Research On TCM Syndrome Elements Distribution Features And The Correlation Between TCM Syndrome Elements And IL-8in Induced Sputum In Patients With Stable COPD

Objective:To collect the Traditional Chinese Medicine (TCM) four diagnostic information of the patients with stable chronic obstructive pulmonary disease (COPD) and research TCM syndrome elements characteristics and the correlation between syndrome elements characteristics and neutrophil percentage and cytokine IL-8in induced sputum in patients with COPD with stable phase through the syndrome elements differentiation and mathematical statistics.The present project would provide scientific basis in COPD TCM syndromes objective research.Methods:A total of120patients with COPD who met the inclusion and exclusion criteria were enrolled in Zhangzhou TCM hospital respiratory out-patient and inpatient from August2011to March2013. TCM four diagnostic information for patients with stable COPD were collected according to the four diagnostic information collection form made by TCM syndromes research institution of Fujian University of Traditional Chinese Medicine. The syndrome elements of the disease location and the disease nature were extracted using the syndrome elements differentiation and integral methods. TCM syndrome elements distribution characteristics were explored. The cells count and cytokine IL-8expression in induced sputum were detected. The features of TCM syndrome elements and the correlation between the features of TCM syndrome elements and neutrophil percentage, IL-8in induced sputum were analyzed with mathematical statistical methods.Results:1. There were10syndrome elements of disease location in patients with stable COPD, the total of frequency were436, The frequency of syndrome elements of disease location more than20%were the lung, the kidney, the heart, the spleen, the liver and the exterior. The frequency of413was94.7%in total,The proportion98.3%of syndrome element of lung was higher than all of the others.The second was of the syndrome element of kidney which proportion was79.2%.There were18syndrome elements of disease nature, the total of frequency were713. The frequency of syndrome elements of disease nature more than20%were phlegm, qi asthenia,yang asthenia,yin asthenia,blood asthenia, dampness,cold,rheum, qi stagnation and blood stasis.The frequency of632was88.6%in total.The proportion92.5%of syndrome element of phlegm was the highest among all of the syndrome elements of disease nature. The second were qi asthenia and yang asthenia,84.2%, and83.3%in total,respectively.2. The score of more than20%of syndrome elements of disease location from high to low in turn were:the lung, the kidney, the exterior, the spleen, the heart, and the liver. Among them the score of the lung and the kidney belong to level three. The score of the lung was higher than that of the kidney. The score of the exterior, the spleen, the heart and the liver were all in level two; The score of more than20%of syndrome elements of disease nature from high to low in turn were:yang asthenia, qi asthenia, phlegm, yin asthenia, blood asthenia, rheum,cold, dampness, qi stagnation, blood stasis.The points of yang asthenia and qi asthenia were the highest which belong to level three. The score of phlegm, yin asthenia, blood asthenia, rheum, cold were in level two. While the others of dampness, qi stagnation, blood stasis were in level one.3. The points of syndrome elements of disease location of the lung, the kidney, the heart, the spleen and the concentration of interleukin8, nuetrophil percentage in induced sputum were correlated positively (P<0.01).The score of syndrome element of the lung and the concentration of interleukin8, neutrophil percentage highly correlated (R=0.966, R=0.962, P<0.01). The points of syndrome elements of disease nature of qi asthenia, yang asthenia, phlegm, cold, rheum and the concentration of interleukin8, neutrophil percentage were correlated positively (P<0.01).Conclusion:1. The syndrome elements of disease location in patients with COPD in stable phase mainly were the lung and the kidney. But the heart, the spleen, the liver and the exterior also were affected. The relationships of five zang-ogans were close. The syndrome elements of disease nature were based on ben deficiency (mainly yang asthenia and qi asthenia), while biao excess were phlegm, rheum, cold, dampness combined with qi stagnation and blood stasis. The major pathogenesis of COPD was concurrence of deficiency and excess, exterior-syndrome and inter io r-syndro me.2. The inflammation in patients with stable COPD mainly located in the lung, but also involved other visceras of the kidney, the heart and the spleen. The syndrome elements of disease nature of yang asthenia, qi asthenia and phlegm, cold, rheum were the major pathological factors in COPD patients with stable phase. The exacerbation of airway inflammation would aggregate with these pathological factors, which may lead to chronic airway inflammation in COPD, and make a progresive development, finally make the illness to be obstinate and recurring with long duration.3. This project objectively illustrated syndrome elements distribution features in patients with stable COPD, the positive correlation between some of the TCM Syndrome elements and neutrophil, IL-8in induced sputum in patients with stable COPD through TCM syndrome elements differentiation and mathematical statistics, The project would provide scientific basis for COPD TCM syndromes research and microscopic explore of TCM syndromes.