中华危重病急救医学
中華危重病急救醫學
중화위중병급구의학
Chinese Critical Care Medicine
2013年
9期
550-553
,共4页
王东强%李银平%李志军%李桥茹%付鹏亮
王東彊%李銀平%李誌軍%李橋茹%付鵬亮
왕동강%리은평%리지군%리교여%부붕량
老年多器官功能障碍综合征%中医证候%聚类分析
老年多器官功能障礙綜閤徵%中醫證候%聚類分析
노년다기관공능장애종합정%중의증후%취류분석
Multiple organ dysfunction syndrome in the elderly%Syndrome differentiation%Cluster analysis
目的 通过对老年多器官功能障碍综合征(MODSE)患者的临床资料进行聚类分析,探讨MODSE的中医证候分布规律.方法 观察200例MODSE患者确诊1、3、7d的临床表现,获得四诊资料,将134个症状作为观察指标,应用聚类分析,对患者四诊症状信息及证型进行分析.结果 根据所聚类别的证候条目分布情况,由专家组结合专业知识与临床实际进行证候判别,其中聚为7类最恰当,参照《中医病证诊断疗效标准》、《中医诊断学》及《中华人民共和国国家标准·中医临床诊疗术语》,结合专家意见归纳为痰湿阻滞证134例(22.3％),所占比例最大,其次为热毒炽盛证113例(18.8％),湿热蕴结证97例(16.2％),阳气亏虚证85例(14.2％),阴阳两虚证67例(11.2％),腑实不通证55例(9.2％),气滞血瘀证48例(8.1％).结论 MODSE患者中医证候初步分为湿热蕴结证、痰湿阻滞证、热毒炽盛证、气滞血瘀证、腑实不通证、阳气亏虚证、阴阳两虚证7大类,其中以痰湿阻滞证最常见,“虚”、“痰”、“瘀”、“毒”为主要病因病机.
目的 通過對老年多器官功能障礙綜閤徵(MODSE)患者的臨床資料進行聚類分析,探討MODSE的中醫證候分佈規律.方法 觀察200例MODSE患者確診1、3、7d的臨床錶現,穫得四診資料,將134箇癥狀作為觀察指標,應用聚類分析,對患者四診癥狀信息及證型進行分析.結果 根據所聚類彆的證候條目分佈情況,由專傢組結閤專業知識與臨床實際進行證候判彆,其中聚為7類最恰噹,參照《中醫病證診斷療效標準》、《中醫診斷學》及《中華人民共和國國傢標準·中醫臨床診療術語》,結閤專傢意見歸納為痰濕阻滯證134例(22.3％),所佔比例最大,其次為熱毒熾盛證113例(18.8％),濕熱蘊結證97例(16.2％),暘氣虧虛證85例(14.2％),陰暘兩虛證67例(11.2％),腑實不通證55例(9.2％),氣滯血瘀證48例(8.1％).結論 MODSE患者中醫證候初步分為濕熱蘊結證、痰濕阻滯證、熱毒熾盛證、氣滯血瘀證、腑實不通證、暘氣虧虛證、陰暘兩虛證7大類,其中以痰濕阻滯證最常見,“虛”、“痰”、“瘀”、“毒”為主要病因病機.
목적 통과대노년다기관공능장애종합정(MODSE)환자적림상자료진행취류분석,탐토MODSE적중의증후분포규률.방법 관찰200례MODSE환자학진1、3、7d적림상표현,획득사진자료,장134개증상작위관찰지표,응용취류분석,대환자사진증상신식급증형진행분석.결과 근거소취유별적증후조목분포정황,유전가조결합전업지식여림상실제진행증후판별,기중취위7류최흡당,삼조《중의병증진단료효표준》、《중의진단학》급《중화인민공화국국가표준·중의림상진료술어》,결합전가의견귀납위담습조체증134례(22.3％),소점비례최대,기차위열독치성증113례(18.8％),습열온결증97례(16.2％),양기우허증85례(14.2％),음양량허증67례(11.2％),부실불통증55례(9.2％),기체혈어증48례(8.1％).결론 MODSE환자중의증후초보분위습열온결증、담습조체증、열독치성증、기체혈어증、부실불통증、양기우허증、음양량허증7대류,기중이담습조체증최상견,“허”、“담”、“어”、“독”위주요병인병궤.
Objective To statistically analyze the clinical data from patients with multiple organ dysfunction syndrome in the elderly (MODSE),and to investigate the distribution pattern of traditional Chinese medicine (TCM)syndromes.Methods TCM data of 200 patients with MODSE was collected on 1,3 and 7 days after diagnosis.Using 134 symptoms as observation indexes,clustering analysis was used to analyze the TCM symptoms and syndromes of these patients.Results In accordance with Diagnostic efticacy of standard TCM Syndrome,Diagnostics of TCM,State Standard of the People's Republic of China ·clinical diagnose and treat Terminology of TCM,expert group differentiate on the professional knowlege and clinical manifestation and 7 types of TCM syndrome were selected.Among all syndrome types,there were 134 (22.3％) cases of phlegm stagnation with the largest population,113 cases (18.8％) of toxic heat flourishing,97 cases (16.2％) of damp-heat accumulation,85 cases (14.2％) of qi-deficiency,67 cases (1 1.2％) of both yin and yang deficiency,55 cases (9.2％) of fu being filled and substances could not pass through,and 48 cases (8.1％) of qi stagnation and blood stasis.Conclusions This preliminary study found 7 primary types of TCM syndrome in patients with MODSE,including syndrome of phlegm stagnation,toxic heat flourishing,accumulation of damp-heat,qi-deficiency,both yin and yang deficiency,fu being filled and substances could not pass through and qi stagnation and blood stasis.The most common syndrome is phlegm stagnation and deficiency,phlegm,blood stasis,toxic are the main etiology and pathology of the disease.
