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阴阳消长理论在评估腹部外科患者炎症免疫状态及预后中的应用作用研究

[Research on the application role of yin-yang consumption theory in evaluating the inflammatory immune state and prognosis of patients with abdominal surgical].

作者信息

Wang Na, Fu Qiang, Du Chao

机构信息

Surgical Intensive Care Unit, Nankal Hospital, Tianjin (300100), China.

出版信息

Zhongguo Zhong Xi Yi Jie He Za Zhi. 2013 Feb;33(2):164-7.

Abstract

OBJECTIVE

To study the differences of the inflammation immune state, severity, and prognosis of patients with abdominal surgical critical illness between yin consumption and yang consumption, to clarify the clinical application of yin-yang consumption theory in evaluating their inflammatory immune state, pathological severity, and prognosis.

METHODS

One hundred and forty-five patients with abdominal surgical critical illness were recruited from Surgical Intensive Care Unit, Tianjin Nankai Hospital from January 2007 to March 2010. According to syndrome typing, all patients were assigned to yang deficiency group (82 cases) and yin deficiency group (63 cases). The patient's vital signs were measured, including body temperature, pulse, respiration, mean arterial pressure (MAP), and so on. The acute physiology and chronic health evaluation II (APACHE II) score was performed. The patients' white blood cell (WBC) count, C-reactive protein (CRP), human leukocyte antigen DR-site (HLA-DR), as well as regulatory T lymphocytes (Treg) were determined. The CU length of stay, the total hospitalization time, the hospitalization cost, and the mortality, were also statistically recorded.

RESULTS

There was no statistical difference in gender, age, or primary disease between the two groups (P > 0.05) . The APACHE U score, the number of organ dysfunction, MAP, HLA-DR, the ICU length of stay, the total hospitalization time, and the hospitalization cost were significantly higher in yang deficiency group than in yin deficiency group (P < 0.05). But the body temperature, heart rate, respiration, WBC count, CRP, and Treg were significantly lower in yang deficiency group than in yin deficiency group (P < 0.05). There was no statistical difference in the mortality between the two groups (P > 0.05).

CONCLUSIONS

In the domain of abdominal surgical critical diseases, the differences in yang consumption and yin consumption of primary disease could help judge the severity of patient's condition and immunodissonance. Yin-yang consumption theory had stronger application value in assistant diagnosis and treatment.

摘要

目的

研究腹部外科危重症患者阴耗与阳耗在炎症免疫状态、病情严重程度及预后方面的差异,阐明阴阳耗损理论在评估其炎症免疫状态、病理严重程度及预后中的临床应用。

方法

选取2007年1月至2010年3月天津南开医院外科重症监护病房收治的145例腹部外科危重症患者。根据辨证分型,将所有患者分为阳虚组(82例)和阴虚组(63例)。测量患者的生命体征,包括体温、脉搏、呼吸、平均动脉压(MAP)等。进行急性生理与慢性健康状况评分系统II(APACHE II)评分。测定患者的白细胞(WBC)计数、C反应蛋白(CRP)、人类白细胞抗原DR位点(HLA-DR)以及调节性T淋巴细胞(Treg)。同时统计记录患者在重症监护病房(ICU)的住院时长、总住院时间、住院费用及死亡率。

结果

两组患者在性别、年龄或原发疾病方面无统计学差异(P>0.05)。阳虚组的APACHE II评分、器官功能障碍数量、MAP、HLA-DR、ICU住院时长、总住院时间及住院费用均显著高于阴虚组(P<0.05)。但阳虚组的体温、心率、呼吸、WBC计数、CRP及Treg均显著低于阴虚组(P<0.05)。两组患者的死亡率无统计学差异(P>0.05)。

结论

在腹部外科危重症领域,原发疾病阳耗与阴耗的差异有助于判断患者病情的严重程度及免疫失调情况。阴阳耗损理论在辅助诊疗方面具有较强的应用价值。

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