| 摘要: |
| 目的 探讨间质性肺疾病（ILD）中医证型与胸部高分辨CT（HRCT）分期及评分、肺功能的关系。方法 回顾性分析2016年5月至2021年10月在北京市第一中西医结合医院呼吸科诊断为ILD的259例患者的中医证型、胸部HRCT分期及评分、肺功能结果，分析三者之间的关系。结果 HRCT分期早期的ILD患者中实证占比较高；中、晚期患者中虚证占比逐渐增高，晚期以肺肾气阴两虚证、肺肾气虚证为著，分别占30.2%（13/43）、20.9%（9/43）。肺肾气阴两虚证、肺肾气虚证患者的HRCT评分最高，分别为（18.67±2.64）、（14.06±2.28）分，与其他中医证型患者相比差异均有统计学意义（P均＜0.01）。肺肾气阴两虚证、肺肾气虚证ILD患者的用力肺活量占预计值的百分比（FVC%pred）、一氧化碳弥散量占预计值的百分比（DLCO%pred）均最低，与其他中医证型患者相比差异均有统计学意义（P＜0.01、P＜0.05）。HRCT评分与DLCO%pred呈强负相关（r＝－0.695，P＜0.01），与FVC%pred、第1秒用力呼气容积占预计值的百分比呈中度负相关（r＝－0.468、－0.402，P均＜0.01），与一秒率占预计值的百分比、一氧化碳弥散系数占预计值的百分比呈弱负相关（r＝－0.364、－0.294，P均＜0.01），与肺总量占预计值的百分比呈极弱负相关（r＝－0.116，P＜0.01）。结论 ILD患者中医证型与HRCT分期及评分、肺功能有一定的关系，其中肺肾气阴两虚证、肺肾气虚证患者的HRCT分期及评分最高、肺功能最差。 |
| 关键词: 间质性肺疾病 中医证型 高分辨率CT 呼吸功能试验 |
| DOI：10.16781/j.CN31-2187/R.20220276 |
| 投稿时间：2022-04-06修订日期：2022-07-01 |
| 基金项目:中央级公益性科研院所基本科研业务费中国中医科学院基础所自主选题（YZ-1643）. |
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| Correlation of traditional Chinese medicine syndrome types of interstitial lung disease with chest high resolution CT stages and scores and pulmonary function |
| MA Ying1,FENG Hai-jun2* |
(1. Department of Radiology, Beijing No. 1 Hospital of Integrated Traditional Chinese and Western Medicine, Beijing 100026, China;
2. Department of Respiratory Medicine, Beijing No. 1 Hospital of Integrated Traditional Chinese and Western Medicine, Beijing 100026, China
*Corresponding author) |
| Abstract: |
| Objective To explore the correlation of traditional Chinese medicine (TCM) syndrome types with chest high resolution computed tomography (HRCT) stages and scores and pulmonary function of interstitial lung disease (ILD). Methods The TCM syndrome types, chest HRCT image stages and scores and pulmonary function results of 259 ILD patients were retrospectively analyzed to explore the relationship between the 3 factors. Results Early ILD patients according to HRCT staging had a high proportion of excess syndrome; the proportion of deficiency syndrome in the middle and late stage patients increased gradually, and the latter was mainly characterized by deficiency of both lung and kidney qi and yin and deficiency of lung and kidney qi, accounting for 30.2% (13/43) and 20.9% (9/43), respectively. The HRCT scores of patients with deficiency of both lung and kidney qi and yin and deficiency of lung and kidney qi were the highest (18.67±2.64 and 14.06±2.28, respectively), which were significantly different from those of other TCM syndrome types (all P＜0.01). The forced vital capacity (FVC) as a percentage of predicted (FVC%pred) and diffusing capacity for carbon monoxide of lung (DLCO) as a percentage of predicted (DLCO%pred) of the ILD patients with both deficiency of lung and kidney qi and yin and deficiency of lung and kidney qi were the lowest, which were significantly different compared with the patients with other TCM syndrome types (P＜0.01, P＜0.05). HRCT score was strongly negatively correlated with DLCO%pred (r＝－0.695, P＜0.01), moderately negatively correlated with FVC%pred and forced expiratory volume in one second (FEV1) as a percentage of predicted (r＝－0.468, －0.402, both P＜0.01), weakly negatively correlated with FEV1/FVCpred as a percentage of predicted and DLCO/alveolar ventilation as a percentage of predicted (r＝－0.364, －0.294, both P＜0.01), and very weakly negatively correlated with total lung volume as a percentage of predicted (r＝－0.116, P＜0.01). Conclusion There is a certain relationship between TCM syndrome types, HRCT stages and scores, and pulmonary function in patients with ILD. The HRCT stage and score of the patients with lung and kidney qi and yin deficiency syndrome or lung and kidney qi deficiency syndrome are the highest, and their pulmonary function is the worst. |
| Key words: nterstitial lung disease traditional Chinese medicine syndrome type high resolution CT respiratory function test |
