Retrospective Analysis of TCM Syndromes and Related Risk Factors of Acute Exacerbation of Chronic Obstructive Pulmonary Disease Complicated with Venous Thromboembolism

GAO Feng; HUANG Lina; WANG Wei; LAI Xue; MA Jizhang; FENG Wenye

doi:10.13288/j.11-2166/r.2022.22.011

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Retrospective Analysis of TCM Syndromes and Related Risk Factors of Acute Exacerbation of Chronic Obstructive Pulmonary Disease Complicated with Venous Thromboembolism

更新时间：2022-11-11

- Retrospective Analysis of TCM Syndromes and Related Risk Factors of Acute Exacerbation of Chronic Obstructive Pulmonary Disease Complicated with Venous Thromboembolism
- Journal of Traditional Chinese Medicine Vol. 63, Issue 22, Pages: 2148-2153(2022)
- 作者机构：
  
  中国中医科学院望京医院，北京市朝阳区望京中环南路6号，100102
- 作者简介：
- 基金信息：
- DOI：10.13288/j.11-2166/r.2022.22.011
  CLC：
- Received：20 March 2022，
  
  Revised：2022-09-10，
  
  Published：17 November 2022
- 稿件说明：
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高峰,黄丽娜,汪伟等.慢性阻塞性肺疾病急性加重合并静脉血栓栓塞症中医证候及相关危险因素的回顾性分析[J].中医杂志,2022,63(22):2148-2153.

GAO Feng,HUANG Lina,WANG Wei,et al.Retrospective Analysis of TCM Syndromes and Related Risk Factors of Acute Exacerbation of Chronic Obstructive Pulmonary Disease Complicated with Venous Thromboembolism[J].Journal of Traditional Chinese Medicine,2022,63(22):2148-2153.
高峰,黄丽娜,汪伟等.慢性阻塞性肺疾病急性加重合并静脉血栓栓塞症中医证候及相关危险因素的回顾性分析[J].中医杂志,2022,63(22):2148-2153. DOI： 10.13288/j.11-2166/r.2022.22.011.

GAO Feng,HUANG Lina,WANG Wei,et al.Retrospective Analysis of TCM Syndromes and Related Risk Factors of Acute Exacerbation of Chronic Obstructive Pulmonary Disease Complicated with Venous Thromboembolism[J].Journal of Traditional Chinese Medicine,2022,63(22):2148-2153. DOI： 10.13288/j.11-2166/r.2022.22.011.

摘要

目的

探讨慢性阻塞性肺疾病急性加重（AECOPD）合并静脉血栓栓塞症（VTE）的中医证候特点、相关危险因素。

方法

回顾性纳入AECOPD患者603例，按是否合并VTE分为VTE组40例和非VTE组563例，并经倾向性评分得到40对匹配病例。比较两组患者一般情况、相关辅助检查、中医四诊信息及中医证候，并对舌脉象与中医证候进行相关性分析，对临床资料、中医证候中有统计学意义的指标进行Logistic回归分析。

结果

本研究共纳入603例AECOPD患者，其中合并VTE者40例（占6.63%）。与非VTE组比较，VTE组患者卧床时间明显延长，一秒用力呼气容积占预计值的百分比（FEV

%pred）、动脉血氧分压（PaO

）水平明显降低，纤维蛋白原（FIB）、D-二聚体水平明显升高，出现面色晦暗、唇甲紫绀、舌质暗红、舌下脉络色暗和迂曲征象的患者明显增多（

＜0.05或

＜0.01）。非VTE组和VTE组患者肺功能分级、AECOPD严重程度分级情况的差异具有统计学意义（

＜0.05），其中VTE组中肺功能极重度及AECOPD Ⅲ级患者明显多于非VTE组（

＜0.05）。Logistic回归分析发现，除FEV

%pred为保护因素外，卧床时间、D-二聚体、肺功能分级、痰热瘀肺证均为危险因素（

＜0.05）。VTE组患者证候以痰热瘀肺权重系数（8.28）最高，明显高于非VTE组（0.58）。两组患者舌质暗红、舌下脉络色暗迂曲在痰热瘀肺证中分布差异具有统计学意义（

＜0.05），且具有正向相关性（

＞0.3，

＜0.05）。

结论

AECOPD合并VTE的中医证候特点是为痰热瘀肺，卧床时间长、FEV1%pred降低、D-二聚体增高、肺功能分级高、痰热瘀肺证是其危险因素。

Abstract

Objective

To investigate the characteristics and related risk factors of traditional Chinese medicine （TCM） syndromes in acute exacerbation of chronic obstructive pulmonary disease （AECOPD） with venous thromboembolism （VTE）.

Methods

A total of 603 patients with AECOPD were retrospectively included and divided into VTE group （40 cases） and non-VTE group （563 cases） according to the presence or absence of VTE， and 40 matched cases were obtained by propensity score. The general conditions， relevant auxiliary examinations， four examinations in TCM， as well as TCM syndromes were collected and compared between the two groups， and the correlation between tongue manifestations and TCM syndromes was analyzed， and logistic regression analysis was performed for statistically significant indicators among clinical data and TCM syndromes.

Results

A total of 603 patients with AECOPD were included in this study， among whom 40 patients （6.63%） had VTE. Patients in the VTE group had significantly longer bed rest time， lower percentage of the predicted forced expiratory volume in one second （FEV1% pred） and arterial partial pressure of oxygen （PaO

） level， significantly higher fibrinogen （FIB） and D-dimer levels， and more patients with dull complexion， cyanotic lip nails， dark red tongue， dark sublingual veins and tortuous signs than those in the non-VTE group （

＜0.05 or

＜0.01）. There were significant differences in pulmonary function class， and AECOPD severity class between the two groups （

＜0.05）， and more patients with extremely severe pulmonary function or grade III AECOPD were found in the VTE group （

＜0.05）. Logistic regression analysis revealed that bed rest time， D-dimer， pulmonary function class， and phlegm-heat obstructing lung syndrome were all risk factors except FEV1% pred， which was a protective factor （

＜0.05）； the weight coefficient of phlegm-heat obstructing lung syndrome （8.28） was the highest in VTE group， which was significantly higher than that in non-VTE group （0.58）. There was a statistically significant difference in the distribution of dark red tongue and dark and tortuous sublingual collaterals in the phlegm-heat obstructing lung syndrome between the two groups （Chi-square test：

＜0.05）， and there was a positive correlation （

＞0.3，

＜0.05）.

Conclusion

The TCM syndrome of AECOPD with VTE is characterized by phlegm-heat obstructing lung， and prolonged bed rest， decreased FEV1% pred， increased D-dimer， more severe pulmonary function grade， and phlegm-heat obstructing lung syndrome are the risk factors.

关键词

Keywords

references

YANG G ， WANG Y ， ZENG Y . et al . Rapid health transition in China， 1990-2010： findings from the Global Burden of Disease Study 2010 ［J］. Lancet ， 2013 ， 381 （ 9882 ）： 1987 - 2015 ．

CHEN Z ， QUN Y ， HUI QG ， et al . Validation of risk assessment models predicting venous thromboembolism in inpatients with acute exacerbation of chronic obstructive pulmonary disease： a multicenter cohort study in China ［J］. Thromb Haemost ， 2022 ， 122 （ 7 ）： 1177 - 1185 .

沈芳，张景熙，刘锦铭，等 . 慢性阻塞性肺疾病加重期合并静脉血栓栓塞症的危险因素分析［J］. 中国呼吸与危重监护杂志， 2019 ， 18 （ 5 ）： 427 - 431 .

PANG HY ， WANG L ， LIU J ， et al . The prevalence and risk factors of venous thromboembolism in hospitalized patients with acute exacerbation of chronic obstructive pulmonary disease ［J］. Clin Respir J ， 2018 ， 12 （ 11 ）： 2573 - 2580 .

岳晓艳，李凤杰，蒋志锋，等 . 慢性阻塞性肺疾病急性加重合并下肢深静脉血栓的临床特征及危险因素［J］. 首都医科大学学报， 2021 ， 42 （ 1 ）： 153 - 157 .

刘翔，赵婷，毕俏杰，等 . 急诊重症监护病房慢性阻塞性肺疾病老年患者下肢深静脉血栓形成的发病特征及危险因素［J］. 中国老年学杂志， 2019 ， 39 （ 13 ）： 3154 - 3156 .

慢性阻塞性肺疾病急性加重（AECOPD）诊治专家组 . 慢性阻塞性肺疾病急性加重（AECOPD）诊治中国专家共识（2017年更新版）［J］. 国际呼吸杂志， 2017 ， 37 （ 14 ）： 1041 - 1057 .

LIM W ， LE GAL G ， BATES SM ， et al . American Society of Hematology 2018 guidelines for management of venous thromboembolism： diagnosis of venous thromboembolism ［J］. Blood Advances ， 2018 ， 2 （ 22 ）： 3226 - 3256 .

中华中医药学会内科分会肺系病专业委员会 . 慢性阻塞性肺疾病中医证候诊断标准（2011 版）［J］. 中医杂志， 2012 ， 53 （ 2 ）： 177 - 178 .

Global strategy for the diagnosis ， management ， and prevention of chronic obstructive pulmonary disease 2021 report ［EB/OL］.（ 2020-11-17 ）［ 2022-08-27 ］. https：//goldcopd.org/gold-reports/ https://goldcopd.org/gold-reports/ .

赵志强，王贤良，张萍，等 . 基于前瞻性临床流行病学调查的射血分数正常心力衰竭中医证候特征分析［J］. 中医杂志， 2019 ， 60 （ 9 ）： 773 - 778 .

吴崇胜，陈家旭，胡立胜 . Delphi法建立中医证候诊断标准中权重系数确定法新探：双百分法［J］. 中国中医基础医学杂志， 2006 ， 12 （ 4 ）： 254 - 255 ．

倪红燕，杨文林，顾慧玲 . 不同程度慢性阻塞性肺疾病稳定期患者凝血及纤溶状况的临床研究［J］. 检验医学与临床， 2021 ， 18 （ 1 ）： 23 - 25 .

安雯，克丽别娜·吐尔逊，李晗，等 . 不同程度慢性阻塞性肺疾病稳定期患者血栓前状态的临床分析［J］. 新疆医科大学学报， 2017 ， 40 （ 1 ）： 45 - 47，54 .

陈俊先，温琼娜，孙兰春，等 . COPD急性加重期并发静脉血栓栓塞症的发病情况及危险因素分析［J］. 广东医科大学学报， 2018 ， 36 （ 5 ）： 527 - 530 .

卓婕，白澎，李莉，等 . 低氧血症是慢性阻塞性肺疾病急性加重期静脉血栓栓塞症的危险因素［J］. 中国呼吸与危重监护杂志， 2011 ， 10 （ 2 ）： 112 - 115 .

曹思哲，摆念祖 . 慢性阻塞性肺疾病急性加重期患者发生静脉血栓的危险因素分析［J］. 血栓与止血学， 2019 ， 25 （ 6 ）： 979 - 980，982 .

毕红兵 . 凝血功能变化对老年AECOPD患者疾病严重程度的相关性及预测价值研究［J］. 临床肺科杂志， 2018 ， 23 （ 9 ）： 1695 - 1698 .

吴红霞，程德云 . 慢性阻塞性肺疾病急性加重期血液高凝状态危险因素研究进展［J］. 临床荟萃， 2015 ， 30 （ 4 ）： 464 - 468 .

周钱留，刘元恺，张媛媛，等 . 口服抗血栓药物的不良反应及毒副作用研究进展［J］. 药学研究， 2020 ， 39 （ 9 ）： 525 - 530 .

李建生，王至婉，余学庆，等 . 基于慢性阻塞性肺病（COPD）急性加重期文献的多元统计方法在证候研究的应用探讨［J］. 河南中医学院学报， 2007 ， 22 （ 6 ）： 8 - 10 .

王海龙 . AECOPD中医证候研究及相关影响因素分析［D］. 天津：天津中医药大学， 2020 .

黄丽娜，汪伟，高峰 . 基于痰瘀相关理论探讨慢性阻塞性肺疾病急性加重的高凝状态［J］. 中医杂志， 2021 ， 62 （ 22 ）： 1940 - 1943 .

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