【摘要】 目的：探讨ICUAW(intensive care unit acquired weakness, ICU获得性肌无力)的不同中医证型与急性骨骼肌肉萎缩进程的相关性。方法：采用回顾性队列研究方法，选择2017年5月至2019年9月就诊于广州中医药大学第一附属医院重症医学科符合纳排标准的94例ICUAW患者作为研究对象，比较ICUAW不同证型之间RFcsa(Rectus Femoris cross-sectional area,股直肌肌肉横截面积)变化率的差异。结果：肺热津伤证与脾胃虚弱证比较，RFcsa变化率大0.13(95%CI:0.05～0.22),P值<0.05。肺热津伤证与湿热浸淫证比较，RFcsa变化率大0.18(95%CI:0.08～027),P值<0.05。不同证型ICUAW患者入住ICU 3 d时的RFcsa变化率比较差异无统计学意义。结论：入住ICU 7 d时，脾胃虚弱证、湿热浸淫证在肌肉萎缩方面较肺热津伤证患者更为迅速，且这种差异可能发生在患者入住ICU第3～7天之间，湿热浸淫与脾胃虚弱可能是ICUAW患者急性期肌肉萎缩的主要中医病机。更多还原

【Abstract】 Objective: To investigate the correlation among different TCM syndromes and acute muscular wasting of patients with ICUAW. Methods: A retrospective cohort was conducted. The data of 94 ICUAW patients in the ICU of the First Affiliated Hospital of Guangzhou University of Chinese Medicine from May 2017 to September 2019 were collected. The change rate of the cross-sectional area of rectus femoris muscle among different TCM syndromes were compared. Results: The rate of change of RFcsa of syndrome of fluid consumption due to lung heat group was 0.13 larger than that of the spleen-stomach deficiency syndrome group,(95% CI: 0.05-0.22), P value<0.05. The change rate of RFcsa of syndrome of fluid consumption due to lung heat group was 0.18 larger than that of damp-heat syndrome group,(95% CI: 0.08-027),P value<0.05. There was no statistically significant difference in the RFcsa change rate between different TCM syndromes when ICU stayed for 3 days. Conclusion: When staying in the ICU for 7 days, spleen-stomach deficiency syndrome group and damp-heat syndrome group are more rapid in muscle atrophy than those in the syndrome of fluid consumption due to lung heat group, and which may occur between 3-7 days after admitting to ICU. damp-heat and Spleen-stomach deficiency may be the main pathogenesis of TCM in the acute phase of muscle atrophy in patients with ICUAW.更多还原