作　　者： ; ; ; ;

机构地区： 广州中医药大学

出　　处： 《中医药导报》 2020年第5期72-76,82,共6页

摘　　要： 目的:探讨哮喘-慢性阻塞性肺疾病重叠(asthma-COPD overlap,ACO)急性加重期的中医证候规律。方法:回顾性分析330例住院的ACO急性加重期患者,制定中医证候信息采集表,提取患者的一般资料、中医证候因子等信息资料,统计及描述中医证候因子的分布规律,并对中医证候因子进行因子分析和聚类分析,探讨中医证候规律。结果:330例患者中出现了51个中医证候因子,频率较高的中医证候因子是气促、咯痰、咳嗽、痰多、喘粗息高;因子分析共提取11个公因子,涵盖69.5%的中医证候因子信息。结合聚类分析结果,ACO急性加重期常见证候有4种,分别为痰热壅肺;风袭肺卫、内引痰浊;肺脾气虚;阳虚水饮;分布占比为32.4%、24.6%、23.5%、19.6%。病位主要在肺,涉及脾肾、肺卫;病性为实证及虚实夹杂;证候因子以痰饮证为主。结论:ACO急性加重期中医证候规律兼有哮喘和COPD的特征,更接近于AECOPD,但其风邪表证较AECOPD更为常见,虚证、表里同病较哮喘急性发作更为常见。临证应抓住ACO肺虚痰饮的主要病机,同时注意表里同治。 Objective:To investigate the TCM Syndrome law in acute exacerbation of asthma-COPD overlap(ACO).Methods:The retrospective analysis contained 330 cases of the ACO inpatients in 5 hospitals.After extracting the patient's general information such as TCM syndrome factor data,with the TCM syndrome information collection table,we statisticed and described the distribution of TCM syndrome factor,and also made a factor analysis and cluster analysis,to explore the law of TCM syndrome.Results:51 TCM syndrome factors were found in 330 patients.The TCM syndrome factors with higher frequency were wheezing,cough,phlegm,wheezing and high breath.A total of 11 common factors were extracted by factor analysis,covering 69.5%of TCM syndromes.Combined with the results of cluster analysis,it is concluded that there are four common syndromes of ACO,which were respectively phlegm heat obstructing lung;wind in the lung with phlegm turbid;lung-spleen deficiency;Yang deficiency with phlegm-water;and the distribution proportion was 32.4%,24.6%,23.5%and 19.6%respectively.Disease locatie mainly in the lung,involving the spleen and kidney;The disease was mixed with excess and deficient facts.The main syndrome factor was phlegm-water syndrome.Conclusion:The TCM syndromes of acute exacerbation of ACO have characteristics of both asthma and COPD,which are closer to AECOPD.However,its wind syndrome is more common than AECOPD,and the deficiency syndrome is more common than the asthma,which suggests that we should grasp the main pathogenesis of ACO,pulmonary deficiency and phlegm,and pay attention to the combination of exterior and interior syndromes.

关 键 词： 哮喘 慢性阻塞性肺疾病重叠 急性加重期 中医证候 因子分析 聚类分析

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