【摘要】 目的 探讨进展性肺纤维化(PPF)患者的临床特征及中医证候分布特点。方法 回顾性收集2015年1月—2022年12月在中日友好医院中西医肺病一部住院的PPF患者的临床资料(包括性别、年龄、病程、疾病亚型、既往情况、临床症状、舌脉特征、临床辅助检查结果等),根据制定的中医证候及中医证素判定标准，分析PPF患者的临床特征和中医证型与性别、年龄、病程、吸烟情况、胸部高分辨CT评分、实验室检测指标的关系。结果 研究共纳入147例PPF患者，临床症状出现频率排名前3位的是咳嗽(128例，占87.07%)、喘息(123例，占83.67%)、咳白痰(86例，占58.50%);舌质以暗红舌(61例，占41.50%)、红舌(45例，占30.61%)为主，舌苔以白苔(78例，占53.06%)、腻苔(67例，占45.58%)为主，脉象以数脉(60例，占40.82%)为主。中医证型分布由高到低依次为痰瘀阻肺证(56例，占38.10%)、痰热壅肺证(36例，占24.49%)、气阴两虚证(20例，占13.61%)、气虚证(16例，占10.88%)、血瘀证(11例，占7.48%)、痰浊阻肺证(8例，占5.44%)。中医病机相关证候要素排名前5的是气虚(123例，占83.67%)、痰(100例，占68.03%)、湿(85例，占57.82%)、血瘀(67例，占45.58%)、火(62例，占42.18%);病位相关证候要素以肺最多(144例，占97.96%)。不同中医证型患者间D-二聚体水平比较差异有统计学意义(P=0.009),性别、年龄、病程、吸烟情况、胸部高分辨CT评分及其他实验室检测指标和中医证型无明显相关性(P均>0.05)。结论 PPF临床表现以呼吸道症状为主，证候特征以虚实夹杂为主，气虚尤为明显，兼以痰、湿、血瘀、火；不同中医证型患者D-二聚体水平有差异。更多还原

【Abstract】 Objective It is to explore the clinical features and distribution of traditional Chinese medicine(TCM) syndrome in patients with progressive pulmonary fibrosis(PPF). Methods The clinical data(gender, age, course of disease, disease subtypes, past health, clinical symptoms, tongue and pulse characteristics and clinical examination results) of PPF patients hospitalized in the Pulmonary Diseases Department I of Integrated Traditional and Western Medicine of China-Japan Friendship Hospital from January 2015 to December 2022 were retrospectively collected, and the relationship between the clinical characteristics and TCM syndrome types of these patients and their gender, age, course of disease, smoking status, high-resolution chest CT scores and laboratory examination indicators were analyzed. Results A total of 147 patients with PPF were included in this study, and the top 3 clinical symptoms were cough(128 patients, 87.07%), wheezing(123 patients, 83.67%), and coughing up white sputum(86 patients, 58.50%); the coating texture was mainly characterized by dark red tongue(61 cases, 41.50%) and red tongue(45 cases, 30.61%), the tongue coating was mainly characterized by white coating(78 cases, 53.06%) and greasy coating(67 cases, 45.58%), and the pulse was mainly rapid pulse(60 cases, 40.82%). The distribution of TCM syndromes in descending order was syndrome of phlegm-stasis obstructing lung(56 cases, 38.10%), syndrome of phlegm-heat accumulating lung(36 cases, 24.49%), syndrome of Qi-Yin deficiency(20 cases, 13.61%), syndrome of Qi deficiency(16 cases, 10.88%), syndrome of blood stasis(11 cases, 7.48%), and syndrome of phlegm-turbidity obstructing lung(8 cases, 5.44%). The top 5 TCM pathogenesis-related elements were Qi deficiency(123 cases, 83.67%), phlegm(100 cases, 68.03%), dampness(85 cases, 57.82%), blood stasis(67 cases, 45.58%), and fire(62 cases, 42.18%); lung was the most disease position pathogenesis-related element(144 cases, 97.96%). There was a statistically significant difference in the level of D-dimer among patients with different TCM syndromes(P=0.009), the gender, age, course of disease, smoking status, high-resolution chest CT score, other laboratory examination indicators were not correlated with TCM syndromes(all P>0.05). Conclusion The clinical symptoms of PPF are mainly respiratory symptoms, and the pattern of symptoms is characterized by a mixture of deficiencies and excesses, with the deficiency of Qi being particularly obvious, and accompanied by phlegm, dampness, stasis, and fire; there is a difference in the level of D-D among patients with different TCM syndromes.更多还原