1500例初治继发性肺结核患者的流行现状及证候特点

摘要

Objective:To understand the epidemiological status and syndrome characteristics of 1500 cases of primary secondary pulmonary tuberculosis in different regions,to explore the independent risk factors of different TCM syndrome types and provide evidence for the prevention and treatment of tuberculosis.Method:The 14 hospitals outpatient or inpatient 1500 cases of initial treatment secondary pulmonary tuberculosis patients were selected,application of TCM four diagnostic information acquisition software,system specification of patients were collected general information,clinical information,objective inspection indexes,the establishment of a database,carried on the comprehensive analysis.Result:18-30 years of age accounted for the highest age of onset of age(45.7%).Men were more than women.Lung Yin deficiency syndrome in different age,education level,the distribution of economic income with statistical difference.Not found on Yin deficiency fire,Qi Yin deficiency of the distribution of the two factors.Multivariate logistic regression analysis:interleukin-1 was Lung Yin deficiency syndrome risk factor.Interleukin-10 was a risk factor for syndrome of hyperactivity of fire due to deficiency of yin. Tumor necrosis factor was the deficiency of Qi and Yin Syndrome and risk factors.Conclusion:Different age, educational level and economic income have important influence on the early treatment of secondary pulmonary tuberculosis.The study is not found on Yin deficiency Fire Syndrome,Qi Yin deficiency of the distribution of two factors.Different syndromes have different risk factors,the target treatment has important significance.%目的：了解不同地区1500例初治继发性肺结核的流行现状及证候特点，发掘实验室指标对不同中医证型的独立危险因素，为制定结核病防治对策提供依据。方法：选取全国14家医院门诊或住院的1500例初治继发性肺结核患者，应用中医四诊信息采集软件，系统规范化地采集患者的一般信息、临床信息、客观指标检查等，建立数据库，对其进行综合分析。结果：18~30岁为发病人群占比最高的年龄阶段（45.7%）；男性多发于女性；肺阴亏虚证在不同年龄、文化程度、经济收入的分布差异有统计学意义（P<0.05）。未发现对阴虚火旺证、气阴两虚证分布相关的因素。Logistic多元回归分析：白介素-1是肺阴亏虚证的危险因子；白介素-10是阴虚火旺证的危险因子；肿瘤坏死因子是气阴两虚证的危险因子。结论：不同年龄、文化程度、经济收入对初治继发性肺结核肺阴虚证有重要影响。本次研究未发现对阴虚火旺证、气阴两虚证分布相关的因素。不同证候各有其危险因子，以其为靶点进行辨治，具有重要意义。