| Objective:By studying the correlation between the distribution characteristics of TCM syndro me element and CAT score,BODE index,acute aggravation times and pulmonary functi on in the stable period of COPD,it is explored that the correlation between syndrome differentiation of traditional Chinese medicine and the condition of COPD in stable pe riod.By studying the distribution of TCM syndrome elements in different clinical chara cteristics.It provides theoretical basis for individualized syndrome differentiation and tre atment of the disease.Methods:In this cross-sectional study,180 COPD patients who met the criteria of inclusion was carried out clinical investigations。The doctor set up a file for each object of obs ervation.The file was including general information,TCM four diagnostic information,ba ric index,pulmonary function,mMRC dyspnea scale,results of a 6-minute walking test,an d drugs used in a stable period.The CAT score,the BODE index and the syndrome dif ferentiation of the TCM syndrome were filled in according to the patient’s condition.T he research studies the correlation between the distribution of the syndrome of TCM a nd the severity of the disease in the stable period of COPD.The patients were divided into different groups depending on the smoking,GOLD stages,acute exacerbation times and severity of symptoms.It is explored the distribution of TCM syndrome elements i n different groups.Results:1.During the stable period of COPD,the interpretation of cause is asthenia in origi n and sthenia in superficiality.Asthenia in origin is mostly deficiency of qi and deficie ncy of yang,often involving yin and blood with the progress of the disease.Sthenia in superficiality also involves phlegm,dampness and drink.The main viscera are the lung,h eart,kidney and spleen.2.Gold grade is positively correlated with kidney,phlegm,yang deficiency,lung,splee n,surface,qi deficiency.The order of correlation coefficient was: kidney,phlegm,yang defi ciency,lung,spleen,surface,qi deficiency.The highest correlation coefficient with kidney w as 0.42.There were differences in the distribution of syndrome elements among patient s with different GOLD grades.(1)GOLD Ⅰ: the disease was located in the lung,the sy mptoms of this deficiency and the standard reality were not obvious;(2)GOLD Ⅱ: the disease was mostly located in the lung,kidney and heart.The deficiency of this diseas e was mostly qi deficiency,yang deficiency,yin deficiency,phlegm and dampness were t he dominant sthenia pathogenic factors.(3)GOLD Ⅲ: most of the diseases were located in lung,kidney,heart.Qi deficiency and yang deficiency were the dominant factors in t his deficiency.phlegm and dampness were the dominant sthenia pathogenic factors in t his group.(4)GOLD Ⅳ: most of the diseases were located in the lung,kidney and hea rt.Qi deficiency,yang deficiency,yin deficiency were the dominant factors in this deficie ncy.phlegm was the dominant sthenia pathogenic factors in this group.3.FEF75%pre is negative correlated with kidney,yang deficiency,spleen and so on.The highest correlation coefficient with kidney was 0.553.FEF50%pre is negative correlated with kidney,spleen,yang deficiency and so on.The highest correlation coefficient with kidney was 0.457.FEF25%pre is negative correlated with spleen,yang deficiency,k idney and so on.The highest correlation coefficient with spleen was 0.474.MMEFpre is negative correlated with spleen,kidney,phlegm and so on.The highest correlation coeffi cient with spleen was 0.43.4.The score of TCM syndrome elements can reflect the change of BODE index t o a certain extent.The BODE index grade is positively correlated with kidney,surface,s pleen and so on.The highest correlation coefficient with kidney was 0.623.The distribut ion of syndrome elements in patients with different BODE index grades was different.The disease of BODE index grade Ⅰwas mostly located in the lung and kidney.Qi defi ciency was dominant factors.Phlegm and dampness were the dominant sthenia pathogen ic factors in this group.The disease of BODE index grade Ⅱ was mostly located in th e lung and heart.Yang deficiency and qi deficiency were dominant factors in this grou p.Phlegm and drink-based were the dominant sthenia pathogenic factors in this group.T he disease of BODE index grade Ⅲwas mostly located in the lung,kidney and hear.Yang deficiency and qi deficiency were dominant factors in this group.cold,wet,phlegm,drink-based were the dominant sthenia pathogenic factors in this group.The disease of BODE index grade Ⅳ was mostly located in the lung,kidney,heart and spleen.Yang de ficiency and qi deficiency were dominant factors in this group.phlegm and dampness were the dominant sthenia pathogenic factors in this group.5.The integral of TCM syndrome element can reflect the changes of CAT score,mMRC score and acute aggravation times to a certain extent.Cat score is correlated w ith heart and kidney in the disease position.Phlegm is the main sthenia pathogenic fact or.Qi deficiency and yang deficiency are the dominant factors in this deficiency,MMR C score is correlated with heart and kidney in the disease position.Phlegm is the main sthenia pathogenic factor.Qi deficiency and yang deficiency are the dominant factor s in this deficiency,Acute exacerbation times is correlated with kidney and heart in the disease position.Yang deficiency is the dominant factor in this deficiency.Blood stasis is the main sthenia pathogenic factor.6.The distribution characteristics of syndrome elements were different in different COPD stable period groups.(1)Most of the patients in group A were located in the lu ng,kidney.Qi deficiency and yang deficiency were the dominant factors in this deficien cy.Phlegm and dampness were the dominant sthenia pathogenic factors.(2)In group B,most of the patients were located in lung,kidney and heart.Qi deficiency,yang deficienc y and yin deficiency were the dominant factors in this deficiency.(3))In group C,most of the patients were located in lung,kidney and spleen.Qi deficiency and yang deficien cy were the dominant factors in this deficiency.Phlegm,dampness and cold were the d ominant sthenia pathogenic factors.(3))In group D,most of the patients were located inl ung,kidney,heart,spleen.Qi deficiency,yang deficiency and yin deficiency were the domi nant factors in this deficiency.phlegm,dampness and drink-based were the dominant sth enia pathogenic factors.7.Under different smoking conditions,there are some differences in the distribution of syndrome elements in patients.(1)Non-smoking group: most of the patients were l ocated in the lung and kidney,Qi deficiency and yang deficiency were the dominant fa ctors in this deficiency.Phlegm and dampness were the dominant sthenia pathogenic fa ctors.(2)Not quitting smoking group:most of the patients were located in the lung and kidney,Qi deficiency,yang deficiency and yin deficiency were the dominant factors in t his deficiency.Phlegm and dampness were the dominant sthenia pathogenic factors.(3)Q uitting smoking group:most of the patients were located in the lung kidney and heart,Qi deficiency,yang deficiency and yin deficiency were the dominant factors in this def iciency.Phlegm,dampness and drink were the dominant sthenia pathogenic factors.8.The patients were divided into four groups: LAMA group,LABA+ICS group,co mbination of three drugs group and oral theophylline group according to the drug use scheme of stable COPD.It was found that the oral theophylline group was often mor e serious in the four group.At the same time,there were some differences in the distri bution of syndrome elements among the four groups.(1)LAMA group: most of the pa tients were located lie in the lung and kidney.Qi deficiency,yang deficiency and yin d eficiency were the dominant factors in this deficiency.Phlegm,heat and dampness were the dominant sthenia pathogenic factors.(2)LABA+ICS group: most of the patients we re located lie in the lung,kidney,heart and spleen.Qi deficiency and yang deficiency we re the dominant factors in this deficiency.Phlegm,cold and dampness were the dominan t sthenia pathogenic factors.(3)Combination of three drugs group: most of the patients were located lie in the lung,kidney and heart.Qi deficiency and yang deficiency were the dominant factors in this deficiency.Phlegm and dampness were the dominant sthe nia pathogenic factors.(4)Oral theophylline group:most of the patients were located lie in lung,kidney,heart,spleen and surface.Qi deficiency,yang deficiency and yin deficienc y were the dominant factors in this deficiency.Phlegm,drink and dampness were the d ominant sthenia pathogenic factors.Conclusion:1.During the stable period of COPD,the interpretation of the cause is asthenia in origin and sthenia in superficiality.most of the diseases were located in the lung,heart,kidney and spleen.Qi deficiency,yang deficiency,yin deficiency were the dominant facto rs in this deficiency.Phlegm,drink and dampness were the dominant sthenia pathogeni c factors in this group.2.The integral of TCM syndrome can reflect the severity of COPD stable patient s.3.The distribution characteristics of TCM syndrome elements in different clinical c haracteristics were different.The comprehensive evaluation index of COPD stable period can be combined with TCM syndrome element dialectics to provide better individuali zed dialectical treatment for patients with COPD stable period. |
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