高海拔地区慢性阻塞性肺疾病急性加重期中医证素关联分析
Correlation Analysis of TCM Pattern Elements and Acute Exacerbation of Chronic Obstructive Pulmonary Disease in High Altitude Area
陈丽 1欧阳银 1杨绍星 1李洋 1李强 1杨英琦 1冯敏 2童桂蓉 2张春霞 2姚惠青 2赵永祥 2谭烨1
作者信息
- 1. 青海大学,青海 西宁 810000;青海省中医院,青海 西宁 810000
- 2. 青海省中医院,青海 西宁 810000
- 折叠
摘要
目的 探讨高海拔环境下慢性阻塞性肺疾病急性加重期(AECOPD)中医实证证素与人口学特征和临床医学资料之间的相关性.方法 选取2020年10月至2021年9月青海省中医院肺病科住院患者634例,收集患者资料进行中医辨证,从证型提取证素,采用多因素Logistic回归分析各证素与人口学特征和临床医学资料之间的相关性.结果 证素痰与血红蛋白(Hb)[OR=0.984,95％CI(0.977～0.992),P＜0.001]呈负相关;证素饮与年龄[OR=1.041,95％CI(1.004～1.081),P=0.031]、AE 次数[OR=1.288,95％CI(1.032～1.608),P=0.025]、AE时间[OR=1.036,95％CI(1.009～1.064),P=0.010]、肌钙蛋白[OR=1.015,95％CI(1.003～1.028),P=0.014]、IgM[OR=2.655,95％CI(1.317～5.352),P=0.006]呈正相关;证素浊与 AE时间[OR=0.918,95％CI(0.857～0.984),P=0.016]、Hb[OR=0.967,95％CI(0.947～0.987),P=0.038]呈负相关,与血氧饱和度(SaO2)[OR=1.088,95％CI(1.005～1.179),P=0.002]、C3[OR=21.177,95％CI(2.12～211.517),P=0.009]呈正相关;证素瘀与 mMRC(4)[OR=0.127,95％CI(0.019～0.835),P=0.032]、PLT[OR=0.995,95％CI(0.991～0.998),P=0.005]呈负相关,与PaCO2[OR=1.048,95％CI(1.002～1.096),P=0.039]、Hb[OR=1.018,95％CI(1.008～1.027),P＜0.001]呈正相关;证素湿与 Hb[OR=1.022,95％CI(1.006～1.039),P=0.007]、降钙素原(PCT)[OR=1.802,95％CI(1.056～3.076),P=0.031]呈正相关.结论 AECOPD实证证素为:痰＞瘀＞热＞饮＞浊＞湿,证素以"痰""瘀"为主.年龄越大、AE次数越多、AE时间越长、肌钙蛋白增高、IgM升高,证素饮出现的可能性较大;SaO2及补体C3升高,证素浊出现的可能性较大,补体C3与证素浊有显著的相关性;PaCO2及Hb升高,证素瘀出现的可能性较大;Hb与PCT同时升高,证素湿出现的可能性较大.
Abstract
Objective:To explore the correlation between TCM pattern elements and demographic characteris-tics and clinical data in acute exacerbation of chronic obstructive pulmonary disease(COPD)in high altitude area.Methods:A total of 634 in-patients in the Respiratory Department of Qinghai Hospital of TCM from October 2020 to September 2021 were selected.The data of patients were collected,and TCM pattern elements differentia-tion was performed.Results:There was a negative correlation between TCM sputum pattern element with serum hemoglobin(Hb)[OR=0.984,95％CI(0.977～0.992),P＜0.001].There were positive correlations between TCM phlegm-retention pattern element with age[OR=1.041,95％Cl(1.004～1.081),P=0.031],AE frequency[OR=1.288,95％CI(1.032～1.608),P=0.025],AE time[OR=1.036,95％CI(1.009～1.064),P=0.010],troponin[OR=1.015,95％CI(1.003～1.028),P=0.014]and IgM[OR=2.655,95％CI(1.317～5.352),P=0.006].There were nega-tive correlations between TCM turbid phlegm pattern element and AE time[OR=0.918,95％CI(0.857～0.984),P=0.016],Hb[OR=0.967,95％CI(0.947～0.987),P=0.038],positive correlation with blood oxygen saturation(SaO2)[OR=1.088,95％CI(1.005～1.179),P＜0.002],C3[OR=21.177,95％CI(2.12～211.517),P=0.009].There were negative correlations between TCM stasis pattern element and mMRC(4)[OR=0.127,95％CI(0.019～0.835),P=0.032]and PLT[OR=0.995,95％CI(0.991～0.998),P=0.005],positive correlations with PaCO2[OR=1.048,95％CI(1.002～1.096),P=0.039],Hb[OR=1.018,95％CI(1.008～1.027),P＜0.001].There were positive correlations between TCM phlegm-damp pattern element and Hb[OR=1.022,95％CI(1.006～1.039),P=0.007],procalcitonin(PCT)[OR=1.802,95％CI(1.056～3.076),P=0.031].Conclusion:The TCM pattern elements of acute exacerba-tion of COPD is sputum＞stasis＞heat＞phlegm-retention＞turbid phlegm＞phlegm-damp,and the main TCM sputum pattern elements were sputum and stasis.The older the age,the more times of AE,the longer the time of AE,the higher troponin and IgM,there is more probability of pattern element of phlegm-retention.With SaO2 and C3 increased,there is more possibility of pattern element of turbid phlegm.With PaCO2 and Hb increased,there is more possibility of pattern element of stasis.With Hb and PCT increased,there is more probability of pattern ele-ment of phlegm-damp.
关键词
慢性阻塞性肺疾病急性加重期/证素实证/证素病证/高海拔地区Key words
Chronic obstructive pulmonary disease/Acute exacerbation TCM excessiveness pattern elements/Syndrome element disease syndrome/High altitude area引用本文复制引用
基金项目
国家中医药管理局青年岐黄学者培养项目(国中医药人教函[2022]256号)
青海省昆仑英才高原名医团队支持项目()
出版年
2024
NETL
NSTL
万方数据