具有“汗出、背凉、易感冒”三联征的COPD患者中医证型分布特点

目的:探讨存在"汗出、背凉、易感冒"三联征的慢性阻塞性肺病患者中医证型分布特点及其发病机理。方法:采取问卷调查的形式收集门诊及住院的慢性阻塞性肺病患者281名,调查其性别、年龄、身高、体重、生活习惯等一般资料及症状特点、肺功能指标,总结分析存在"三联征"的慢阻肺患者的中医证型分布特点。结果:在281例慢阻肺患者中,存在"三联征"的患者146例,占调查总人数的52%,其中男82例占56.2%,女64例占43.8%;年龄分布中,<45岁的患者12例,占8.2%,45～65岁的患者52例,占35.6%,>65岁的患者82例,56.2%;证型分布中,属实证的37(25.3%)例,属虚证的79(54.1%)例,虚实夹杂的30(20.6%)例,其中存在肺气虚的80例,肺阴虚的20例,存在脾气虚的8例,存在肾阴虚或肾阳虚的33例;慢阻肺分级中,慢阻肺1级的患者32例,慢阻肺2级的患者58例,慢阻肺3级的患者39例,慢阻肺4级的患者17例。结论:存在"汗出、背凉、易感冒"三联征的慢性阻塞性肺病患者男女性别之间无显著差异;在各年龄段分组中,以>65岁组患者显著多于其他年龄段的患者,且随着年龄的增长,发病率有增高趋势;中医辨证分型以虚证多见,虚证中又以肺、脾、肾三脏虚证多见,以肺气虚证为主。故而治疗当以益气固表法为基础,兼顾肺脾肾三脏并贯穿病程始终。

Distribution of TCM Syndromes of COPD Patients with Triad

Objective:To discuss the TCM distribution of sweating-back cool-easy cold triad of chronic obstructive pulmonary disease patients.Methods:With the survey to collect 281 patients in out-patient and hospitalization with chronic obstructive pulmonary disease,investigation of their gender,age,height,weight,habits and other characteristics of general information,symptoms and pulmonary function indexes were made to summarize and analyze the TCM distribution.Results:There are 146 patients with triad,accounting for 52% of the total number of investigations which include 82 men,accounted for 56.2%;64 women accounted for 43.8%);for age distribution,12 patients are under 45 years old,accounting for 8.2%,65 patients are aged 45 to 52,accounting for 35.6%,82 patients are over 65 years old,and accounted for 56.2%;for Chinese syndrome type distribution,the number of excess syndrome is 37(25.3%),the deficiency syndrome is of 79(54.1%),and excess and deficiency mixed type is 30(20.6%),of which there are 80 cases of lung deficiency,20 cases of lung yin deficiency,8 cases of spleen-deficiency,there are 33 cases of kidney Yang deficiency,in the classification of COPD,there are 32 patients in COPD level 1,58 patients in COPD level 2,patients with COPD level 3 are 39,17 cases are COPD level 4.Conclusion:For patients have sweating-back cool-easy cold triad with chronic obstructive pulmonary disease,there is no significant difference in genders;in all age groups,patients over 65 years were significantly more than patients of other ages,and with age increased,the deficiency incidence rate tends to increase,deficiency of lung,spleen and kidney is common,and the main is lung deficinecy.Therefore treatment of COPD patients with triad should be treated with reinforcing Qi and strengthening exterior defence and take care of lung,spleen and kidney throughout the treatment course.