Distribution And Correlation Analysis Of TCM Syndrome Types In Patients With Chronic Obstructive Pulmonary Disease Complicated With Osteoporosis

BACKGROUNDThe prevalence and mortality of chronic obstructive pulmonary disease(COPD)are increasing year by year around the world,seriously affecting the quality of life of patients and increasing the burden of public health,which has attracted the attention of many scholars.With the deepening of the current research,it’s found that complications have a far-reaching impact on the overall disease development and prognosis of patients with COPD.Osteoporosis(OP),as an important complication in patients with COPD,can potentially increase the number of acute episodes of COPD patients,aggravate the clinical symptoms of dyspnea in COPD patients,and then reduce the quality of life of patients,thus accelerating the disease process of patients and increasing their disability and mortality.Therefore,early diagnosis of COPD patients with OP is important for early intervention and treatment,blocking the further development of OP and preventing the occurrence of adverse events.OBJECTIVEThe purpose of this study is to investigate the distribution of TCM syndrome types in patients with and without OP,to compare and analyze the differences of functional examination,main laboratory indexes and TCM syndrome types between the two groups,and to explore the distribution law of TCM syndrome types in COPD patients with OP and its correlation with functional examination and main laboratory indexes,and,explore the risk factors of COPD combined with OP.METHODThis study uses cross-sectional research methods.According to inclusion and exclusion criteria,included in COPD patients from Xiyuan Hospital Respiratory ward between July 2018 to December 2020,divide into two groups according to Bone density test of the COPD patients.Collect and record the patient’s basic data,lung function,bone density,and main laboratory test indicators,combined with four clinics of TCM.Through the classification of TCM syndromes,mMRC grading and CAT scoring for patients,compare differences between groups.In addition,by making intra-group differences in the COPD group with osteoporosis.Further analyze the correlation between the above indicators and COPD patients with OP,and explore the risk factors of COPD combined with OP.RESULTS(1)Among the 199 COPD cases included,52 patients were diagnosed with OP,the ratio was 19.94%.(2)The distribution of TCM syndromes in 199 COPD patients is that the number of cases of Qi deficiency and phlegm stasis syndrome is the largest,accounting for 16.08%.The second is Yang deficiency phlegm coagulation syndrome,accounting for 13.07%.The deficiency of Qi and Yin Deficiency Syndrome is the least,accounting for 6.03%.In the group of COPD patients with OP,Qi deficiency and blood stasis syndrome are the most common,accounting for 17.3%,followed by Yin deficiency and blood stasis syndrome,accounting for 15.3%,and phlegm and blood stasis syndrome is the least common,accounting for 3.8%;In the group of COPD patients without OP,Qi deficiency and phlegm stasis syndrome are the most common,accounting for 15.6%,followed by Yang deficiency and phlegm coagulation syndrome,accounting for 13.6%,and Qi and Yin deficiency are the least common,accounting for 5.4%.There is no statistically significant difference in the distribution of TCM syndrome types between the two group(P>0.05).There was also no significant difference between the two groups of patients in the overall TCM syndrome distribution proportions of the empirical syndrome,the deficiency syndrome,and the syndrome of combination of both.In both groups,the syndromes of empirical syndromes are more common,followed by the deficiency syndromes,and finally the syndrome of combination of both.(3)The analysis between groups of COPD patients with OP found that there were 23 cases(44.2%)in the syndrome of deficiency and empirical,followed by 19 cases(36.5%)in the syndrome of deficiency,and 10 cases(19.2%)in the empirical syndrome.There are statistically significant differences in FEV]%pred,mMRC classification and bone mineral density among various syndrome types(P<0.05).COPD patients with syndromes of deficiency and empirical have FEV1%pred,higher mMRC grade,and lower bone mineral density.(4)Compared with COPD patients without OP,COPD patients with OP have lower FEV1%pred and FEV1/FVC levels,higher CAT scores,and more acute exacerbations within 1 year.(5)There was no statistically significant difference in inflammatory factors and serum calcium and phosphorus in COPD patients with OP group and without OP group(P>0.05).(6)The correlation analysis between the bone mineral density of COPD and OP patients and various factors showed that age,COPD course and FEV1%pred are correlated with bone mineral density.With the decrease of FEV1%pred,the increase of age and the course of COPD,the bone mineral density of COPD patients will also decrease.(7)The binary logistic regression analysis showed that age,gender,smoking,COPD course,inhaled corticosteroids,and the number of acute exacerbations in the past year are risk factors for COPD patients with OP.CONCLUSION(1)In COPD patients with OP group and without OP group,the syndromes of deficiency and empirical are the most common.Among them,the syndrome of qi deficiency and phlegm stasis is the most common,followed by the syndrome of yang deficiency,phlegm coagulation and lung,spleen and kidney deficiency.(2)COPD patients with OP have more acute exacerbations in 1 year than patients without COPD,the degree of lung function decline is greater,the health level and the quality of life are worse,the above factors may increase the disability rate and mortality of COPD patients.(3)The bone mineral density of patients in the COPD combined with OP group is related to age,COPD course and FEV1%pred,indicating that the severity of OP is closely related to age,COPD course and severity.(4)Increased age,female sex,long course of COPD,smoking,inhaled corticosteroids,more acute exacerbations in the previous year,high CAT score and low FEV1%pred may be risk factors for COPD patients with OP.