MODS患者脱证的诊断探讨

目的研究多脏器功能不全（MODS）患者脱证及其诊断。方法选取109例MODS患者按照中医诊断学辨证标准进行中医辨证，按照某一证型的有无将患者分为无此证型组和有此证型组，筛选出两组之间有显著差异的指标，对其指标进一步分析以筛选出最能反映证型变化的指标。结果在脱证和非脱证之间差异有显著的指标，按照对判别脱证有无的作用大小依次排列为：末梢冷、声音微弱无力、舒张压降低、冷汗不止、收缩压降低、神情烦躁或淡漠、皮肤瘀点瘀斑、面色苍白、脉微欲绝、MAP降低、舌苍白、舌瘀点、竹延长、心率增快、BUN升高、尿量减少、口干欲饮、APTT延长等。结论脱证与末梢循环障碍表现一致，可用血压降低等诊断。中医证型诊断和西医诊断可相互补充，有助于更合理地指导相应中医药的临床应用。

The Diagnostic Study of Collapse Syndrome in Patients with MODS

Objective: To study Collapse Syndrome and the diagnosis of MODS.Methods: 109 patients with MODS were differentiated on the standard of diagnosis of TCM and divided into two groups which with or without a system based on some Syndrome,In the two groups. the items with obvious differentia should be vepreseutative after they were seleeted.Results: The items of obvious differentia in the tow groups which with or without Collapse Syndrome were vanged by their effect: cold peripheral, faint sound, lower DBP, cold sweat, lower SBP, fidpet or dimface, petechia, pallor face, faint pulse, et al.Conclusion: Collapse Syndrome accorded with dusturbance of peripheral ciraulation and was vepresented with lower BP.