糖尿病合并肺部感染的病原学特点和中医证型分布的研究

邱学艳 夏艳萍 崔志华 钱锐

摘要：目的 探讨糖尿病合并肺部感染患者病原學特点和中医证型分布，为糖尿病合并肺部感染的中西医临床治疗提供更多依据。方法 选取确诊为糖尿病合并肺部感染所有资料完整的107例患者，并根据病历资料进行回顾性分析，对患者感染菌株进行统计和分类，探讨病原菌的感染特点和分布规律，归纳证型分布并探讨其与感染菌株之间有无关联性。结果 在107例糖尿病合并肺部感染患者检出病原菌中，革兰氏阴性菌占62.6%，革兰氏阳性菌占18.7%，真菌占18.7%;从证型分布情况来看，各证型的发生频率为气阴两虚证>痰湿蕴肺证>痰热壅肺证>风热犯肺证。结论 糖尿病合并肺部感染以革兰氏阴性菌感染为主，其次是革兰氏阳性菌和真菌。在不同的中医证型中，病原菌的分布未见明显差异。

关键词：糖尿病;肺部感染;病原菌;中医证型

中图分类号：R587.1 文献标志码：A 文章编号：1007-2349（2021）03-0022-04

【Abstract】Objective： To explore the etiological characteristics and the distribution of TCM syndromes in patients with diabetes mellitus complicated with pulmonary infection and to provide more evidence for the clinical treatment of the patients. Methods： 107 patients diagnosed as diabetes mellitus complicated with pulmonary infection and with complete data were selected and their medical records were given a retrospective analysis and their infection strains were statistically conducted and categorized， exploring the infection characteristics and distribution rules of pathogenic bacteria， and summarizing the distribution of syndrome types and discussing its relation to the infected strain. Results： Among the 107 cases of diabetic patients with lung infection， gram-negative bacteria accounted for 62.6%， gram-positive bacteria accounted for 18.7% and fungi accounted for 18.7%. From the distribution of syndrome types， the occurrence frequency of each syndrome type was Qi and Yin Deficiency Syndrome>Phlegm-Damp Accumulation Lung Syndrome>Phlegm-heat Obstructing Lung Syndrome>Wind-heat Invading Lung Syndrome. Conclusion： Diabetes mellitus complicated with lung infection is mainly caused by gram-negative bacteria， followed by gram-positive bacteria and fungi. There is no obvious difference in the distribution of pathogenic bacteria in different TCM syndrome types.

【Key words】Diabetes mellitus;Lung infection;Pathogenic bacteria;TCM syndrome

糖尿病患者因其自身基础代谢紊乱、机体免疫力低下等原因容易并发各种感染。随着我国成人糖尿病患病率逐年升高，糖尿病合并感染的发生率亦随之升高。目前，临床上糖尿病患者常见的感染中以肺部感染发生率最高，糖尿病合并肺部感染的发生率约占所合并感染的45%[1]。糖尿病患者并发严重感染是导致糖尿病患者死亡的重要因素，如果对糖尿病合并肺部感染的情况不能采取有效干预，有可能加重患者病情，甚至威胁患者生命安全。因此，对糖尿病合并肺部感染患者的临床特点进行分析对其治疗及预后具有重要意义。本次研究选取……