穩(wěn)定期慢阻肺患者各影像表型的中醫(yī)證型及IL-6、SP-D水平分析
發(fā)布時(shí)間：2019-05-14 18:47
【摘要】：目的:通過研究慢性阻塞性肺疾病(Chronic Obstructive Pulmonary Disease,COPD)穩(wěn)定期患者胸部HRCT表型與中醫(yī)證型關(guān)系、各HRCT表型患者外周血中IL-6、SP-D因子水平,為COPD表型的研究提供參考依據(jù)。方法:收集2015.1-2015.12在山西省人民醫(yī)院就診的COPD穩(wěn)定期患者,記錄其一般資料,選擇符合診斷標(biāo)準(zhǔn)的慢阻肺穩(wěn)定期患者150例,行胸部高分辯CT,根據(jù)臨床HRCT表型分組方法,將150例穩(wěn)定期COPD患者分為A型、E型、M型3組。對患者臨床癥狀、舌象和脈象進(jìn)行采集,進(jìn)而進(jìn)行中醫(yī)辨證診斷,根據(jù)對患者的診斷結(jié)果將患者分為肺氣虛、肺脾氣虛、肺腎氣虛。抽取所有患者外周血3ml,檢測IL-6及SP-D濃度。對采集的資料進(jìn)行統(tǒng)計(jì)分析,研究慢性阻塞性肺疾病穩(wěn)定期患者胸部HRCT表型與中醫(yī)證型、HRCT表型與外周血中IL-6和SP-D因子的相關(guān)性。結(jié)果:1)患者HRCT表型可分為A型有45例,E型有52例,M型有53例。三者進(jìn)行表型比較,其結(jié)果存在統(tǒng)計(jì)學(xué)差異,P0.05。2)HRCT表型與慢阻肺穩(wěn)定期三種證型有一定的相關(guān)性,其中肺氣虛型與HRCT表型中A型關(guān)系密切,肺脾氣虛型與M型關(guān)系密切,肺腎氣虛型與E型關(guān)系相對密切。3)在HRCT3種表型間,M型患者外周血中IL-6平均濃度高于A型與E型,P0.05有統(tǒng)計(jì)學(xué)意義;SP-D外周血在3種表型間未被發(fā)現(xiàn)有統(tǒng)計(jì)學(xué)意義,P0.05無統(tǒng)計(jì)學(xué)意義。結(jié)論:1.HRCT作為慢性阻塞性肺疾病的一種表型有一定可靠性,HRCT可以定量分析肺氣腫和支氣管增厚情況,可為臨床慢阻肺患者的個(gè)體化治療提供方法和可靠依據(jù)。2.IL-6是慢阻肺有關(guān)的炎癥因子,不同影像學(xué)表型的COPD患者,呈現(xiàn)的全身炎癥嚴(yán)重度不相同。SP-D作為是一種抑炎因子與肺氣腫有相關(guān)性,但其對慢阻肺穩(wěn)定期患者意義不大。3、慢阻肺HRCT表型與慢阻肺穩(wěn)定期中醫(yī)證型有一定相關(guān)性,肺腎氣虛型與肺氣腫關(guān)系密切;支氣管壁增厚型與肺脾氣虛有相關(guān)性;肺氣虛型屬于慢阻肺初級階段,癥狀較輕、急性加重少、生活質(zhì)量較好的患者型。
[Abstract]:Objective: to study the relationship between chest HRCT phenotype and TCM syndrome type in patients with chronic obstructive pulmonary disease (Chronic Obstructive Pulmonary Disease,COPD) in stable stage, and the level of IL-6,SP-D factor in peripheral blood of patients with HRCT phenotype, so as to provide reference for the study of COPD phenotype. Methods: the patients with stable stage of COPD treated in Shanxi people's Hospital on May 12, 2015.1 were collected and their general data were recorded. 150 patients with stable stage of chronic obstructive pulmonary disease who met the diagnostic criteria were selected for chest high resolution CT,. According to the phenotypic grouping method of clinical HRCT, 150 patients with stable COPD were divided into three groups: type A, type E and type M. The clinical symptoms, tongue images and pulse images of the patients were collected, and then the patients were diagnosed by syndrome differentiation of traditional Chinese medicine (TCM). According to the diagnosis results of the patients, the patients were divided into deficiency of lung qi, deficiency of lung and spleen, deficiency of lung and kidney qi. The concentrations of IL-6 and SP-D were measured by taking 3 ml of peripheral blood from all patients. The data collected were statistically analyzed to study the correlation between chest HRCT phenotype and TCM syndrome type, HRCT phenotype and IL-6 and SP-D factors in peripheral blood of patients with stable chronic obstructive pulmonary disease (COPD). Results: 1) the phenotypes of HRCT were divided into A type (45 cases), E type (52 cases) and M type (53 cases). There was significant difference among the three phenotypes. P0.05.2) there was a certain correlation between HRCT phenotype and three syndromes in stable stage of chronic obstructive pulmonary disease (COPD), and the type of lung qi deficiency was closely related to type A of HRCT phenotype. The type of deficiency of lung and spleen qi was closely related to type M, and the type of deficiency of lung and kidney qi was relatively closely related to type E. 3) among the phenotypes of HRCT3, the average concentration of IL-6 in peripheral blood of patients with type M was higher than that of type A and type E, P 0.05. The peripheral blood of SP-D was not found among the three phenotypes, but there was no significant difference between the three phenotypes (P 0.05). Conclusion: 1.HRCT is reliable as a phenotype of chronic obstructive pulmonary disease. HRCT can quantitatively analyze emphysema and bronchial thickening. It can provide a method and reliable basis for individualized treatment of patients with chronic obstructive pulmonary disease. 2.IL-6 is an inflammatory factor related to chronic obstructive pulmonary disease and COPD patients with different imaging phenotypes. The severity of systemic inflammation is different. SP-D, as an anti-inflammatory factor, is correlated with emphysema, but it is of little significance to patients with stable stage of COPD. 3, the phenotype of HRCT in COPD is related to the syndrome type of TCM in stable stage of COPD. The type of deficiency of lung and kidney qi is closely related to emphysema. There is a correlation between the thickening of bronchial wall and deficiency of lung and spleen qi, and the type of deficiency of lung qi belongs to the primary stage of chronic obstructive pulmonary disease, with mild symptoms, less acute aggravation and better quality of life.
【學(xué)位授予單位】：山西中醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R259
本文編號：2476956
[Abstract]:Objective: to study the relationship between chest HRCT phenotype and TCM syndrome type in patients with chronic obstructive pulmonary disease (Chronic Obstructive Pulmonary Disease,COPD) in stable stage, and the level of IL-6,SP-D factor in peripheral blood of patients with HRCT phenotype, so as to provide reference for the study of COPD phenotype. Methods: the patients with stable stage of COPD treated in Shanxi people's Hospital on May 12, 2015.1 were collected and their general data were recorded. 150 patients with stable stage of chronic obstructive pulmonary disease who met the diagnostic criteria were selected for chest high resolution CT,. According to the phenotypic grouping method of clinical HRCT, 150 patients with stable COPD were divided into three groups: type A, type E and type M. The clinical symptoms, tongue images and pulse images of the patients were collected, and then the patients were diagnosed by syndrome differentiation of traditional Chinese medicine (TCM). According to the diagnosis results of the patients, the patients were divided into deficiency of lung qi, deficiency of lung and spleen, deficiency of lung and kidney qi. The concentrations of IL-6 and SP-D were measured by taking 3 ml of peripheral blood from all patients. The data collected were statistically analyzed to study the correlation between chest HRCT phenotype and TCM syndrome type, HRCT phenotype and IL-6 and SP-D factors in peripheral blood of patients with stable chronic obstructive pulmonary disease (COPD). Results: 1) the phenotypes of HRCT were divided into A type (45 cases), E type (52 cases) and M type (53 cases). There was significant difference among the three phenotypes. P0.05.2) there was a certain correlation between HRCT phenotype and three syndromes in stable stage of chronic obstructive pulmonary disease (COPD), and the type of lung qi deficiency was closely related to type A of HRCT phenotype. The type of deficiency of lung and spleen qi was closely related to type M, and the type of deficiency of lung and kidney qi was relatively closely related to type E. 3) among the phenotypes of HRCT3, the average concentration of IL-6 in peripheral blood of patients with type M was higher than that of type A and type E, P 0.05. The peripheral blood of SP-D was not found among the three phenotypes, but there was no significant difference between the three phenotypes (P 0.05). Conclusion: 1.HRCT is reliable as a phenotype of chronic obstructive pulmonary disease. HRCT can quantitatively analyze emphysema and bronchial thickening. It can provide a method and reliable basis for individualized treatment of patients with chronic obstructive pulmonary disease. 2.IL-6 is an inflammatory factor related to chronic obstructive pulmonary disease and COPD patients with different imaging phenotypes. The severity of systemic inflammation is different. SP-D, as an anti-inflammatory factor, is correlated with emphysema, but it is of little significance to patients with stable stage of COPD. 3, the phenotype of HRCT in COPD is related to the syndrome type of TCM in stable stage of COPD. The type of deficiency of lung and kidney qi is closely related to emphysema. There is a correlation between the thickening of bronchial wall and deficiency of lung and spleen qi, and the type of deficiency of lung qi belongs to the primary stage of chronic obstructive pulmonary disease, with mild symptoms, less acute aggravation and better quality of life.
【學(xué)位授予單位】：山西中醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R259
【引證文獻(xiàn)】
相關(guān)碩士學(xué)位論文 前1條
1 李磊磊;肺脹常見三證型與血清ADPN、AQP-5的相關(guān)性研究[D];云南中醫(yī)學(xué)院;2017年
，本文編號：2476956
本文鏈接：http://sikaile.net/zhongyixuelunwen/2476956.html
最近更新
教材專著
