目的探讨慢性阻塞性肺疾病(COPD)急性加重期营养不良中医证候规律。方法采用中医临床流行病学研究方法，制定“慢性阻塞性肺疾病急性加重期患者中医证候调查表”。将符合纳入标准的220例住院患者分为2组，其中合并营养不良120例，非营养不良100例。观察营养不良组与非营养不良组临床资料，对比分析2组证候构成要素，探讨 COPD 急性加重期营养不良证候规律特征。结果 COPD 急性加重期营养不良在证候构成要素方面，呼吸系统之外常见症状消瘦、气短、易感冒、恶风、恶寒、纳呆食少、脘腹胀满、大便干结、嗳气、头晕耳鸣、齿松发脱、腰膝酸软等出现频率明显增高，涉及脾虚、脾胃不和证候较多。COPD急性加重期营养不良者中单一证候36例(30%)，复合证候84例(70%)；单纯实证38例(31.67%)，单纯虚证23例(19.17%)，虚实夹杂证59例(49.17%)。结论 COPD营养不良急性加重期证候以复合证候为主，多表现为虚实夹杂证；脾虚、脾胃不和可能是COPD营养不良的重要病机。%Objective To observe the TCM syndromes of acute exacerbation of chronic obstructive pulmonary disease (COPD) with malnutrition. Methods TCM Syndromes Questionnaire of Acute Exacerbation of COPD was formulated with TCM clinical epidemiology methods. Totally 220 cases of hospitalized patients met the inclusion criteria were divided into two groups, 120 cases of malnutrition and 100 cases of non-malnutrition. The clinical data were observed and syndrome elements of malnutrition group and non-malnutrition group were analyzed to discuss the rule of syndromes in acute exacerbation period. Results In addition to respiratory system, the frenquency of symptoms such as weight loss, shortness of breath, easy cold, aversion to wind and cold, poor appetite, abdominal distension, constipation, belching, dizziness and tinnitus, tooth loose and hair loss, soreness and weakness of waist and knees significantly increased in COPD with malnutrition, mainly involving in syndromes of spleen deficiency and incoordination between spleen and stomach. In patients with acute exacerbation of malnutrition COPD, the single syndromes were 36 cases (30%), the composite syndromes were 84 cases (70%). The simple excess syndromes were 38 cases (31.67%), the simple deficiency syndromes were 23 cases (19.17%), and the intermingled deficiency and excess syndromes were 59 cases (49.17%). Conclusion Patients with acute exacerbation of COPD with malnutrition are mainly composite syndromes and the intermingled deficiency and excess syndromes. Spleen deficiency and incoordination between spleen and stomach may be the important pathogenesis of COPD with malnutrition.
展开▼
