| Objective:To explore the distribution of TCM patterns in the risk window period of acute exacerbation of COPD complicated with chronic cor pulmonale as a whole and based on GOLD2017 group assessment in Qinghai area;and to analyze the relationship between TCM patterns and demographic data with clinical objective indicators.Methods:Patients with COPD complicated with chronic cor pulmonale who were hospitalized in the outpatient department of pulmonology department of Qinghai Provincial Hospital of Traditional Chinese Medicine or admitted to hospital or referred to the department of pulmonology from other departments for 24 months were included.Demographic data and clinical objective indicators was collected,the information of four diagnostic methods of TCM was collected and classified according to patterns differentiation.The distribution of TCM patterns as a whole and assessed by GOLD2017 groupings was counted,and the correlation between TCM patterns and demographic data with clinical objective indicators was statistically analyzed.Results:(1)Among 491 patients in the risk window period of acute exacerbation of COPD complicated with chronic cor pulmonale in Qinghai area,19 cases(3.87%)of phlegm-drinking and lung-spleen-qi deficiency pattern were identified,and 57cases(11.61%)were phlegm-drinking and lung-kidney-qi deficiency pattern,25 cases(5.09%)were phlegm-drinking and lung-kidney yin deficiency pattern,45 cases(9.16%)were phlegm-drinking and heart-kidney-yang deficiency pattern;31 cases(6.31%)were phlegm-draining and lung-spleen-qi deficiency pattern,40 cases(8.15%)were phlegm-draining and lung-kidney-qi deficiency pattern,20 cases(4.07%)were phlegm-draining and lung-kidney yin deficiency pattern,25 cases(5.09%)were phlegm-draining and heart-kidney-yang deficiency pattern;40 cases(8.15%)were phlegm and blood stasis with lung-spleen-qi deficiency pattern,86 cases(17.52%)were phlegm and blood stasis with lung-kidney-qi deficiency pattern,29 cases(5.91%)werephlegm and blood stasis with lung-kidney yin deficiency pattern,28 cases(5.70%)were phlegm and blood stasis with heart-kidney-yang deficiency pattern,others were 46 cases(9.37%).(2)Phlegm-drinking with deficiency pattern was negatively correlated with peripheral blood red blood cell count,hemoglobin and mean erythrocyte hemoglobin;Phlegm-draining with deficiency pattern were positively correlated with platelet count,fibrinogen and D-dimer,respectively,it were negatively correlated with prothrombin time and thrombin time;Phlegm and blood stasis combined with deficiency pattern were positively correlated with hemoglobin;Phlegm and blood stasis combined with deficiency pattern was positively correlated with CD3~+,CD3~+CD4~+,CD3~+CD8~+of peripheral blood T lymphocyte subsets respectively;Heart-kidney-yang deficiency combined with demonstration pattern was positively correlated with CD3~+,CD3~+CD4~+,CD3~+CD8~+.(3)Through the GOLD2017 group evaluation of the collected 491 clinical cases,the distribution of patterns in each group shows that there are at most 284 cases(57.84%)in group D,among which the common patterns include phlegm and blood stasis with lung-kidney-qi deficiency pattern,phlegm-drinking and lung-kidney-qi deficiency pattern,phlegm-drinking and heart-kidney-yang deficiency pattern;followed by 49 cases(9.98%)in group B,among which the common patterns were phlegm and blood stasis with lung-kidney-qi deficiency pattern,phlegm-drinking and lung-kidney-qi deficiency pattern and phlegm-draining and lung-spleen-qi deficiency pattern;43 cases(8.76%)in group C,among which the common patterns were phlegm and blood stasis with lung-spleen-qi deficiency pattern,phlegm and blood stasis with lung-kidney-qi deficiency pattern;there were at least 9 cases in group A(1.83%).Conclusion:(1)The most common TCM pattern in the risk window period of acute exacerbation of COPD complicated with chronic cor pulmonale is phlegm and blood stasis with lung-kidney-qi deficiency pattern in Qinghai area.(2)Patients with phlegm-drainage and deficiency pattern are more likely to have abnormal coagulation function and even the risk of pulmonary vascular thrombosis;The degree of blood viscosity increased in patients with phlegm and blood stasis with deficiency pattern;Phlegm and blood stasis with deficiency pattern and heart-kidney-yang deficiency with demonstration pattern are more likely to have abnormal autoimmune function.(3)Most of the patients in the risk window period of acute exacerbation of COPD complicated with chronic cor pulmonale in Qinghai area are in group D of the GOLD2017,and the most common TCM pattern is the phlegm and blood stasis with lung-kidney-qi deficiency pattern. |
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