慢性阻塞性肺病中肺气虚和脾气虚患者呼吸功能的差别

目的]探讨慢性阻塞性肺病（COPD）肺气虚和脾气虚患者呼吸功能的差别。方法]将42例COPD患者按中医辨证分为肺气虚型和脾气虚型两组，分别检测肺通气功能（FVC、FEV1、FEV1／FVC、MVV）、最大吸气压（MIP）、最大呼气压（MEP）和口腔阻断压（p0.1)，并与正常对照组比较。结果]COPD组与正常对照组比较肺通气功能（FVC、FEV1、FEV1／FVC、MVV）明显下降（P＜0.01)，其中脾气虚组比肺气虚组下降更为明显（P＜0.05)；COPD肺气虚组MIP下降（P＜0.05)，而MEP无明显变化（P＞0.05)；脾气虚组MIP、MEP均下降（P＜0.05)；COPD患者无论肺气虚组，还是脾气虚组，其p0.1均升高（P＜0.05）。结论]COPD脾气虚患者与肺气虚患者比较，肺通气功能下降更为明显，更易发生呼吸肌疲劳，但是两者的呼吸驱动均增强，表明无论是在通气功能、还是在呼吸肌疲劳方面，从肺气虚到脾气虚是病情逐渐加重的过程。

Difference of Respiratory Function Between Spleen-qi Deficiency Pattern and Lung-qi Deficiency Pattern in Chronic Obstructive Pulmonary Disease

To explore the difference of respiratory muscle strength and respiratory drive between lung qi deficiency pattern and spleen qi deficiency pattern in chronic obstructive pulmonary disease (COPD).Forty two cases of COPD were differentiated as lung qi deficiency pattern (n=23, Group A) and spleen qi deficiency pattern(n=19, Group B) and twenty healthy volunteers served as control (Group C). Pulmonary ventilatory function such as forced vital capacity(FVC), forced expiratory volume in one second (FEV 1), FVC/ FEV 1 and maximum voluntary ventilation (MVV) were examined; and the maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP) and oral blocking pressure were also detected.As compared with Group C, pulmonary ventilation was decreased in both Group A and Group B and more obviously in Group B (P< 0 01 or P< 0 05); MIP was reduced in Group A (P< 0 05) and the change of MEP was not significant (P>0 05); MIP and MEP in Group B differed from those in Group C (P< 0 05); and the oral blocking pressure was increased in both Group A and Group B (P< 0 05).Conclusion]Pulmonary ventilation decreases obviously and respiratory muscle becomes exhausted easily in COPD of spleen qi deficiency pattern as compared with those of lung qi deficiency pattern. However, respiratory drive is enhanced in both syndromes as far as ventilatory function and exhaustion of respiratory muscle is concerned, showing that the cases with either syndrome are aggravated in the course of COPD.