內科加護病房病人轉歸與中醫徵象的相關性

THE CORRELATION BETWEEN THE SIGNS OF TRADITIONAL CHINESE MEDICINE & PROGNOSIS OF PATIENTS IN MEDICAL INTENSIVE CARE UNIT

目的：評估內科加護病房病人轉歸的中醫徵象。方法：採前瞻性觀察型研究。收案病患來自亞東紀念醫院內科加護病房，共272人，分別記錄中醫徵象和追蹤預後，採用存活分析探討中醫徵象和轉歸的相關性。結果：死亡56人（20.6%），一週內死亡率14.0%，一個月內死亡率19.5%。內科加護病房病人轉歸差和面色白、口唇黯、舌紫、水腫、手足冰冷、脈細、脈沉或伏、脈弱、脈微、脈不能觸及呈正相關，和手足溫暖、脈滑呈負相關。其中出現手足冰冷、脈不能觸及、口唇黯的病人死亡風險較高。The purpose of this study was to evaluate the correlation between pattern identification and prognosis in severely ill patients. The study group comprised 272 severely ill patients recruited from the medical intensive care unit of the Far Eastern Memorial Hospital in Taiwan. The results showed that total mortality rate was 20.6%. The mortality rate within one week was 14.0% and within a month was 19.5%. Poor prognosis was correlated with white facial complexion, dark lip, purplish tongue, edema, cold extremities, fine pulse, deep or hidden pulse, weak pulse, faint pulse, and impalpable pulse. Good prognosis was correlated with warm limbs and slippery pulse. We draw the conclusions that the severely ill patients with cold limbs, impalpable pulse, and dark lip have higher hazard ratio of mortality.