Differential Diagnosis Of Connective Tissue Disease - Related Pulmonary Interstitial Lesions And Idiopathic Pulmonary Interstitial Fibrosis

Idiopathic pulmonary fibrosis (IPF) is the most common interstitial lung disease, due to the lack of effective treatment and the prognosis is poor, has been the world health organization (WTO) listed as one of refractory diseases:And connective tissue disease (CTD-ILD) refers to the class of immune reaction caused by disease, these diseases often accumulative total lung, called connective tissue diseases related to pulmonary interstitial lesions (CTD-ILD).ObjectiveThis research through the method of retrospective study to discuss the IPF and CTD-ILD in patients with different syndromes, compare Idiopathic pulmonary fibrosis and secondary pulmonary syndromes differences, for the purpose of comparing the two different clinical syndrome factor and syndrome, at the same time to compare clinical symptoms and lung of the correlation between TCM syndrome factor and syndrome, and western medicine diagnosis of IPF and CTD-ILD standards, imaging findings and treatment are reviewed.MethodsThis study adopts the method of retrospective study, according to the cases included in the standard screening cases, cases in 153 cases, including 111 cases of patients with idiopathic pulmonary fibrosis (72.5%),42 patients with connective tissue disease caused by pulmonary interstitial lesions (27.5%). According to the requirements, design in advance the pulmonary interstitial disease of traditional Chinese medicine clinical observation form, according to the observation content, the form of clinical studies, each case record, the record data including general demographic information (gender, age. smoking history, occupational/environmental exposure history. medical history, always taking drugs, etc.). doctor of clinical symptoms (including coating on the tongue and pulse condition, etc.). according to the patient at the time of acquisition table of syndromes, and combines the syndromes of traditional Chinese medicine to determine the syndromes of each patient, through the SPSS statistical software, IPF and CTD-ILD is analyzed and discussed the clinical symptoms, signs and syndromes of differences.Conclusion(1) The average onset age of IPF and CTD-ILD is in the 60 s. IPF men more than women, and women with CTD-ILD than male patients.(2) In terms of clinical symptoms, IPF with CTD-ILD in coughing, wheezing, clubbing, lung burst, rash and no statistical differences, and the difference in the aspect of joint pain, CTD-ILD in IPF joint pain patients more.(3) In terms of documents syndrome,111 cases of IPF patients is deficiency syndrome in most frequency, phase and the two documents appear most of qi and Yin deficiency syndrome, three or with the Shanghai type phase and with qi and Yin deficiency syndrome. In 42 patients with CTD-ILD qi deficiency is one of the most cards, after the card type distribution, there is the highest frequency of qi and Yin deficiency syndrome,(4) The IPF with CTD-ILD in documents syndrome after Fisher’s exact test comparison, found in both qi deficiency syndrome, has statistically haemorrheological nature card and card of damp and hot.(5) In the aspect of syndrome distribution of the actual situation, TCM syndrome types of IPF in card factors more, give priority to with the virtual. And TCM syndrome type of CTD-ILD with empirical bullish.(6) In terms of involving the zang-fu organs,111 cases of IPF involved the most were lung, followed by the spleen, kidney, heart, liver,42 cases of CTD-ILD all involves the lungs, followed by the spleen, kidney, and heart, is not involved to the liver.(7) Through chi-square test, results showed that patients with smoking and non-smoking patients caused by the TCM syndrome of qi deficiency syndrome, Yin deficiency syndrome, phlegm wet with smoking status was statistically significant, and phlegm heat syndrome, blood stasis and smoking or not has no statistical significance. The CTD-ILD smoking with distribution of syndromes shows no statistical significance.(8) By chi-square test, IPF with CTD-ILD always has no statistical relationship between medicine and TCM syndrome.(9)By chi-square test, CTD-ILD has no statistical significance between the primary disease and syndromes.