司东旭 阎玥 史琦 高龙霞 包海鹏 刘桂廷 李友林

摘要 目的：研究支氣管哮喘慢性持续期肺脾脏腑功能特征性临床表现。方法：选取2015年9月至2018年4月中日友好医院中医肺病二部门诊及病房收治的支气管哮喘慢性持续期患者104例作为研究对象，通过采集病例信息，采取聚类分析总结CDBA肺脾脏腑功能特征。结果：1）主要症状聚类结果为聚类Ⅰ：胸闷、喘息、大便异常;聚类Ⅱ：鼻部不适、口咽不适、咳嗽、咳痰、睡眠差;聚类Ⅲ：自汗、神疲乏力、气短、头晕、面色不华、夜尿频。2）舌脉聚类结果为聚类Ⅰ：舌淡红、舌暗红、苔腻、苔黄、脉沉、脉滑、脉弦;聚类Ⅱ：舌质红、舌质暗淡;聚类Ⅲ：苔薄、苔白、脉细。结论：CDBA肺脾脏腑功能特征性临床表现，除主证喘息、胸闷、气短、咳嗽、咳痰之外，还有鼻窍不利、口烟不适、自汗、神疲乏力、睡眠不佳、大便不调等表现。

关键词 支气管哮喘;慢性持续期;肺脾脏腑功能;中医;辨证论治;聚类分析

Study on Functional Characteristics of Lung and Spleen in Chronic Duration of Bronchial Asthma

SI Dongxu1，YAN Yue2，SHI Qi2，GAO Longxia1，BAO Haipeng1，LIU Guiting1，LI Youlin2

（1 Beijing University of Chinese Medicine，Beijing 100029，China; 2 The Second Department of Pulmonary Disease，The Key Unit of State Administration of Traditional Chinese Medicine（Pneumonopathy Chronic Cough and Dyspnea），Beijing Key Laboratory of Prevention and Treatment of Allergic Diseases with Traditional Chinese Medicine，Center of Respiratory Medicine，China-Japan Friendship Hospital，National Clinical Research Center for Respiratory Diseases，Beijing 100029，China）

Abstract Objective：To study the characteristic clinical manifestations of lung，spleen，and organ function in the chronic persistent period of bronchial asthma through case analysis.Methods：From September 2015 to April 2018，a total of 104 patients with chronic persistent bronchial asthma admitted to the Second Department of Lung Disease and Ward of China-Japan Friendship Hospital were selected as the research objects.Case information was collected and cluster analysis was used to summarize chronic duration of bronchial asthma （CDBA） lungs functional characteristics of the spleen and organs.Results：1） The main symptom cluster results were cluster Ⅰ：chest tightness，wheezing，abnormal stool; cluster Ⅱ：nasal discomfort，oropharyngeal discomfort，cough，sputum，poor sleep; cluster Ⅲ：spontaneous sweating，fatigue，shortness of breath，dizziness，lusterless complexion，frequent urination at night.2） The clustering results of tongue and pulse were：cluster I：light red tongue，dark red tongue，greasy coating，yellow coating，deep pulse，slippery pulse，wiry pulse; cluster II：red tongue，dim tongue; clustering Ⅲ：thin coating，white coating，thin pulse.Conclusion：In addition to the main symptoms of wheezing，chest tightness，shortness of breath，cough，and sputum production，the clinical manifestations of lung and spleen in the CDBA include inhibited nasal orifices，oropharyngeal discomfort，spontaneous sweating，fatigue，poor sleep，and irregular bowel movements etc.

Keywords Bronchial asthma; Chronic duration; Function of lung and spleen; Traditional Chinese medicine; Syndrome differentiation and treatment; Cluster analysis

中图分类号：R256.1文献标识码：Adoi：10.3969/j.issn.1673-7202.2021.06.025

支气管哮喘（Bronchial Asthma，BA）是一种以免疫功能异常、多种免疫细胞浸润为主的呼吸道慢性炎症反应性疾病，持续的慢性呼吸道炎症反应引发气道高反应。发作多在晚间和（或）凌晨、大部分症状可以自行或经治疗后缓解。临床症状表现以胸闷、喘息、气急、咳嗽等反复发作为特征[1]。西方医学治疗BA主要使用支气管扩张剂联合糖皮质激素为主控制临床症状，而且需要长期规律用药，无法从根本上治愈[2-6]。临床上，大部分患者处在急性发作和缓解之间的支气管哮喘慢性持续期（Chronic Duration of Bronchial Asthma，CDBA）。……