休克病人陰陽辨證與疾病嚴重度的臨床觀察

The Relationship between Yin-Yang Pattern and Several Disease Severity Scoring Systems in Shock Patients

劉亮吟(Liang-In Liu) ； 史麗珠(Lai-Chu See) ； 張厚台(Hou-Tai Chang) ； 陳運嵩(Yun-Sung Chen) ； 游智勝(Jyh-Sheng You)

《Mid-Taiwan Journal of Medicine》 13卷4期 (2008/12) Pp. 194-199

https://doi.org/10.6558/MTJM.2008.13(4).4

摘要

背景／目的　經由休克病人的臨床觀察，歸納提出陽證和陰證在現代重症病人可應用的診斷指標，並將該診斷指標和西醫一些疾病嚴重度評分系統作比較。
方法　採橫斷面觀察型研究。收集台灣亞東紀念醫院內科加護病房休克病人，處於休克狀態或因休克使用升壓劑，發病一週以內者，共116人。同時記錄中醫陰陽辨證及西醫疾病嚴重度(LOD、APACHE Ⅱ、APACHE Ⅲ)，統計分析中醫辨證及西醫疾病嚴重度的相關性。
結果　LOD評分的疾病嚴重度由輕到重依序爲陰陽混合、偏陽證、偏陰證，APACHE Ⅱ及APACHE Ⅲ的疾病嚴重度由輕到重依序爲偏陽證、陰陽混合、偏陰證，偏陰證的疾病嚴重度都較偏陽證嚴重。西醫生理變數中以腎系（尿素氮、肌酐酸、每日尿）和休克陰陽辨證最有關聯。
結論　休克陰陽辨證和疾病嚴重度有相關性存在。

關鍵字

休克 ； 陰陽 ； 疾病嚴重度評分系統

並列摘要

Background/Purpose. To propose a diagnostic criterion based on yin and yang patterns in shock patients and to compare these patterns with the LOD, APACHE Ⅱ, and APACHE Ⅲ severity scoring systems.
Methods. The study group comprised 116 shock patients recruited from the medical intensive care unit of the Far Eastern Memorial Hospital in Taiwan. The yin-yang patterns and severity scoring systems (LOD, APACHE Ⅱ, APACHE Ⅲ) were simultaneously recorded in order to analyze their correlation.
Results. Low LOD scores corresponded with the yin-yang mixed pattern; moderate LOD scores correlated with a yang pattern; and high LOD scores were associated with a yin pattern. Low APACHE Ⅱ and APACHE Ⅲ scores corresponded with a yang pattern; moderate APACHE Ⅱ and APACHE Ⅲ scores correlated with a yin-yang mixed pattern; and high APACHE Ⅱ and APACHE Ⅲ scores were associated with a yin pattern. The yin pattern corresponded with greater severity of illness than the yang pattern in all severity scoring systems. The kidney function parameters, including BUN, creatinine, and urine output, correspond with the yin-yang pattern identification.
Conclusion. The yin-yang pattern correspond with the LOD, APACHE Ⅱ, and APACHE Ⅲ severity scoring systems.

並列關鍵字

Shock ； yin yang ； severity scoring systems