| Objective:To explore the distribution characteristics of TCM syndromes of COPD complicated with type 2 diabetes mellitus and its correlation with clinically relevant indicators,deepen the understanding of COPD,and provide ideas and methods for improving the accuracy of dialectical treatment.Methods:Using the method of retrospective study,by retrieving the electronic medical records of the Affiliated Hospital of Shandong University of Traditional Chinese Medicine,including patients with COPD complicated type 2 diabetes who met the inclusion criteria from January 2019 to January2022 inpatient treatment in the Department of Respiratory and Critical Care Medicine and Endocrinology,the clinical data of patients was collected,and the clinical information collection form was formulated and filled in.Sp SS24.0 software was used to cluster the collected clinical information,and the cluster results were named dialectically,so as to complete the identification of patients with comorbidities,and then statistically analyze the distribution of the syndrome in terms of gender,age,onset season,smoking history,underlying disease,length of hospitalization,laboratory examination,pulmonary auscultation and pulmonary function examination.Results:1.General data: A total of 125 patients with COPD and type 2 diabetes mellitus were included in this study,including 98 males and 27 females,with a male-to-female ratio of 3.6:1.The median age was(69.58±8.22)years.The average length of hospital stay was(14.31±3.85)days.There were more patients with a history of smoking in the past,accounting for 70.4%.In the spring and winter,there were more people who were admitted to the hospital for treatment,accounting for 34.4% and 28.8% respectively.The top three common underlying diseases were hypertension,coronary heart disease,and cerebrovascular disease.Pulmonary auscultation was most commonly caused by crackles,accounting for 32.0%.Tongue images were mainly red tongue(36.8%),white moss(53.6%),and greasy moss(60%),and the veins were more common in slippery veins(51.2%)and chord veins(42.4%).22 patients(16.7%)WBC were in an elevated state,54 patients(43.2%)were in an elevated state,115patients(92.0%)had PLT in the normal range,42 patients(33.6%)had an elevated hs-CRP,and 47 patients(37.6%)had an elevated D-D.96 patients(76.8%)had elevated FPG,121(96.8%)had elevated 2h PBG,and 117(93.6%)had elevated Hb A1 c.Moderate airflow restriction was present in 44.0% of patients and severe airflow restriction in 52.8% of patients.2.Characteristics of the distribution of TCM certificate typesIn 125 patients with chronic obstructive pulmonary disease and type 2diabetes,the TCM syndromes were classified according to frequency from large to small: 49 cases(39.2%)of lung and spleen deficiency and sputum turbidity,27 cases of hepatic fire inflammation and sputum fever(21.6%),21 cases of sputum stasis mutual evidence(16.8%),11 cases of wind chill lung evidence(8.8%),and 17 cases of liver and kidney yin deficiency evidence(13.6%).In this study,the evidence of pulmonary and spleen deficiency and sputum turbidity was the most common clinical manifestation,followed by hepatic fire inflammation combined with sputum fever and sputum stasis.In terms of sex and age distribution,there was no statistical significance between the various types(P>0.05),and the patients of each type were more "male".The average age of each type of evidence was more than 60 years old,and the age group of each type was the most 61-90 years old;the difference between the types of evidence in the distribution of the incidence season was not statistically significant(P>0.05),but according to this study,the good season of each type was slightly different,the lung and spleen deficiency and sputum turbidity certificate and phlegm stasis were more common in "spring",the liver fire inflammation and sputum fever certificate were more frequent in "winter",and the wind cold lung and liver and kidney yin deficiency were more frequent in "spring" and "winter";There were no statistically significant differences in the distribution of hypertension,coronary heart disease and cerebrovascular disease between the various types(P>0.05),but according to this study,the lung and spleen deficiency and sputum turbidity and wind chill lung were more common in "hypertension",hepatic fire inflammation combined with sputum fever and liver and kidney yin deficiency were more common in "hypertension" and "coronary heart disease",and sputum stasis was mutually confirmed by "hypertension" and "cerebrovascular disease";in terms of the distribution of length of hospitalization,the difference between the various types was not statistically significant(P>0.05),and the average length of hospital stay of each certificate type was more than 10 days.There was no statistical significance in the distribution of smoking history between the various types(P>0.05),but the various types of evidence were mostly in patients with "smoking history";the differences between the various types were not statistically significant in the distribution of auscultation rales in the lungs(P>0.05),the evidence of lung and spleen deficiency and phlegm turbidity accounted for the largest proportion of "wet rales",the liver fire inflammation and sputum fever and liver and kidney yin deficiency evidence accounted for more "dry rales",the sputum stasis mutual evidence was more likely to be "no rales" and "wet rales",and the wind and cold lung evidence was more likely to be "no rales" and "dry rales";In terms of laboratory examinations,the level of WBC in the five types of hepatic inflammatory inflammation and sputum fever and hepatic and renal yin deficiency was higher than that of other types,and the WBC level of wind chill lung evidence was the lowest,and the difference was statistically significant(P<0.05);the NEUT% level of hepatic fire and sputum fever was the highest,and the NEUT%level of wind chill lung syndrome was the lowest.The difference was statistically significant(P < 0.05);the PLT level of hepatic fire inflammation and sputum fever was higher than that of other types,and the PLT level of lung and spleen and sputum turbidity was the lowest,and the difference was statistically significant(P<0.05);the hs-CRP level of lung and spleen deficiency and sputum turbidity was lower than that of other types,and the hs-CRP level of hepatic fire and sputum fever was higher than that of other types,but the distribution of hs-CRP between each type was not statistically significant(P>0.05);The D-D level of hepatic and renal yin deficiency is higher than that of other types,and the D-D level of hepatic inflammatory inflammation and sputum fever was lower than that of other types.The distribution difference between the various types in D-D was not statistically significant(P>0.05);the FPG level of hepatic and renal yin deficiency was higher than that of other types,the FPG level of the wind and cold lung syndrome was lower than that of other types,the distribution difference between different TCM types in FPG was not statistically significant(P>0.05);the 2h PBG level of the wind chill lung syndrome was lower than that of other types,and the distribution difference between the2 h PBG level of each syndrome was not statistically significant(P>0.05);the Hb A1 c level of sputum and stasis mutual syndrome was higher than that of other types,and the distribution difference between the different types in Hb A1 c was statistically significant(P < 0.05);In terms of pulmonary function indicators,there were no significant differences in the distribution of FEV1%,FEV1/FVC% and GOLD grades between different TCM types(P>0.05).The FEV1%level of liver and kidney yin deficiency was lower than that of other types,and the distribution difference between different TCM types in FEV1% was not statistically significant(P>0.05);the level of FEV1/FVC% of sputum stasis was higher than that of other types,and the level of FEV1/FVC% of hepatic and renal yin deficiency was lower than that of other types,but the distribution difference between different TCM types in FEV1/FVC% was not statistically significant(P>0.05);the lung and spleen deficiency and sputum turbidity and hepatic fire inflammation and sputum fever accounted for more in GOLD 2,the lung and spleen deficiency and sputum turbidity certificate accounted for the largest proportion in GOLD 3,the wind chill lung certificate accounted for the least proportion in GOLD 3,and the lung and spleen two deficiency and sputum turbidity certificate accounted for the largest proportion in GOLD 4,but the distribution difference between different TCM certificate types in GOLD grade was not statistically significant(P>0.05).Conclusion:1.General data analysis: COPD combined with type 2 diabetes patients are mainly male,the age is mainly over 60 years old,most patients are hospitalized for more than 10 days,there are more patients with smoking history,the onset season is concentrated in spring and winter,the underlying diseases are most common in hypertension,coronary heart disease,cerebrovascular disease is the most common,and pulmonary auscultation is more common than crackles.Patients with red tongue,white and greasy moss,smooth pulse strings are more common,and the sputum fever is obvious.COPD combined with type 2diabetes patients are often accompanied by inflammatory reactions,poor glycemic control,and pulmonary function is dominated by moderate and severe airflow restriction.2.Analysis of the distribution characteristics of traditional Chinese medicine certificates: COPD combined with type 2 diabetes mellitus is mostly in the middle of the virtual,there are 5 common types of evidence: lung and spleen two deficiency and sputum turbidity evidence > liver fire inflammation and sputum fever evidence > sputum stasis mutual evidence > wind cold lung evidence > liver and kidney yin deficiency evidence.the evidence type is the most common in the lung and spleen and the sputum turbidity,and the long-term deficiency of the sick body,mixed with sputum,heat and blood stasis are important pathological factors and pathogenesis characteristics of patients with comorbid diseases.The distribution differences between the five types in WBC,NEUT%,PLT and Hb A1 c are statistically significant,while the distribution differences in the remaining research factors such as FPG,2h PBG,pulmonary auscultation,and pulmonary function tests are not statistically significant,and further research and analysis are needed. |
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