体质辨识在支气管扩张症中的应用

目的]探讨支气管扩张症患者中医体质特点以及体质与证型关联性，为支气管扩张症的临床防治提供依据。方法]选取2011年5月至2012年3月浙江中医药大学附属第一医学院呼吸内科住院及门诊符合纳入条件的支气管扩张症患者80例，采用标准化的体质量表进行体质辨识和辩证分型，归纳分析体质与证型的关系。结果]①支气管扩张症患者中医体质以平和质、气虚质和阴虚质为多见，其次为痰湿质、湿热质、阳虚质和气郁质，特禀质和血瘀质少见。②中医证候类型以痰热郁肺证最多，占48.75%，肝火犯肺证和阴虚火旺证分别占21.25%和18.75%，气阴两虚证仅占11.25%。③从不同体质支扩患者中医证候类型分布可以发现：平和质、气虚质、阳虚质、痰湿质、湿热质患者以痰热郁肺证较多；气虚质患者以气阴两虚证较多；阴虚质患者以阴虚火旺证较多；气郁质患者以肝火犯肺证较多。结论]支气管扩张症患者中痰热郁肺证是最主要的中医证型，符合支气管扩张症本虚标实的病理特征；不同体质的患者发病后决定其不同的证候类型。

Application of the Differentiation of Body Constitution in Bronchiectasis

Objective] To investigate the relationship between the body constitution and the syndromes of the bronchiectasis patients and provide the basis for the clinical treatment.Methods] Col ected 80 out-patients and in-patients of bronchiectasis in the first affiliated hospital of Zhejiang Chinese Medical University from May 2011 to March 2012. Al patients met with the inclusion criteria, adopted the standardization of physical scale for physical identifica-tion and dialectical type and analyzed the relationship between constitution and syndrome.Results] ①The gentleness type, qi-deficiency type and yin-defi-ciency type were more popular in the bronchiectasis, fol owed by the phlegm-wet type, wetness-heat type, yang-deficiency type and qi-depression type. The special inherited type and blood-stasis type were very rare. ②The syndrome of phlegm heat obstructing lung was the top one in the Chinese tradi-tional medical syndromes（48.75%）.The frequency of liver-fire attacking lung syndrome, hyperactivity of fire due to yin deficiency syndrome and qi-yin de-ficiency syndrome were 21.25%, 18.75% and 11.25% respectively. ③From different body constitution distribution of TCM syndromes in patients with bronchiectasis, it could be found：gentleness type, qi-deficiency type, yang-deficiency type, phlegm-wet type and wetness-heat type were most presented as phlegm-heat stasis lung syndrome. Patients with qi-deficiency type were most presented as qi-yin deficiency syndrome .Patients with Yin deficiency type were always performed as hyperactivity of fire due to yin-deficiency syndrome. Patients with lung qi-stasis type were liver-fire invading lung syn-drome.Conclusion] Phlegm-heat stasis syndrome was the main syndrome in patients with bronchiectasis. It conformed to the pathological characteristics of deficiency essence with virtual reality. Different body constitutions decided the different traditional Chinese medical syndromes after the disease onset.