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郭健, 汤瑾, 朱亮, 钱风华, 赵雷, 钱义明. 重症肺炎患者中医证型与氧合指数、乳酸、D-二聚体的关系研究[J]. 实用临床医药杂志, 2021, 25(1): 81-84. DOI: 10.7619/jcmp.20200734
引用本文: 郭健, 汤瑾, 朱亮, 钱风华, 赵雷, 钱义明. 重症肺炎患者中医证型与氧合指数、乳酸、D-二聚体的关系研究[J]. 实用临床医药杂志, 2021, 25(1): 81-84. DOI: 10.7619/jcmp.20200734
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GUO Jian, TANG Jin, ZHU Liang, QIAN Fenghua, ZHAO Lei, QIAN Yiming. Study on relationships between traditional Chinese medicine syndromes and oxygenation index, lactic acid, D-dimer in patients with severe pneumonia[J]. Journal of Clinical Medicine in Practice, 2021, 25(1): 81-84. DOI: 10.7619/jcmp.20200734
Citation: GUO Jian, TANG Jin, ZHU Liang, QIAN Fenghua, ZHAO Lei, QIAN Yiming. Study on relationships between traditional Chinese medicine syndromes and oxygenation index, lactic acid, D-dimer in patients with severe pneumonia[J]. Journal of Clinical Medicine in Practice, 2021, 25(1): 81-84. DOI: 10.7619/jcmp.20200734
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重症肺炎患者中医证型与氧合指数、乳酸、D-二聚体的关系研究

Study on relationships between traditional Chinese medicine syndromes and oxygenation index, lactic acid, D-dimer in patients with severe pneumonia

    摘要
  • 摘要:
      目的  探讨重症肺炎中医证型分布特点及其与氧合指数pa(O2)/FiO2、乳酸(Lac)、D-二聚体(D-D)的关系。
      方法  选取118例重症肺炎患者为研究对象，观察主要中医证型分布特点。观察患者急性生理与慢性健康状况评分系统Ⅱ(APACHE Ⅱ)评分，检查血常规，并检测C反应蛋白(CRP)、pa(O2)/FiO2、Lac、D-D、血清总胆红素(TBil)、血清肌酐(Cr)水平。
      结果  118例重症肺炎患者中，痰热壅肺证68例(57.63%), 痰湿阻肺证25例(21.19%), 热闭心包证14例(11.86%), 邪陷正脱证11例(9.32%)。邪陷正脱证、热闭心包证患者APACHE Ⅱ评分、白细胞计数(WBC)、CRP、D-D、TBil水平均高于痰热壅肺证及痰湿阻肺证患者，而pa(O2)/FiO2水平低于痰热壅肺证及痰湿阻肺证患者，差异有统计学意义(P < 0.05); 邪陷正脱证患者Lac及Cr水平均高于其他证型患者，差异有统计学意义(P < 0.05); 痰热壅肺证患者WBC及CRP水平均高于痰湿阻肺证患者，差异有统计学意义(P < 0.05); 邪陷正脱证患者D-D水平高于热闭心包证患者，差异有统计学意义(P < 0.05)。
      结论  重症肺炎患者入院时中医证型主要为痰热壅肺证、痰湿阻肺证、热闭心包证和邪陷正脱证，其中痰热壅肺证最常见。检测pa(O2)/FiO2、Lac、D-D水平对中医辨证分型有一定参考价值。

     

    Abstract:
      Objective  To study relationships between traditional Chinese medicine (TCM) syndromes and oxygenation indexpa(O2)/FiO2, lactic acid (Lac), D-dimer (D-D) in patients with severe pneumonia.
      Methods  A total of 118 patients with severe pneumonia were selected as study objects, and their distribution characteristics of TCM syndromes were observed. APACHE Ⅱscores, blood routine examination, levels of C-reactive protein (CRP), pa(O2)/FiO2, Lac, D-D, serum total bilirubin (TBil) and serum creatinine (Cr) were measured.
      Results  Out of 118 patients with severe pneumonia, there were 68 cases(57.63%) with phlegm-heat accumulating in lungs syndrome, 25 cases (21.19%) with phlegm-dampness obstructing lungs syndrome, 14 cases (11.86%) with heat closure pericardium syndrome, and 11 cases (9.32%) with interior invasion of pathogen and vital qi collapse syndrome. The APACHE Ⅱ scores, the levels of white blood cell count(WBC), CRP, D-D and TBil in the patients with interior invasion of pathogen and vital qi collapse syndrome and heat closure pericardium syndrome were significantly higher, and the levels of pa(O2)/FiO2 were significantly lower than those with phlegm-dampness obstructing lungs syndrome and phlegm-heat accumulating in lungs syndrome (P < 0.05). The levels of Lac and Cr in patients with interior invasion of pathogen and vital qi collapse syndrome were higher than those with other syndromes(P < 0.05). The levels of WBC and CRP in patients with phlegm-heat accumulating in lungs syndrome were significantly higher than those with phlegm-dampness obstructing lungs syndrome (P < 0.05); the levels of D-D in patients with interior invasion of pathogen and vital qi collapse syndrome were significantly higher than those with heat closure pericardium syndrome (P < 0.05).
      Conclusion  At admission, TCM syndromes of patients with severe pneumonia mainly include phlegm-heataccumulating in lungs, phlegm-dampness obstructing the lungs, heat closure pericardium, and interior invasion of pathogen and vital qi collapse, and the most commonly occurring syndrome is phlegm-heat accumulating in lungs. The detection of pa(O2)/FiO2, Lac and D-D levels has certain reference value for TCM syndrome differentiation.

     

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