标题:煤工尘肺病患者中医证素特点初探
作者:赵微,樊改荣,刘睿 陕西中医药大学附属铜川矿务局中心医院,陕西 铜川 727000
卷次:
2019年30卷23期
【摘要】 目的 运用统计学方法,结合证素辨证,初探煤工尘肺病患者中医证素分布规律。方法 选择铜川矿务局中心医院职业病科2017年10月至2018年10月150例煤工尘肺病患者,采集四诊信息,运用描述性分析、频数分析、χ2检验、Fisher确切概率法等统计学方法分析病位、病性证素分布特点。结果 煤工尘肺病患者平均年龄(56.69±8.98)岁,56~65岁年龄组患者75例,占50.0%;平均接尘工龄(17.69±4.18)年,11~20年者74例,占49.3%;病程平均(9.29±4.38)年,6~10年者54例,占36.0%;Ⅰ期尘肺30例,占20.0%,Ⅱ期尘肺78例,占52.0%,Ⅲ期尘肺42例,占28.0%;病位证素前五位依次为肺、脾、肾、心、胃,其中肺证素频率显著高于脾、肾、心、胃,脾证素频率显著高于肾、心、胃,依次类推;实性证素前几位依次为寒、湿、痰、饮、水停、血瘀、气滞;虚性证素前几位依次为气虚、气不固、阳虚、阴虚;尘肺病患者各分期与病位证素有关(P<0.05),其中Ⅰ、Ⅱ期与肺、脾有关(P<0.05);Ⅰ、Ⅲ期与肺心、肺肾有关(P<0.05);Ⅱ、Ⅲ期与肾心、肺脾、脾心、肺心、脾肾均有关(P<0.05);肾心较脾心与Ⅱ、Ⅲ期显著相关(P<0.01)。结论 本研究显示煤工尘肺病患者病位证素前五位依次为肺、脾、肾、心、胃;病性证素实性证素依次为寒、湿、痰、饮、水停、血瘀、气滞;虚性证素前几位依次为气虚、气不固、阳虚、阴虚。Ⅰ、Ⅱ期与肺、脾有关,Ⅰ、Ⅲ期与肺、心有关,Ⅱ、Ⅲ期与肾、心有关。
【关键词】 煤工尘肺病;中医证素;特点;分布
【中图分类号】 R135.2 【文献标识码】 A 【文章编号】 1003—6350(2019)23—3023—04
Characteristics of TCM syndrome elements for coal workers with pneumoconiosis.
ZHAO Wei, FAN Gai-rong, LIURui. Tongchuan Mining Bureau Central Hospital Affiliated to Shaanxi University of Traditional Chinese Medicine,Tongchuan 727000, Shaanxi, CHINA
【Abstract】 Objective To investigate the distribution of TCM syndrome elements in patients with coal worker'spneumoconiosis by statistical method and syndrome element differentiation. Methods A total of 150 patients of coalworkers' pneumoconiosis were selected from the Department of Occupational Disease, Tongchuan Mining Bureau Cen-tral Hospital Affiliated to Shaanxi University of Traditional Chinese Medicine from October 2017 to October 2018, andthe information of the four diagnoses were collected. Descriptive analysis, frequency analysis, χ2 test, Fisher's exact prob-ability method and, other statistical methods were used to analyze the distribution characteristics of disease sites and syn-drome elements. Results The average age of patients with coal workers' pneumoconiosis was (56.69±8.98) years old,with 75 patients aged 56-65 years old (accounting for 50.0%). The average working age of dust exposure was (17.69±4.18) years, and 74 cases were exposed to dust for 11-20 years (accounting for 49.3%). The mean course of disease was(9.29±4.38) years, and 54 cases had a disease course of 6-10 years (accounting for 36.0%). There were 30 patients withstage Ⅰ pneumoconiosis (20.0% ), 78 patients with stage Ⅱ pneumoconiosis (52.0% ), and 42 patients with stage Ⅲpneumoconiosis (28.0%). The top five location-syndrome elements were lung, spleen, kidney, heart, and stomach, andthe frequency significantly decreased in turn in the five locations. The leading solid elements of disease syndrome werecold, dampness, phlegm, drinking, water stagnation, blood stasis, and Qi stagnation; the top deficiency elements of dis-ease syndrome were Qi deficiency, Qi unsteadiness, Yang deficiency, and yin deficiency. All stages of pneumoconiosispatients were correlated with pathologic syndrome elements (P<0.05); stages Ⅰ and Ⅱ were correlated with lung andspleen (P<0.05); stageⅠ andⅢ were related to lung heart and lung kidney (P<0.05); stageⅡ andⅢ are related to kid-ney heart, lung spleen, spleen heart, lung heart, spleen and kidney (P<0.05); Kidney heart was more correlated withstageⅡ andⅢ than spleen heart (P<0.01). Conclusion The top five location-syndrome elements are lung, spleen, kid-ney, heart, and stomach. The leading solid elements of disease syndrome were cold, dampness, phlegm, drinking, waterstagnation, blood stasis, and Qi stagnation; the top deficiency elements of disease syndrome were Qi deficiency, Qi un-steadiness, Yang deficiency, and yin deficiency. StagesⅠ andⅡ are related to lung and spleen, stagesⅠ andⅢ are re-lated to lung and heart, stagesⅡ andⅢ are associated with the kidney and heart.
【Key words】 Coal worker's pneumoconiosis; TCM syndrome element; Characteristics; Distribution
下载PDF