肺间质纤维化影像学特点与中医证型关系初探

【作者】 郭静；

【导师】 徐艳玲；

【作者基本信息】 辽宁中医药大学 ， 中医内科， 2011， 硕士

【摘要】 目的:探寻肺间质纤维化的中医证候分型与影像学分期、动脉血氧分级之间是否存在一定联系。方法:以问卷调查的方式,收集已经确诊的肺间质纤维化的患者患者的病史资料、临床症状和体征,采集CT检查结果及动脉血氧分压值,对收集的临床资料进行观察研究。结果:在搜集的95例肺间质纤维化病人中,93例患者于近期进行了CT检查。CT表现为肺泡炎期的患者7例,证型为痰热郁肺的2例,痰瘀阻络2例,肺脾两虚1例,肺肾两虚2例。CT表现为纤维化期者50例,证型为痰热郁肺的7例,肺脾两虚8例,肺肾两虚10例,痰瘀阻络25例。其中痰瘀阻络型患者人数占肺纤维化期患者总数的50.0%。蜂窝肺期患者36例,证型为痰热郁肺者4例,肺脾气虚7例,肺肾两虚19例,痰瘀阻络6例。其中肺肾两虚型患者人数占蜂窝肺期患者总数的52.8%。共有87例患者采集动脉血,行动脉血气分析检查,血氧分压值大于80mmHg的患者13例,证型为痰热郁肺的3例,痰瘀阻络5例,肺脾两虚2例,肺肾两虚3例。血氧分压值在60-80mmHg的患者43例,证型为痰热郁肺的6例,肺脾两虚6例,肺肾两虚7例,痰瘀阻络24例。其中痰瘀阻络证患者人数,占该组患者总数的55.8%。动脉血氧分压值小于等于60mmHg者31例,证型为痰热郁肺的3例,肺脾两虚6例,肺肾两虚16例,痰瘀阻络6例。其中,肺肾两虚型患者人数,占该组患者总数的51.6%。结论:CT表现为肺纤维化期的患者,辩证以痰瘀阻络证型为多,治疗可予逐瘀通络,宣肺化痰;蜂窝肺期患者辩证多为肺肾两虚证型,治疗应侧重补益肺肾。更多还原

【Abstract】 Objective: To explore whether there was special relationship between CT imaging appearances and syndrome differentiation in TCM of ILD .Methods: Collect and analyze the clinical syndrome, CT report and blood gas analysis of patients’who have diagnosed in ILD by the method of Questionnaire survey.Results:There are 95 ILD patients,in which 93 patients done the CT examination recently. 7 cases’CT performance was in the alveolar inflammation period, 2 cases of spittle-heat deficiency, 2 cases of pulmonary spleen two virtual , 1 cases of kidney lung two virtual, 2 cases of contact on blood- spittle blocking. The performance of CT fibrosis period, 50, 7 cases of spittle-heat deficiency,10 cases of pulmonary spleen two virtual , 8 cases of kidney lung two virtual, 25 cases of contact on blood- spittle blocking,take 50.0% of the people in fibrosis period. The cellular lung 36 patients, 4 cases of spittle-heat deficiency,7 cases of pulmonary spleen two virtual , 19 cases of kidney lung two virtual,take 52.8% of the patients whose CT image in the period of cellular lung, 6 cases of contact on blood- spittle blocking.There are 87 patients do the check of arterial blood gas analysis . 43 cases’PaO2 value was more than 80mmHg , 3 cases of spittle-heat deficiency, 5 cases of contact on blood- spittle blocking ,2 cases of pulmonary spleen two virtual , 3 cases of kidney lung two virtual. There are 43 cases that PaO2 is in the value of 60-80mmHg, 6 cases of spittle-heat deficiency,6 cases of pulmonary spleen two virtual , 7 cases of kidney lung two virtual, 24 cases of contact on blood- spittle blocking,take 55.8% of the patients whose PaO2 is in the value of 60-80mmHg.And 31 cases’PaPO2 less than 60 mmHg, 3 cases of spittle-heat deficiency,6 cases of pulmonary spleen two virtual , 16 cases of kidney lung two virtual,take 51.6% of the people whose PaPO2 less than 60 mmHg, 6 cases of contact on blood- spittle blocking. Conclusion3:In the performance of CT fibrosis period , blood- spittle blocking has the most cases,and kidney lung two virtual in the cellular lung period.更多还原