A Primary Study On The TCM Differentiation Of Symptoms And Signs In Acute Exacerbations Of COPD

ObjectiveTo explore the distribute regulation of TCM symptom-sign in acuteexacerbations of COPD, and the regulation of syndrome differentiation ofsymptom-sign which match TCM clinical practice. Then apply reference frame forclinical and basal study of COPD.MethodsOn the foundation which checks related articles and books extensively,combines the authoritative COPD symptom differentiation certificate of presentstage, and ask for exports' opinions, design "the form of retrospective studyfor COPD symptom-sign of TCM". According to decides the standard collection todiagnose the acute exacerbations of COPD patient to be in the first affiliatedhospital of Guangzhou University of Chinese Medicine 150 examples. The patientsby the clinical symptoms primarily, including rales, jugular vein, hemanalysisand blood gas analysis and so on, each observation target establishes the SPSSdatabase as the entry of variable computer, divides into regarding the symptomserious degree has not appeared, is mild, moderate, the specific weight fourlevels, uses 0, 1, 2, 3 values to express separately to the symptom which gradeswith difficulty divides into does not appear, appears respectively records is1, 1 values. After all symptoms, tongue, vein…etc, articles transformateclassifications change the deal, (0, 1…4..), Delete the occurrent frequencysmaller 5% or although over and above 5% little dialectical meanings of articles.The general information use descriptive statistics. All articals of symptomcollected, we analyse, by method of system cluster and sample cluster (the methodof ward), line up frequency and percentage of symptoms, tongue, vein…etc of everycluster, then decide the pattern of syndrome of every cluster, then decide the pattern of syndrome of every cluster category combining theory of TCM.ResultsPassing by cluster analysis, the TCM syndromes, physical sign, hemanalysisand blood gas analysis in the patients with the acute exacerbations of COPD caninclude to five type: First, it includes cough, cough up white phlegm, catch acold easily, gasping, aggravation actively, chest distress, cyanosis, lack ofpower, breathlessness, lower void, Dry mouth, ropyphlegm, red tongue, slide veinlike of string,…etc in variance, belonging to syndrome of deficiency of Qi andYin, phlegm stagnating lung dialectically; Second, it includes cough, cough upyellow ropy sputum, bitter taste of mouth, chest distress, catch a cold easily,lack of power, anorexia, waist and knee soreness, breathlessness, exhalation morethan inhalation, slender and rapid vein,…etc in variance, belonging to syndromeof deficiency of lung, spleen and kidney, phlegm-fieber stagnating lungdialectically; Third, it includes cough, cough up white phlegm, ropy phlegm,chest distress, grey vultus, slide vein like of string and so on in variance,belonging to syndrome of phlegm stagnating lung dialectically; Fourth, itincludes cough, cough up white phlegm, gasping, aggravation actively, catch acold easily, breathlessness, exhalation more than inhalation, lower void, waistand knee soreness, slide vein like of string and so on in variance, belongingto syndrome of deficiency of lung-Qi, and kidney-Qi, phlegm stagnating lungdialectically; Fifth, it includes cough, gasping, prostrating unably, chestdistress, cyanosis, wheezing tale, dark vultus, engorged jugular vein, catch acold easily, lack of power and so on in variance, belonging to syndrome ofdeficiency of lung-Qi, phlegm-blood stagnating lung dialectically.ConclusionCough, to cough up phlegm, gasping is the basic feature of symptoms, andcyanosis, catch a cold easily is also frequent symptoms. All syndromes includesyndrome of phlegm stagnating lung, it is in line with the characteristic thatsputum is the major pathological factor of Acute Exacerbations of COPD. It inducessyndrome of phlegm-blood when sputum and blood is incorporated, accumulation ofheat and sputum leads to syndrome of phlegm-fieber; in other word, the majorappearance of the disease is phlegm. Syndrome of deficiency of Qi is 72%,including syndrome of deficiency of Qi and Yin, phlegm stagnating lung, syndrome of deficiency of lung, spleen and kidney, phlegm-fieber stagnating lung, syndromeof deficiency of lung-Qi, and kidney-Qi, phlegm stagnating lung, syndrome ofdeficiency of lung-Qi, phlegm-blood stagnating lung, and so on. It verifies thefact that syndrome of deficiency of Qi is the capital factor in the essence ofacute exacerbations of COPD. Spleen is the foundation after birth, the sourceof Qi, blood and sputum, so when we are distinguishing and curing, it is correctthat the cure of pulmonary disease is based on the therapy of spleen. The elementaltherapy is invigorating spleen to remove phlegm, nourishing Yin, promoting bloodflow and cleaning pathogenic heat…etc is subsidiary.