CAJ | 학술논문

目的：通过比较炎症性肠病（ IBD）患者、腹泻型肠易激综合征（ IBS）患者、健康人群肺功能指标及肺部表现的差异，总结IBD患者肺支气管病损的发病规律，寻找中医“肺与大肠相表里”的临床依据。方法选取符合纳入标准的IBD患者219例（ IBD组），其中溃疡性结肠炎（ UC ）183例，克罗恩病（ CD）36例。腹泻型IBS患者30例（ IBS组），同时选择20例健康志愿者作为对照组。采集一般资料和肺部症状，检测血清肝肾功能，并行胸部X线及肺功能检查。结果 IBD组患者中，肺功能异常占71.2%，胸片异常占19.6%，咳嗽、气短等肺部症状占18.7%，复发性口腔溃疡等其他除肺以外的肠外表现占30.1%；IBS组患者中，肺功能异常占33.3%，肺部症状占3.3%；对照组肺功能异常占20%，无肺部伴随症状。CD患者肺活量（ VC）、一秒率（ FEV 1.0%）、最大中期呼气流速（ MMEF）、75%肺活量时的最大呼气流速（ FEF 75%）、一氧化碳弥散量（ DLCO）及肺总量（ TLC）指数较腹泻型IBS患者及健康志愿者明显下降；UC患者FEV 1.0%、FEF 75%、MMEF及DLCO指数较腹泻型IBS患者及健康志愿者明显下降。结论与腹泻型IBS患者及健康志愿者相比，IBD患者更容易出现肺功能异常。CD患者肺功能损害以阻塞型通气障碍和限制型通气障碍为主。UC患者的肺功能损害表现为阻塞型或混合型通气障碍。IBD患者的肺部损害远远高于其他肠外表现，从而证明了肺与大肠间病损的特异性。
목적：통과비교염증성장병（ IBD）환자、복사형장역격종합정（ IBS）환자、건강인군폐공능지표급폐부표현적차이，총결IBD환자폐지기관병손적발병규률，심조중의“폐여대장상표리”적림상의거。방법선취부합납입표준적IBD환자219례（ IBD조），기중궤양성결장염（ UC ）183례，극라은병（ CD）36례。복사형IBS환자30례（ IBS조），동시선택20례건강지원자작위대조조。채집일반자료화폐부증상，검측혈청간신공능，병행흉부X선급폐공능검사。결과 IBD조환자중，폐공능이상점71.2%，흉편이상점19.6%，해수、기단등폐부증상점18.7%，복발성구강궤양등기타제폐이외적장외표현점30.1%；IBS조환자중，폐공능이상점33.3%，폐부증상점3.3%；대조조폐공능이상점20%，무폐부반수증상。CD환자폐활량（ VC）、일초솔（ FEV 1.0%）、최대중기호기류속（ MMEF）、75%폐활량시적최대호기류속（ FEF 75%）、일양화탄미산량（ DLCO）급폐총량（ TLC）지수교복사형IBS환자급건강지원자명현하강；UC환자FEV 1.0%、FEF 75%、MMEF급DLCO지수교복사형IBS환자급건강지원자명현하강。결론여복사형IBS환자급건강지원자상비，IBD환자경용역출현폐공능이상。CD환자폐공능손해이조새형통기장애화한제형통기장애위주。UC환자적폐공능손해표현위조새형혹혼합형통기장애。IBD환자적폐부손해원원고우기타장외표현，종이증명료폐여대장간병손적특이성。
Objective To compare the differences in lung function indexes and pulmonary manifes-tations among the patients of inflammatory bowel disease( IBD)and irritable bowel syndrome( IBS)as well as healthy group so as to sum up the occurrence rule of bronchial damage in IBD patients and seek the clinical evidence on“interaction of lung and large intestine”. Methods Two hundred and nineteen IBD patients were in accordance with the inclusive criteria,of them,183 cases had ulcerative colitis and 36 cases Crohn′s disease( CD). Thirty patients were collected,suffered from diarrhea IBS,and at same time 20 healthy volun-teers were chosen in the control group. The general data and lung symptoms were collected. Serum liver and kidney functions were detected. X-ray test of chest and lung function examinations were given. Results A-mong IBD patients,71. 2% of them had lung dysfunction,19. 6% of them had abnormal indications on the chest X-ray film,18. 7% of them had lung symptoms such as cough and short breath and 30. 1% of them had parenteral symptoms except lung such as recurrent dental ulcer. Among those diarrhea IBS patients, 33. 3% of them had lung dysfunction,3. 3% of them had lung symptoms. Among the healthy volunteers,20%of them had lung dysfunction and no case had lung symptom. The results of VC,FEV 1. 0%,MMEF,FEF 75%,DLCO and TLC in CD patients were reduced apparently as compared with those diarrhea IBS patients and healthy volunteers. The results of FEV 1. 0%,FEF 75%,MMEF and DLCO in UC patients were reduced apparently as compared with those diarrhea IBS patients and healthy volunteers. Conclusion Compared with diarrhea IBS patients and healthy volunteers,IBD patients have lung dysfunction more likely. The lung damage in CD patients is obstructive ventilation impairment and restrictive ventilation impairment and that in UC pa-tient is obstructive or mixed ventilation impairment;and that in IBD patients is much serious than the other parenteral manifestation. All of those prove the specificity of the disorders between lung and large intestine.