Tcm Syndromes Of Cough After Infection And Sputum Cytology And Airway Reactivity Correlation Study

This essay consists two parts:literature review and clinical research.Literature review:Review the Chinese and Western medicine research progress of postinfectious cough (PIC). The definition of PIC is that after viruses, bacteria, mycoplasma, chlamydia or other pathogens infection, the acute respiratory symptoms have disappeared, but cough remains, ruling out pneumonia and other reasons.The pathogenesis of PIC is though to be due to the extensive disruption of epithelial integrity,widespread airway inflammation of the upper and/or lower airways with or without transient airway hyperresponsiveness and airway neurogenic inflammations. PIC shows a irritating cough or cough a few white mucous sputum, cough lasts 3-8 weeks, and the chest radiograph findings are negative. The diagnosis of postinfectious cough is clinical and one of exclusion. It is self-limited and will usually resolve in time. The guidelines recommend the first-generation antihistamines with pseudoephedrine as its treatment therapy. TCM holds that postinfectious cough belongs to "pathogenic cough", the pathogenesis is that people infect climatic pathogens, by error cure or wrong treatment, leading to healthy qi weak, pathogens unwilling to leave, so cough lasting for a long time, and it is easy to change to dryness caused by consumption of body fluid, even change to other diseases. Chinese medicine diagnosis and treatment, and the combination of Chinese traditional and western medicine treatment have already demonstrated their superiority and effect iveness, reduced the pain of patients. However a lot of works still need to be done, including traditional and western medicine research.Clinical research:objective:to explore the distribution characteristics of each type of PIC, the correlation with airway responsiveness, induced sputum cell classification and cough symptom scores. Method:give typification to all 37 patients with TCM four diagnostic methods, combining induced sputum and bronchial provocation test(BPT),use the statistical methods to do the statistics. Result: Among all 37 PIC patients, there are 11 patients belonging wind cold invade lung syndrome which take up 29.7% of all; 9 patients belonging wind heat invade lung syndrome which take up 24.3% of all; 10 patients belonging wind dryness invade lung syndrome which take up 27% of all; 7 patients belonging pathogen wind remained lungSyndrome which take up 19% of all.12 patients have airway hyperresponsiveness which take up 32.4%, the other 25 patients have a normal airway responsiveness which take up 67.6%;45.5 %wind cold invade lung syndrome patients have airway hyperresponsiveness,33.3% wind heat invade lung syndrome patients have airway hyperrespons iveness,40% wind Dryness invade lung syndrome patients have airway hyperresponsiveness, 14.3% pathogen wind remained lung syndrome patients have airway hyperresponsiveness. In wind cold invade lung syndrome patients the percentage of induced sputum neutrophil is 85.89±7.99%, in wind heat invade lung syndrome patients the percentage of induced sputum neutrophil is 70.5±13.27%, In wind dryness invade lung syndrome patients the percentage of induced sputum neutrophil is 62.67±12.19%, in pathogen wind remained lung syndrome patients the percentage of induced sputum neutrophil is 56.38±9.18%. The neutrophil percentage of normal airwayResponsiveness patients is 71±16.88%, that of airway hyperresponsiveness patients is 74.50±13.29%.All the patients, the average of daytime symptom score is 1.62±0.76, the average of nighttime symptom score is 0.83±0.96, have a significant deviation. To the patients whose cough duration is 3～4th week, followed up in the 8th week, the percentage of induced sputum neutrophil is recuced from 77.44±15.41% to 62.77±9.23%; otherwise among the the 6 patients who have airway hyperresponsiveness,4 patients put back. Conclusion:the PIC types distributional difference is not obvious, PIC patients may have a transient airway hyperresponsiveness, the percentage of induced sputum neutrophil of wind cold invade lung syndrome and wind dryness invade lung syndrome patients is higher than the other two types; the airway responsiveness has no relationship with the percentage of neutrophil;daytime symptom score is significantly higher than nighttime score.