. There is a correlation between the thickening of bronchial wall and deficiency of lung and spleen qi, and the type of deficiency of lung qi belongs to the primary stage of chronic obstructive pulmonary disease, with mild symptoms, less acute aggravation and better quality of life.
【学位授予单位】：山西中医学院
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259
【引证文献】
相关硕士学位论文 前1条
1 李磊磊;肺胀常见三证型与血清ADPN、AQP-5的相关性研究[D];云南中医学院;2017年
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