Correlation Analysis And TCM Syndrome Research Of Chronic Obstructive Pulmonary Disease With Peripheral Arterial Disease

BackgroundChronic obstructive pulmonary disease(COPD),with increasingly incidence and mortality,indeed affect the health and quality of life of patients,and increase the economic and social burden.With deeper researches,more and more attention has been paid to acute exacerbation and comorbidities of COPD.Acute exacerbation of chronic obstructive pulmonary disease(AECOPD)will increase admission rate,mortality and medical expenditure.It is an important event in the course of COPD and seriously affects the health and prognosis of the patients.Comorbidities may have a significant impact on the disease course.Peripheral arterial disease(PAD)is one of the cardiovascular comorbidities of COPD.Many studies have shown that PAD may have significant implications for functional activity as well as quality of life in patients with COPD.In addition,with highly related to other cardiovascular diseases,PAD is of great significance to the prediction of severe cardiovascular comorbidities of COPD and adverse events.Traditional Chinese Medicine(TCM)thinks that COPD belongs to the category of "lung distension" and the asthenia in origin and excess in superficiality is the main pathogenesis.In the period of "Huangdi Neijing",TCM has put forward the view that lung disease will lead to poor blood circulation and vascular disease,which is consistent with the mechanism of patients with COPD combined PAD.Modern Chinese medicine used syndrome classification method to research COPD,making the understanding of etiology and pathogenesis more accurate and objective.ObjectiveThe purpose of this study is to explore the condition of patients with AECOPD combined PAD and the distribution characteristics of TCM syndrome type by combining the investigation related with PAD and TCM syndrome type in patients with AECOPD.MethodIn this study,prospective and cohort study methods were used.The patients with AECOPD in Department of respiration of Xiyuan Hospital were enrolled in this study.The PAD was diagnosed by Doppler ultrasound.The patients’ basic data and laboratory indexes were collected,and the syndromes of TCM,mMRC classification and CAT score were compared,and the differences were compared between the groups,and the correlation between the above indexes and the complication of PAD was analyzed.Result1)Among the 239 patients with AECOPD,61 patients diagnosed with PAD accounted for 25.5%.2)Compared with the control group,the patients in PAD group had more acute exacerbation times within 1 year(P=0.022);the proportion of grade 2 in mMRC classification was smaller(P=0.004),the proportion of grade 3 was greater(P=0.021)and CAT score was higher(P=0.043).The incidence of PAD was correlated with the number of acute exacerbations within 1 year and CAT score(P=0.01,r=0.166;P=0.01,r=0.167).3)Compared with the control group,the levels of PCT,HsCRP and D-Di in PAD group were higher(P=0.044,P=0.047,P=0.042).The incidence of PAD was correlated with PCT and TNF-a(P=0.002,r=0.200;P=0.002,r=0.199),and was correlated with D-Di(P=0.008,r=0.172),and was negatively correlated with IgA(P=0.035,r=-0.137).4)There was no significant difference in the total TCM syndromes between the two groups in the empirical,asthenia,deficiency and excess syndromes(P>0.05).In the proportion of specific empirical evidence,the proportion of phlegm and blood stasis syndrome in PAD group was higher(P=0.035),and the proportion of the remaining empirical syndrome type and specific deficiency syndrome type was not significantly different(P>0.05).5)Age and male sex(Smoking is more common)were risk factors for the incidence of PAD in patients with AECOPD(OR-1.06,P=0.002,OR=2.17,P=0.036).ConclusionThe results of this study show that PAD may make patients with COPD have more frequent acute exacerbation,worse health and quality of life,and may bring with higher levels of inflammatory response,risk of thrombosis and the risk of reducing the immune response,and the risk factors for older and sexually sexed men(Smoking is more common)may be the risk factors.TCM syndrome classification shows that the syndrome type is the main syndrome type of acute exacerbation of chronic obstructive pulmonary disease.The patients with acute exacerbation of chronic obstructive pulmonary disease with peripheral artery disease have a higher proportion of phlegm and blood stasis syndrome type,and there may be more pathological basis of blood stasis.