间质性肺病52例辨证分型与肺功能评分关系的临床观察

目的比较52例间质性肺病（ILD）患者临床常见中医证型之间肺功能的差异，试图寻找一些肺功能和中医证候分类之间的规律。方法本研究采用流行病学研究方法进行回顾性分析，对所收集的ILD患者中医证候进行证候分类，分析得出ILD辨证分型的分布特点，同时采集其相应肺功能指标（VCmax、TLC、DLCOSB、DLCO／Va），对中医不同证候的肺功能差异做比较。结果52例肺功能经统计分析显示4种辨证分型之间（肺气亏虚、肾阳亏虚、痰浊郁肺、痰热郁肺）之间的VCmax、DLCOSB、DLCO／Va比较，差异均有统计学意义（P〈0．05）；肾阳亏虚型组VCmax低于肺气亏虚型组，两组间比较差异有统计学意义（P〈0．05）；而在DLCOSb及DLCO／Va上，肾阳亏虚型与肺气亏虚、痰浊阻肺、痰热阻肺差异有统计学意义（P〈0．05），其损害以肾阳亏虚型最为严重。结论ILD患者中医不同证候的肺功能比较存在差异。肺间质纤维化患者肾阳亏虚型患者其肺功能损害程度较肺虚及痰瘀组严重，与古人病在肺其病浅，病在肾其病深的论述相符，提示肺功能情况与其中医分型有关。

Clinical observation on the relationship between traditional Chinese medical pattern differentiation and pulmonary function in Interstitial Lung Disease

Objective To analyz the objective law between the traditional Chinese medical pattern differentiation and pulmonary function in Interstitial Lung Disease （ILD）. Methods By review test collected clinical ILD suffers assorted into four types （Deficiency of lung Qi, Deficiency of kidney Yang, sputum abound lung, sputum and heat abound lung） ,datas about pulmonary function include Vcmax,TLC ,DLCO Sb and DLCO/Va shoud be collected for every patient,then affiliation shoud be found. Results Based on the cardinal adopt standard patterns, 52 cases were grouped as four types, Research has shown that There are significant difference of VA max, DLCOSB and DLCO/VA among the four pattern combinations （ P 〈 0. 05 ） , VCmax was lower in the patients with the deficiency of kidney Qi than with the deficiency of kidney Yang （P 〈 0. 05）. The deficiency of kidney Yang type had the worst pulmonary function in different traditional Chinese medical patterns of interstitial lung disease （ P 〈 0. 05 ）. Conclusions There are significant difference of pulmonary function in different traditional Chinese medical patterns of interstitial lung disease. Pulmonary function in cases of Deficiency of kidney Yang is damaged more than the other three traditional Chinese medical patterns. With the deteriorating of disease, the injure viscera will change from lung to kidney. Pulmonary function can be used as a new standard for discriminating the traditional Chinese medical pattern differentiation.