| Background:The respiratory function of Fei Zang in TCM means that the Fei Zang are in charge of breathing.Through breathing exercises,they can inhale the clear air in the natural world and exhale the muddy air in the body to realize the function of gas exchange between the body and the outside.The respiratory function of Fei Zang in TCM corresponds to the function of the respiratory system of modern biomedicine to breathe under the regulation of neurohumoral.The process of breathing in the Fei Zang of TCM is actually equivalent to the process of external breathing in biomedicine.The Fei Zang in TCM mainly include the respiratory system and skeletal muscles,bones,bone connections,and smooth muscles involved in breathing.At the same time,the respiratory function of Fei Zang in TCM is also regulated by the corresponding neurohumoral.Abnormal respiratory function of Fei Zang can lead to a variety of respiratory diseases,such as wheezing,asthma,and lung distension,etc.Respiratory diseases are the most frequent among human diseases and are the leading killer endangering human health.It is of great practical significance to realize the objective evaluation of the abnormal respiratory function of Fei Zang in TCM,early identification of abnormalities of the respiratory function of Fei Zang,early intervention and conditioning to prevent them from developing into diseases.The current medical model is undergoing a transition from disease medicine to health medicine.In the context of general health as a national strategy,people’s focus has gradually shifted from paying attention to disease to paying attention to health,and from paying attention to structure to function.TCM attaches importance to the whole,the function,the differentiation of symptoms and signs,and it has good intervention and conditioning methods for abnormal changes in the respiratory function of Fei Zang.However,since the current evaluation of the abnormal respiratory function of Fei Zang in TCM mainly relies on the subjective evaluation of looking,smelling,asking,and pulse feeling and palpation.Some objective measures used in modern biomedicine such as pulmonary function tests,respiratory function monitoring,etc.,one is a short-term test under specific conditions(eg,hospital,laboratory,etc.)and the other,although long-term monitoring,cannot be applied in the daily state because it is.mainly aimed at vital sign monitoring in critically ill patients.So all can’t reflect the diagnosis and treatment characteristics of TCM,they cannot carry the application as usual,and TCM lacks objective detection tools and methods with its own characteristics,which becomes one of the urgent problems to be solved on the modernization road of TCM.As a part of the national key research and development plan "Wearable Five Zang Functional Situation Monitoring Equipment Key Technology Research(2019YFC1711700)" project,this research conducted an exploratory study on the observation and evaluation of the abnormal respiratory function of Fei Zang in TCM with TCM characteristics.Objective:To study the symptoms and symptom characteristics,syndrome characteristics and pathogenesis explanations of abnormal respiratory function of Fei Zang,and clarify the diagnosis and treatment characteristics of TCM;Under the guidance of TCM theory,the use of a piezoelectric ceramic sensor-based respiratory motion detection device to carry out long-term real-time non-invasive detection of the respiratory function of Fei Zang in TCM in the natural state,and realize the objective evaluation of the abnormal respiratory function of Fei Zang with the characteristics of TCM.Realize the objective evaluation of the abnormal respiratory function related symptoms and syndromes of Fei Zang.Method:(1)Research on the Symptoms and Syndromes of the Abnormal Respiratory Function of Fei ZangThis study first conducted in-depth data mining on the historical database of TCM medical records.Under the guidance of TCM theories,using methods such as Φ correlation analysis,the study combed the symptoms and clinical features(including the location of symptoms,the nature of symptoms,and the factors that aggravate symptoms)of abnormal respiratory function of Fei Zang.Secondly,based on the TCM symptom and pathogenesis database,using methods such as induction and summarization,research and sort out the syndromes of abnormal respiratory function of Fei Zang,and establish the corresponding relationship between the syndromes and symptoms and their clinical characteristics,and give the corresponding pathogenesis.These provide theoretical guidance for the next step of clinical experimental research,and provide theoretical basis for exploring a method of objective evaluating of the abnormal respiratory function of Fei Zang with the characteristics of TCM diagnosis and treatment.(2)Experimental Study on Objective Evaluation of Abnormal Respiratory Function of Fei Zang in TCMThis study collected the basic information of subjects,and was based on the clinical observation table of abnormal respiratory function of Fei Zang and the dialectical results of multiple TCM experts.Participants were divided into groups with normal and abnormal respiratory function of Fei Zang,the related symptomatic and non-symptomatic groups,the related syndrome and non-symptomatic groups of abnormal respiratory function of Fei Zang.Using a respiration detection device based on a piezoelectric ceramic sensor,a long-term real-time non-invasive detection of the subject’s breathing during sleep is carried out in a natural state,and long-term breathing data of the subject is collected.Visual Basic 6.0 and Matlab 2014b software were used for data analysis.In order to ensure the comparability of breathing data between groups,this study uniformly extracted 5 hours of sleep breathing data for each subject.Recognize the subject’s breathing waveform from the sleep breathing data,draw a breathing scatter diagram with the distance between the apexes of consecutive adjacent breathing waveforms as the horizontal and vertical coordinates for nonlinear analysis,and extract the breathing waveform and related parameters of the respiratory scatter diagram.For the extracted respiratory parameters and respiratory scatter diagrams,quantitative and qualitative methods are used for research respectively.In SPSS 24.0 software,t-test and non-parametric test were used to study the differences in respiratory parameters between the two groups;the ROC curves were constructed for respiratory parameters with significant differences between the two groups to study the effects of respiratory parameters on abnormal respiratory function of Fei Zang,Independent diagnostic value of abnormal respiratory function related symptoms and syndromes of Fei Zang,and visualize the diagnostic value;The non-conditional Logistic multiple stepwise regression analysis method was used in SAS 6.12 statistical software to study the comprehensive diagnostic value of respiratory parameters for abnormal respiratory function of Fei Zang,abnormal respiratory function related symptoms and syndromes of Fei Zang,and establish a diagnostic model.Qualitatively analyze the graphical characteristics of the respiratory scatter diagram,and explore its intrinsic physiological and pathological significance.Results:(1)The Research Results of Symptoms and Syndromes of the Abnormal Respiratory Function of Fei Zang in TCM①The symptom units of abnormal respiratory function of Fei Zang are mainly cough,shortness of breath,dyspnea,rough breathing,hemoptysis,phlegm in the throat,chest pain,chest tightness,barrel chest,shortness of breath;Symptomatic site of abnormal respiratory function of Fei Zang are mainly the throat,chest,and nose;The nature of the symptoms of abnormal respiratory function of Fei Zang are mainly sputum,shortness of breath,dyspnea,rough breathing,sticky texture,hoarseness,thick texture,foaming,heavy voice turbidity,open mouth and shoulders,paroxysmal,taste fishy,low voice,smelly,red color,clear quality,unsmooth,yellow and white,less breathing,rusty color,green color,salty taste,shortness of breath,mouth opening,green color,red crimson,pus and blood,less air,cough such as dog barking,pus,small amount,bright red,smelly smell;the main factors for relieving symptoms of abnormal respiratory function of Fei Zang are aggravated cough,aggravated at night,aggravated in the afternoon,relieved in daylight,aggravated in ash,aggravated in the morning,The evening becomes worse and breathing becomes worse.②There are various syndromes of abnormal respiratory function of Fei Zang,including exogenous syndromes such as wind cold invading the Fei Zang,wind dryness insulting the Fei Zang,as well as internal injury syndromes such as phlegm-dampness accumulating the Fei Zang,and deficiency of the Fei Zang-qi and Pi Zang-qi.The disease is mainly located in the lungs.Involving the other four Zang.Symptoms of abnormal respiratory function of Fei Zang can appear in a variety of syndromes,and the clinical features(including the nature of symptoms,the location of symptoms,and the remission factors of symptoms)in different syndromes are also different,and the etiology and pathogenesis are complex and different.Therefore,modern biomedicine commonly used short-term(Clinical respiratory monitoring is a long-term test,but because it is mainly for vital signs monitoring of critically ill patients,it cannot be used in the daily state)under specific conditions(such as hospitals,laboratories,etc.)The test cannot fully reflect the characteristics of TCM syndromes of the abnormal respiratory function of Fei Zang,so it is difficult to learn from and apply.(2)Experimental Research Results of Objective Evaluation of Abnormal Respiratory Function of Fei Zang①In this study,523 people were collected for long-term sleep breathing data.Subjects with incomplete clinical observation table data and respiratory data less than 5 hours were excluded,leaving 397 cases.Use propensity scores and other methods to match the gender,age,weight,height,and other underlying diseases of subjects with normal respiratory function of Fei Zang and subjects with abnormal respiratory function of Fei Zang.The final statistical sample number included was 145 patients in the respiratory function abnormality group,including 62 males(42.76%),83 females(57.24%),average age(61.83±13.46)years,average height(164.86±6.62)cm,average Body weight(65.79±11.08)kg.There were 145 patients in the normal respiratory function group,including 58 males(40.00%)and 87 females(60.00%).The average age was(60.10±14.47)years,the average height was(165.23±7.16)cm,and the average weight was(65.33±10.03)kg.There was no significant difference between the two groups in terms of gender,age,height,weight,and other underlying diseases after statistical testing(p>0.05),and the two groups were comparable.②According to the clinical observation table of abnormal respiratory function of Fei Zang in TCM,the common symptoms of 145 subjects with abnormal respiratory function of Fei Zang were sorted and counted.The results found that the incidence of 6 symptoms of sputum expectoration,cough,wheezing,tightness of the chest and diaphragm,suffocation,and dyspnea was higher,of which cough Phlegm,cough,and wheezing are objective symptoms,and the chest and diaphragm are full of tightness,suffocation,and dyspnea are subjective symptoms.The subjects with abnormal respiratory function of Fei Zang were divided into groups according to the above 6 symptoms.From 145 subjects with normal respiratory function of Fei Zang,the populations whose basic information such as gender,age,and height in the above 6 symptom groups were consistent with the baseline were matched.After baseline matching,the situation of each group is as follows:100 people in the sputum expectoration group and 145 people in the non-sputum expectoration group,245 people in total;94 people in the cough group and 94 people in the non-cough group,184 people in total;83 people in the wheezing group and 83 people in the non-wheezing group,166 people in total;There were 80 people in the dyspnea group and 80 people in the non-thoracic-diaphragmatic group,a total of 160 people;58 people in the suffocation group and 145 people in the non-breathing group,203 people in total;30 people in the dyspnea group and 145 people in the non-dyspnea group,175 people in total.There was no significant difference between the two groups in terms of gender,age,height,weight,and other underlying diseases after statistical testing(p>0.05),and the two groups were comparable.③In the analysis of TCM syndromes in 145 subjects with abnormal respiratory function of Fei Zang,it was found that phlegm and blood stasis obstructing the Fei Zang,pulmonary Pi Zang qi deficiency syndrome(8.97%),phlegm stasis obstructing the Fei Zang syndrome(8.28%),phlegm stasis obstructing the Fei Zang,Fei Zang and Shen Zang qi deficiency syndrome(8.28%),phlegm-heat accumulating Fei Zang syndrome(6.90%)occurred more frequently.However,due to the scattered distribution of TCM syndrome types of subjects with abnormal respiratory function of Fei Zang,the sample size of each group is too small,and relevant research cannot be grouped according to TCM syndromes.Based on this situation,this study extracted the relevant syndrome elements from the TCM syndromes of abnormal subjects in accordance with the TCM syndrome element extraction standards,it was found that the main disease elements of the subjects with abnormal respiratory function of Fei Zang were:Fei Zang,Pi Zang,Shen Zang,Gan Zang,etc.The main disease elements were phlegm,qi deficiency,blood stasis,heat,etc.Yang deficiency and so on.Among them,the three groups of phlegm syndrome,qi deficiency syndrome and blood stasis syndrome have the most samples.Therefore,from the 145 subjects with normal respiratory function of Fei Zang,the populations with the same baseline information as gender,age,and height of the phlegm syndrome group,qi deficiency syndrome group,and blood stasis syndrome group were matched.After baseline matching,82 persons in the phlegm syndrome group and 145 persons in the non-phlegm syndrome group,totaling 227 persons;70 persons in the qi deficiency syndrome group and 70 persons in the non-qi deficiency syndrome group,totaling 140 persons;45 persons in the blood stasis syndrome group and 145 persons in the non-stasis syndrome group People,a total of 190 people.There was no significant difference between the two groups in terms of gender,age,height,weight,and other underlying diseases after statistical testing(p>0.05),and the two groups were comparable.④The results of comparative statistical analysis of respiratory parameters between the normal and abnormal respiratory function of Fei Zang,the related symptomatic and non-symptomatic groups,the related syndromes and the non-symptomatic groups of abnormal respiratory function of Fei Zang showed:except for the RSPA,RR,TI,TE,RC,RBR,DBR,IS:ES,IA:EA,I:E,CD,LA,SA,a total of 12 respiratory parameters have significant differences,indicating that the respiratory function of each group of people with abnormal respiratory function is more rapid than the normal population,the airflow patency during inhalation and exhalation is worse,and the respiratory rhythm is uneven.⑤The ROC curves were constructed for the respiratory parameters with significant differences between these groups(the normal and abnormal respiratory function of Fei Zang,the related symptomatic and non-symptomatic groups,the related syndromes and the non-symptomatic groups of abnormal respiratory function of Fei Zang),and the results showed:1.DBR has higher value in the diagnosis of sputum,cough,and full chest and diaphragm;DBR and RR have higher value in the diagnosis of wheezing separately.DBR and RR and I:E have higher value in the diagnosis of suffocation separately.RR is of higher value in diagnosing dyspnea alone.2.DBR and RR have higher value in the diagnosis of phlegm syndrome separately.DBR and RR and I:E have higher value in the diagnosis of Qi deficiency syndrome separately.RR,IA:EA,I:E,SA have higher value in the diagnosis of blood stasis syndrome separately.⑥The unconditional Logistic multiple stepwise regression method was used to study the comprehensive diagnostic value of respiratory parameters to the normal and abnormal respiratory function of Fei Zang,the related symptomatic and non-symptomatic groups,the related syndromes and the non-symptomatic groups of abnormal respiratory function of Fei Zang.The results showed:1.DBR and RR have a significant positive influence on abnormal respiratory function of Fei Zang;comprehensively considering these two parameters has a higher diagnostic value for abnormal respiratory function of Fei Zang.2.DBR and RR have a significant positive influence on sputum expectoration,wheezing,and full thoracic and diaphragmatic congestion;comprehensively considering these two parameters are of higher diagnostic value for sputum expectoration,wheezing,and thoracic and diaphragmatic congestion.DBR has a significant positive influence on cough.TI has a significant negative influence on cough.Comprehensive consideration of these two respiratory parameters has a higher diagnostic value for cough.DBR,RR,IA:EA has a significant positive influence on holding breath;comprehensively considering these three breathing parameters has a higher diagnostic value for holding breath.DBR,RR and IS:ES has a significant positive influence on dyspnea;comprehensive consideration of these three respiratory parameters has a higher diagnostic value for dyspnea.3.DBR,RR and SA have a significant positive influence on phlegm syndrome;comprehensively considering these three respiratory parameters has a higher diagnostic value for phlegm syndrome.DBR and RR have a significant positive influence on Qi-deficiency syndrome;comprehensively considering these two respiratory parameters,the diagnostic value of Qi-deficiency group is higher.DBR,IA:EA and SA have a significant positive influence on blood stasis syndrome.LA has a significant negative influence on blood stasis syndrome.Comprehensive consideration of these four respiratory parameters is of higher value in the diagnosis of blood stasis syndrome.⑦Respiratory scatter diagram can directly reflect the changes in respiratory rhythm.Qualitative analysis of the graphical characteristics of the respiratory scatter diagram shows that the shape of the respiratory scatter diagram of people with normal respiratory function of Fei Zang is mostly like a baseball bat with a big tail and a small head.The shapes of the scatter diagrams of people with abnormal respiratory function of Fei Zang are mostly irregular,segmented,fan-shaped,and so on.Among them,there is a type of respiratory scatter diagram of people with reduced lung ventilation showing similar graphic features(that is,a nearly elliptical shape symmetrically distributed along x=y,and two roughly symmetrical irregular graphics appearing at the tail position).After research,this kind of graphic features can reflect the central nervous system’s regulation of respiratory movement and carbon dioxide’s reflex regulation of respiratory movement,showing the influence of central nervous system regulation on breathing.This research is a preliminary exploration,and it can be used as an entry point for more in-depth research in the future.Conclusion:(1)Based on the TCM history database and TCM symptom and pathogenesis database,mining and sorting out the characteristics of syndromes of abnormal respiratory function of Fei Zang and the explanation of the pathogenesis,related symptoms and clinical features,and find that there are various syndromes of abnormal respiratory function of Fei Zang,including exogenous syndromes such as wind cold invading the Fei Zang,wind dryness insulting the Fei Zang,as well as internal injury syndromes such as phlegm-dampness accumulating the Fei Zang,and deficiency of the Fei Zang-qi and Pi Zang-qi.The disease is mainly located in the Fei Zang.Involving the other four Zang.Symptoms of abnormal respiratory function of Fei Zang can appear in a variety of syndromes,and the clinical features(including the nature of symptoms,the location of symptoms,and the remission factors of symptoms)in different syndromes are also different,and the etiology and pathogenesis are complex and different.Therefore,the ideal objective evaluation method should conform to the characteristics of TCM diagnosis and treatment,and conform to the holistic,dialectical,dynamic concept and time-space views of TCM,and adopt a long-term real-time non-invasive detection method under natural conditions with a calibrated time sequence,it reflects the subject’s respiratory function of Fei Zang in a comprehensive and comprehensive manner.(2)This research is an exploratory research.The piezoelectric ceramic-based respiratory motion detection device used can achieve long-term real-time non-contact detection under natural conditions,and can reflect the functional changes of the subject in the daily state to the greatest extent.The diagnosis and treatment are characterized by a combination of subjective and objective methods,combining objective testing and syndrome differentiation of multiple Chinese medicine experts,and jointly assisting Chinese medicine diagnosis and treatment.The ideas and methods used in this study can be extended to the field of objective detection of other functions of TCM,which has reference value.The respiratory motion detection device based on piezoelectric ceramic sensors is used to conduct guest objective evaluation of the abnormal respiratory function of Fei Zang.It can realize long-term real-time non-invasive detection under natural conditions,can reflect the functional changes of subjects in the daily state to the greatest extent,and conform to the characteristics of TCM diagnosis and treatment.It adopts a combination of subjective and objective methods,combining objective testing and syndrome differentiation of multiple TCM experts,and jointly assisting TCM diagnosis and treatment.The ideas and methods used in this study can be extended to the field of objective detection of other functions of Zang Xiang in TCM,which has important reference value.(3)Through the combination of quantitative analysis and qualitative analysis,an objective quantitative diagnosis of respiratory parameters and visualization graphs for evaluating the abnormal respiratory function of Fei Zang and its related symptoms and related syndromes are given.And found that the respiratory scatter diagram can directly reflect the changes in respiratory rhythm,some of its graphical features(that is,a nearly elliptical shape symmetrically distributed along x=y,and two roughly symmetrical irregular graphics appearing at the tail position)reflect the central nervous system’s regulation of respiratory movement and carbon dioxide’s reflex regulation of respiration,and visually demonstrate the influence of central nervous system regulation on breathing.This study explores the way to objectively evaluate the abnormal respiratory function of Fei Zang,and also provides new methods and new ideas for the future observation and evaluation of TCM functions. |
PDF Full Text Request