【摘要】 目的通过小样本调查的方式,探知老年慢性阻塞性肺疾病(COPD)致肺心病急性加重期患者的证候学特征,为老年COPD致肺心病急性加重期的中医治疗提供临床依据。方法筛选2013年01月至今符合要求的老年COPD致肺心病急性加重期患者366名,采用问卷调查的方式收集患者中医四诊资料,建立数据库,采用聚类分析和logistic回归分析相结合的方法对该类疾病的中医证候特点进行分析,寻找其证候学特点。结果将四诊资料进行统计发现,频率≥90%症候要素为:喘促、咳嗽、咳痰、唇甲青紫、胸闷、舌暗红、气短、乏力、神疲、心悸、脉数;通过K类中心聚类和二分类logistic回归分析的结果发现,该疾病的证候类型分别为肺肾气阴两虚+痰热壅肺+血瘀证(214例),痰湿阻肺+阳虚水泛证(110例),寒饮停肺+心肺气虚证(42例);在符合第一类证候的患者中,痰黏色黄,腰膝酸软,舌有瘀斑,失眠,脉滑的影响较大。结论基于本次调查结果,老年COPD致肺心病急性加重期患者的中医证候以肺肾气阴两虚+痰热壅肺+血瘀证的复合证候居多;痰黏色黄,腰膝酸软,舌有瘀斑,失眠,脉滑是该证型的证候要素。更多还原

【Abstract】 Objective To discuss the syndromatologic characteristics of pulmonary heart disease( PHD) induced by chronic obstructive pulmonary disease( COPD) at acute aggravated stage in senile patient through small-sample investigation so as to provide the clinical evidence for TCM treatment of the disease.Methods From January 2013 till now,366 cases of COPD-induced PHD at acute aggravated stage were selected in terms of the criteria. The questionnaire survey was adopted to collect TCM four diagnostic information and set up database. The cluster analysis and logistic regression were combined to analyze TCM syndromes of the disease and explore the syndromatologic characteristics. Results Based on the statistical analysis on four diagnostic information,the syndromes with the frequency ≥90% included: asthmatic breathing,cough,sputum,cyanosis,chest oppression,dark tongue,short breath,lassitude,palpitation and rapid pulse.The K-means cluster analysis and binary logistic regression showed: the syndrome patterns included qi and yin deficiency of lung and kidney + accumulation of phlegm and heat in the lung + blood stagnation( 214cases),blockage by phlegm and damp in the lung + edema due to yang deficiency( 110 cases),retention of cold in the lung + qi deficiency of heart and lung( 42 cases). For the patients complying with the first category of syndrome,the predominated symptoms were yellow sticky sputum,soreness and weakness of lumber region and knee joint,stagnant spots in the tongue,insomnia and rolling pulse. Conclusion On the basis of the investigation,the senile patients of COPD-induced PHD at acute aggravated stage are mostly differentiated as the complex syndrome as qi and yin deficiency of lung and kidney + accumulation of phlegm and heatin the lung + blood stagnation,in which,yellow sticky sputum,soreness and weakness of lumber region and knee joint,stagnant spots in the tongue,insomnia and rolling pulse are the predominated symptoms.更多还原