支气管扩张症患者气流受限程度与临床特征及中医证候的相关性研究

目的:通过对稳定期支气管扩张症(简称支扩)患者进行横断面调查,分析支扩患者气流受限严重程度与疾病临床特征及中医证型分布规律的相关性。方法:选取2017年8月至2018年3月期间中国中医科学院西苑医院门诊收集的稳定期支扩患者142例,根据FEV1%pred将患者气流受限分为轻、中、重、极重4个等级,分析气流受限与患者病程、急性加重次数、体质量指数(BMI)、免疫功能及炎症指标、肺CT评分、痰培养、生活质量SGRQ评分的相关性,探讨中医证型分布规律。结果:142例稳定期支扩患者轻度气流受限患者35例(24.65%),中度65例(45.77%),重度26例(18.31%),极重度16例(11.27%),利用Spearman相关性分析得出气流受限严重程度与BMI、IgG、PA呈负相关,与病程、急性加重次数、CRP、肺CT Reiff评分、生活质量SGRQ评分均呈正相关。142例患者中虚实夹杂者最多80例(56.34%)],实证患者共62例(43.66%)。结论:支扩患者气流受限与病情存在明显相关性;而中医证候随着气流受限加重呈现实证减少,虚实夹杂证增多趋势。

Correlation study on the degree of airflow restriction and clinical characteristics and TCM syndrome in patients with bronchiectasis

Objective:Through a cross-sectional survey of patients with stable phase of bronchiectasis,the correlation between the severity of airflow restriction and the clinical characteristics of the disease and the distribution of TCM syndrome was analyzed.Methods:Choose between August 2017 and March 2018 outpatient visits during the period of stabilization of 142 patients with bronchiectasis disease as investigation object,according to FEV1%pred of lung function,patients with airflow restriction were divided into four grades:light,medium,heavy and extremely heavy.To analyze the correlation between airflow restriction and course of disease,times of acute exacerbations,body mass index(BMI),immune function and inflammation index,lung CT Score,sputum culture,quality of life,and to explore the distribution of TCM syndrome types.Results:In 142 patients with stable bronchiectasis,35 patients(24.65%)were mild airflow restriction,65 patients(45.77%)were moderate,26 patients(18.31%)were heavy,16 patients(11.27%)were extremely heavy.Spearman correlation analysis showed that the severity of airflow restriction was negatively correlated with BMI,IgG and prealbumin,and positively correlated with course of disease,number of acute exacerbations,CRP,lung CT Score(Reiff)and quality of life(SGRQ).Among the 142 patients,80 patients(56.34%)had deficiency and excess syndrome,and 62 patients(43.66%)had positive syndrome.Conclusion:There was a significant correlation between airflow restriction and the disease in patients with bronchiectasis.However,with the aggravation of airflow limitation,positive syndrome is decreasing,while the deficiency and excess syndrome is increasing.