【摘要】：目的：運(yùn)用統(tǒng)計(jì)學(xué)方法探討CAP的證型與癥狀、炎癥指標(biāo)(如白細(xì)胞計(jì)數(shù)、C反應(yīng)蛋白、降鈣素原)、影像學(xué)表現(xiàn)和預(yù)后的相關(guān)性。方法：采用回顧性研究方法,收集2010年10月至2016年1月我院病區(qū)收治的診斷為社區(qū)獲得性肺炎的患者,根據(jù)入組標(biāo)準(zhǔn)納入合格病例,根據(jù)排除標(biāo)準(zhǔn)剔除不合格病例,總共收集241例病例,記錄不同證型社區(qū)獲得性肺炎的一般資料、主要臨床癥狀(發(fā)熱、咳嗽痰白、咳痰色黃、干咳無(wú)痰、胸痛等)、舌脈,以及病人入院時(shí)檢查的白細(xì)胞、C-反應(yīng)蛋白(CRP)、降鈣素原(PCT)和X線檢查的結(jié)果,并記錄不同證型病例最終疾病轉(zhuǎn)歸及住院時(shí)間。最后使用SPSS22.0統(tǒng)計(jì)軟件進(jìn)行分析。結(jié)果：1.主要臨床癥狀：CAP各個(gè)證型與部分癥狀之間相關(guān)性是有統(tǒng)計(jì)學(xué)意義的,其中邪犯肺衛(wèi)證型的病人出現(xiàn)中低熱癥狀的較多,而出現(xiàn)高熱的54人病例中多見(jiàn)于痰熱壅肺證型,在出現(xiàn)咳嗽痰白癥狀的患者中,以痰濁阻肺證證型的病人為多見(jiàn),而出現(xiàn)咳痰色黃的80人病例中以痰熱壅肺證型多見(jiàn),在出現(xiàn)干咳無(wú)痰這一癥狀的46人中,大多數(shù)是正虛邪戀證證型的患者。2.炎癥指標(biāo)：肺炎證型和降鈣素原異常率和白細(xì)胞計(jì)數(shù)相關(guān)性有統(tǒng)計(jì)學(xué)意義,而與C反應(yīng)蛋白相關(guān)性無(wú)統(tǒng)計(jì)學(xué)意義。其中痰熱壅肺證型的白細(xì)胞計(jì)數(shù)和C反應(yīng)蛋白都是最高的,邪犯肺衛(wèi)證和痰熱壅肺證降鈣素原出現(xiàn)異常的較多。3.影像學(xué)表現(xiàn)：影像學(xué)表現(xiàn)與證型相關(guān)性有統(tǒng)計(jì)學(xué)意義,但是四個(gè)證型都是以支氣管炎癥表現(xiàn)為主,間質(zhì)性炎癥表現(xiàn)最少見(jiàn)。而間質(zhì)性炎癥表現(xiàn)主要見(jiàn)于痰熱壅肺證和邪犯肺衛(wèi)證。4.預(yù)后：CAP證型與住院時(shí)間相關(guān)性無(wú)統(tǒng)計(jì)學(xué)意義,但是其中正虛邪戀證型住院天數(shù)最長(zhǎng)。結(jié)論：社區(qū)獲得性肺炎的證型分布有一定規(guī)律,其與癥狀、炎癥指標(biāo)、影像學(xué)表現(xiàn)有一定相關(guān)性,與住院天數(shù)相關(guān)性無(wú)統(tǒng)計(jì)學(xué)意義。
[Abstract]:Objective: to investigate the correlation between syndromes and symptoms, inflammatory indexes (such as leukocyte count, C-reactive protein, procalcitonin), imaging findings and prognosis of CAP. Methods: retrospective study was used to collect the patients diagnosed as community-acquired pneumonia in our hospital from October 2010 to January 2016. The eligible cases were included according to the criteria of admission, and the substandard cases were excluded according to the exclusion criteria. A total of 241 cases were collected to record the general data of community-acquired pneumonia of different syndromes, the main clinical symptoms (fever, cough, white phlegm, yellow sputum, dry cough, no phlegm, chest pain, etc.), the pulse of tongue, and the white blood cells examined on admission. C-reactive protein (CRP),) procalcitonin (PCT) and X ray examination were performed, and the final disease outcome and hospitalization time were recorded in different syndromes. Finally, SPSS22.0 statistical software is used to analyze. Results: 1. The main clinical symptoms: the correlation between each syndrome type of CAP and some symptoms was statistically significant, among which the patients with evil invasion of lung health syndrome had more moderate and low fever symptoms, while 54 cases with high fever were more commonly seen in phlegm and heat blockage of lung syndrome. Among the patients with cough and phlegm white symptoms, the type of phlegm turbid obstruction of the lung syndrome was more common, while in the 80 cases with yellow color of expectoration, phlegm heat was more common in the patients with phlegm heat obstruction of the lung syndrome, and in 46 patients with dry cough without phlegm, Most of them are the patients with syndrome of deficiency and evil. 2. Inflammation index: pneumonia syndrome type, abnormal rate of procalcitonin and white blood cell count had statistical significance, but had no statistical significance with C-reactive protein. The white blood cell count and C-reactive protein of phlegm heat blocking lung syndrome were the highest, and the abnormal procalcitonin proto appeared in the lung health syndrome and phlegm heat blocking lung syndrome were more than 3. 3%. Imaging findings: the correlation between imaging manifestations and syndromes was statistically significant, but the four syndromes were mainly bronchitis, interstitial inflammation was the most rare. The interstitial inflammatory manifestations were mainly found in phlegm and heat in the lung syndrome and evil invasion of lung health syndrome. 4. Prognosis: there was no significant correlation between CAP syndrome type and hospitalization time, but the duration of hospitalization was the longest. Conclusion: the distribution of syndromes of community-acquired pneumonia has a certain regularity, which has certain correlation with symptoms, inflammatory indexes and imaging manifestations, but has no statistical significance with the days of hospitalization.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R259

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