本文關(guān)鍵詞：COPD合并CAP熱痰證與寒痰證患者病原學(xué)和炎癥特征探討　出處：《福建中醫(yī)藥大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 慢性阻塞性肺疾病 社區(qū)獲得性肺炎 炎癥 痰證 證候特征

【摘要】：目的:觀察慢性阻塞性肺疾病合并社區(qū)獲得性肺炎熱痰證患者與寒痰證患者的病原學(xué)和炎癥特征,對(duì)比兩者的異同點(diǎn)。分別分析熱痰證證候積分、寒痰證證候積分與炎癥指標(biāo)的關(guān)系,為臨床差異性治療方案提供新的思路。方法:收集2016年1月至2017年1月入住福建中醫(yī)藥大學(xué)附屬人民醫(yī)院肺病科的COPD合并CAP患者。按照熱痰證和寒痰證的中醫(yī)辨證標(biāo)準(zhǔn)分別納入熱痰證組和寒痰證組,采集兩組病例的性別、年齡、身高、體重、病程、吸煙指數(shù)等一般資料,并檢測(cè)血常規(guī)、Hs-CRP、PCT、呼吸道病原體譜(抗呼吸道合胞病毒IgM抗體、抗腺病毒IgM抗體、抗流感病毒A型IgM抗體、抗流感病毒B型IgM抗體、抗副流感病毒IgM抗體、抗肺炎支原體IgM抗體、抗肺炎衣原體IgM抗體、抗嗜肺軍團(tuán)菌IgM抗體)、痰培養(yǎng)、肺功能(FEV1/FVC%、FEV1%pred)、FeNO等指標(biāo)。對(duì)比熱痰證組和寒痰證組上述指標(biāo)的差異,分別分析熱痰證組和寒痰證組上述指標(biāo)與各自證候積分的相關(guān)性。結(jié)果:本研究共納入COPD合并CAP患者60例,其中熱痰證組30例,寒痰證組30例。①兩組患者的性別、年齡、病程、BMI、吸煙指數(shù)無(wú)統(tǒng)計(jì)學(xué)差異(P0.05),具有可比性。②熱痰證組痰培養(yǎng)陽(yáng)性率高于寒痰證組,而呼吸道病原體譜陽(yáng)性率低于寒痰證組,但差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。③熱痰證組NE%、Hs-CRP、PCT高于寒痰證組,LY%低于寒痰證組,差異均具有統(tǒng)計(jì)學(xué)意義(P0.05);兩組在FeNO改變上沒(méi)有顯著性差異(P0.05)。④熱痰證組FEV1%pred低于寒痰證組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。⑤熱痰證證候積分與Hs-CRP、PCT呈正相關(guān);寒痰證證候積分與WBC、NE%呈負(fù)相關(guān),差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:①COPD合并CAP熱痰證的炎癥水平高于寒痰證。②COPD合并CAP熱痰證的氣流受限程度較寒痰證明顯。③COPD合并CAP熱痰證和寒痰證患者的證候輕重均與炎癥程度存在相關(guān)性。Hs-CRP、PCT可協(xié)助判斷COPD合并CAP熱痰證的證候輕重,而WBC、NE%有助于COPD合并CAP寒痰證證候輕重的判斷。
[Abstract]:Objective: to observe the etiological and inflammatory characteristics of patients with chronic obstructive pulmonary disease (COPD) complicated with community acquired pneumonia with heat phlegm syndrome and cold phlegm syndrome. The relationship between syndrome integral of cold phlegm syndrome and inflammation index. To provide a new way of thinking for clinical differential treatment. Methods:. From January 2016 to January 2017, we collected COPD patients with CAP who were admitted to the Department of Pulmonary Diseases, people's Hospital affiliated to Fujian University of traditional Chinese Medicine. According to the TCM syndrome differentiation criteria of heat phlegm and cold phlegm respectively, we included heat phlegm. Syndrome group and cold phlegm syndrome group. The data of sex, age, height, weight, course of disease and smoking index were collected. Respiratory pathogen spectrum (anti-respiratory syncytial virus IgM antibody, anti-adenovirus IgM antibody, anti-influenza virus type A IgM antibody, anti-influenza virus type B IgM antibody, anti-parainfluenza virus IgM antibody). Anti mycoplasma IgM antibody, anti Chlamydia pneumoniae IgM antibody, anti Legionella pneumoniae IgM antibody, sputum culture, pulmonary function and FEV1 / FVC1pred. FeNO and other indicators. Compared the heat phlegm syndrome group and cold phlegm syndrome group of the above indicators. Results: 60 cases of COPD combined with CAP were included in this study, including 30 cases of heat phlegm syndrome group and 30 cases of heat phlegm syndrome group. There was no significant difference in sex, age, course of disease and smoking index between the two groups in 30 cases of cold phlegm syndrome group (P 0.05). The sputum culture positive rate in heat phlegm syndrome group was higher than that in cold phlegm syndrome group. But the positive rate of pathogen spectrum in respiratory tract was lower than that in cold phlegm syndrome group, but there was no significant difference between the two groups (P 0.05.3). The positive rate of Hs-CRP PCT in heat phlegm syndrome group was higher than that in cold phlegm syndrome group. LY% was lower than that of cold phlegm syndrome group, the difference was statistically significant (P 0.05). There was no significant difference in FeNO between the two groups. The FEV1%pred of the phlegm syndrome group was lower than that of the cold phlegm syndrome group. There was a positive correlation between the score of heat phlegm syndrome and Hs-CRP PCT. There was a negative correlation between the score of cold phlegm syndrome and WBCN%. The difference was statistically significant (P0.05). ... conclusion:. 1the inflammatory level of CAP with heat phlegm syndrome is higher than that of cold phlegm syndrome. 2 the airflow limitation degree of COPD with CAP hot phlegm syndrome is more obvious than that of cold phlegm syndrome. 3 COPD patients with CAP heat phlegm syndrome and cold phlegm syndrome. The severity of syndromes were correlated with the degree of inflammation. Hs-CRP. PCT can help to judge the severity of COPD combined with CAP hot phlegm syndrome, while WBCN% is helpful to judge the severity of COPD combined with CAP cold phlegm syndrome.
【學(xué)位授予單位】：福建中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R259

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 俞寧寧;嚴(yán)萍;;慢性阻塞性肺疾病合并社區(qū)獲得性肺炎的影響因素分析[J];預(yù)防醫(yī)學(xué);2017年03期

2 黃志衛(wèi);陸玲;;HNL、PCT、CRP及膜聯(lián)蛋白A1對(duì)COPD合并呼吸系統(tǒng)感染的診斷價(jià)值[J];山東醫(yī)藥;2017年06期

3 石明;楊中衛(wèi);李威;唐友勇;王正艷;;下呼吸道細(xì)菌定植對(duì)穩(wěn)定期COPD患者炎性因子及免疫細(xì)胞水平的影響[J];醫(yī)學(xué)綜述;2016年08期

4 王艷玲;;C反應(yīng)蛋白和血沉聯(lián)合檢測(cè)對(duì)慢性阻塞性肺疾病并發(fā)急性感染的預(yù)測(cè)價(jià)值[J];感染、炎癥、修復(fù);2016年01期

5 李代昆;李韻青;郭亞楠;蔡偉;余雪梅;薛建江;張德純;;慢性阻塞性肺疾病肺部感染的實(shí)驗(yàn)室檢測(cè)指標(biāo)分析[J];國(guó)際檢驗(yàn)醫(yī)學(xué)雜志;2016年02期

6 蔡海榮;黃永蓮;黃鉅明;陳伯鈞;;成人社區(qū)獲得性肺炎降鈣素原與中醫(yī)證型相關(guān)性分析[J];浙江中醫(yī)藥大學(xué)學(xué)報(bào);2015年12期

7 浦斌紅;丁宏娟;楊蕓峰;鄭敏宇;;慢性阻塞性肺病常見(jiàn)證候和證候要素的現(xiàn)代文獻(xiàn)研究[J];中華中醫(yī)藥學(xué)刊;2015年06期

8 李勇;黃振炎;盧育明;龍文英;;慢性阻塞性肺疾病急性期不同中醫(yī)證型相關(guān)指標(biāo)的比較及臨床意義[J];中國(guó)醫(yī)藥指南;2015年16期

9 劉平莉;;慢性阻塞性肺疾病合并社區(qū)獲得性肺炎的臨床比較研究[J];徐州醫(yī)學(xué)院學(xué)報(bào);2015年05期

10 廖茜;;TNF-α、sTREM-1、IL-6、PCT在慢性阻塞性肺疾病伴肺炎診斷中的應(yīng)用[J];臨床肺科雜志;2015年03期

，

本文編號(hào)：1357628