慢性阻塞性肺疾病急性期与稳定期中医症状及体征特点的比较

目的:比较慢性阻塞性肺疾病急性期与稳定期中医症状及体征的特点。方法:运用统一制订的临床信息采集表,分别在急性期和稳定期两个时点对774例慢性阻塞性肺疾病患者的症状(包括体征)表现进行动态收集,建立基于Ep idata 3.1的症状数据库,运用统计软件对两期各自的症状出现频率进行统计、比较。结果:急性期和稳定期出现频率均较高的症状为咳嗽、咯痰、喘息、乏力、气短;急性期神疲、少气懒言、胸闷、纳呆、口咽干燥、口渴等症状的出现频率也较高,舌象以舌红、苔薄黄腻、舌下络脉异常(增粗/曲张/青紫)为主,脉象以滑、细、数、沉为主;稳定期的症状主要为咳嗽、咯痰、喘息、乏力、气短,舌象以舌淡红、苔薄白腻为主,脉象以细、沉、滑为主。在主要症状(如咳嗽、喘息、咯痰、气短)中,凡是有该症状的急性期患者以中度、重度为多见(占60%以上),而稳定期的患者则以轻度多见(占90%以上)。结论:慢性阻塞性肺疾病急性期、稳定期的共同主要症状为咳、痰、喘,急性期的症状多且重;急性期具有本虚标实的证候特点,稳定期则以虚证为主。

Comparison of Chinese Medicine Symptoms and Signs of Chronic Obstructive Pulmonary Disease Between Acute Stage and Stable Stage

Objective： To compare the characteristics of symptoms and signs of chronic obstructive pulmonary disease（COPD） between acute stage and stable stage.Methods： Applying to the clinical investigation stable,we collected the symptoms and signs of 744 patients of COPD in acute stage and stable stage separately.The symptom data-base was established on the basis of Epidata 3.1 and the frequencies of the symptoms of the two stages were analyzed.Results： The most common symptoms of both two stages were cough,sputum,asthma,asthenia and shortness of breath.The frequencies of the symptoms of fatigue,disinclination to talk due to deficiency of qi,constriction in chest,anorexia,dry mouth,thirsty and so on were higher in acute stage;the main conditions of tongue of acute stage were red tongue,thin yellowish greasy tongue fur and bluish and abnormal sublingual vessels;the main conditions of pulse of acute stage were slippery pulse,thready pulse,rapid pulse and deep pulse.The main symptoms of stable stage were cough,sputum,asthma,asthenia and shortness of breath;the main conditions of tongue of stable stage were light-red tongue,thin whitish greasy tongue fur;the main conditions of pulse of stable stage were thready pulse,deep pulse and slippery pulse.The main symptoms such as cough,asthma,sputum and shortness of breath of the patients in acute stage were severe while the symptoms of the patients in stable stage were mild.Conclusion： The common symptoms of the patients with COPD in both acute and stable stages are cough,sputum and asthma and the symptoms of acute stage are more and severe.The characteristics of the syndrome types of acute stage are deficiency in the root and excess in the branch,and the syndrome of stable stage is most of deficiency-syndrome.