社区获得性肺炎中医证型和炎性指标临床观察研究.docVIP

社区获得性肺炎中医证型和炎性指标临床观察研究 　　摘要：目的通过对社区获得性肺炎（Community acquired pneumonia，CAP）患者血白细胞计数（WBC）、C反应蛋白（CRP）、D-二聚体（D-D）、血清降钙素原（PCT）等炎性指标的临床观察研究，找出其差异性，为中医“风温肺热病”辨证分型提供客观依据。 方法选取CAP中医证型属邪犯肺卫（60例）、痰热壅肺（68例）、痰浊阻肺（65例）、正虚邪恋（56例）4个证型，检测各证型WBC，CRP，D-D，PCT等4项指标，分析各证型间炎性指标的差异性。 结果WBC：在4证型间比较：痰热壅肺痰浊阻肺邪犯肺卫正虚邪恋；CRP：在4证型间比较：痰热壅肺邪犯肺卫痰浊阻肺正虚邪恋；D-D：在4证型间比较：正虚邪恋痰浊阻肺痰热壅肺邪犯肺?l；PCT：在4证型间比较：邪犯肺卫痰热雍肺痰浊阻肺正虚邪恋。 结论CAP各炎性指标（WBC、CRP、D-D、PCT）在不同中医证型间其数值存在差异，具有一定的规律性，这可为CAP（相当于中医学之“风温肺热病”）中医辨证分型提供客观参考依据。 　　关键词：社区获得性肺炎；风温肺热病；中医证型；炎性指标；差异性分析 　　中图分类号：R5631文献标志码：A文章编号：1007-2349（2017）07-0024-04 　　【Abstract】Objective： To study the inflammatory indicators of white blood cell count （WBC）， C-reactive protein （CRP）， D-dimer （D-D）， serum procalcitonin （PCT） in patients with community acquired pneumonia （CAP） and to find out differences in order to provide an objective basis for TCM “wind-warm lung-heat disease？” syndrome differentiation Methods： CAP patients with 4 TCM syndromes were selected， namely， 60 cases with pathogen invading lung-defense phase， 68 cases with phlegm-heat obstructing lung， 65 cases with turbid phlegm obstructing lung and 56 cases with lingering pathogen due to vital qi deficiency WBC， CRP， D-D and PCT of each syndrome were detected to analyze the differences of inflammatory indicators among these different syndromes Results： In comparison of four types of syndromes， WBC was as phlegm-heat obstruction lungsturbid phlegm obstructing lungpathogen invading lung-defense phaselingering pathogen due to vital qi deficiency， CRP was as phlegm-heat obstructing lungpathogen invading lung-defense phaseturbid phlegm obstructing lunglingering pathogen due to vital qi deficiency， D-D was as lingering pathogen due to vital qi deficiencyturbid phlegm obstructing lungphlegm-heat obstruction lungspathogen invading lung-defense phase and PCT was as pathogen invading lung-defense phasephlegm-heat obstructing lungturbid phlegm obstructing lunglingering pathogen due to vital qi deficiency Conclusion： There are