Establish The Standard For Development Speed Of COPD And Analysis Characteristics Of This Patient With TCM Constitution

Objective: using the Delphi method to develop the criteria to measure the of COPDdevelopment, and using which screen patients with COPD disease with fast or slowprogression. Their TCM constitution, lifestyle survey were analyzed to make sure thephysical characteristics and differences between those two groups of patients for the sakeof providing a theoretical basis for prevention and treatment to the the COPD, andforecast its development direction.Methods: on the basis of the preliminary epidemiological investigation, literature researchand clinical experience, the present study prepares two expert questionnaires using theDelphi method. In according with clinical respiratory medicine professional, richexperience in accordance with the long-term engaged has deputy high professional titleabove (including the Deputy High), work experience in10years,20experts were selectedto be investigate in10cities of Xinjiang. Then20experts were selected from the ChineseSociety of Respiratory Diseases Branch in10other provinces of china in the purpose ofendorsing the judgment of each evaluation. SPSS17.0software was used to analyze thedata and the degree of coordination by factor analysis and Kappa consistency test.Through those results, the evaluation criteria of the two types of patients may beestablished, and use that criteria screen the COPD patients. The measurement data arepresented as mean±standard deviation, using t-test to analyze, and the count data areanalyzed using the chi-square test. Logistic regression analysis also could be used toanalyze the multi-factor. P <0.05was considered statistically significance.Results:(1) two surveys recoveries are100%, according to meet the number of small, andthe coefficient of variation of0.3screening criteria, a development of "fast" to remove indicators: the duration of≤10years, lung function≥Class II, acute exacerbation duration≥1month, six-minute walk test1to2; development indicators "slow" delete: acuteexacerbations of≤1week,3to4, of the six-minute walk test; the second development"fast "delete indicators: disease duration≤3years,8years, lung function Class IV, BMI<21; development of" slow "to delete indicators: duration of≥10years,20years,pulmonary function I level. A development of "fast" questionnaire Kendall coefficient ofconcordance of0.354(P=0.000), the development of the "slow" questionnaire Kendallcoefficient of concordance was0.224(P=0.000); the second development "fast"questionnaire Kendall coefficient of concordance0.356(P=0.000), the development ofthe "slow" questionnaire Kendall coefficient of concordance of0.342(P=0.000).(2) theresults of analysis of the retained the evaluation factor showed that between eightvariables, judged by the cumulative contribution rate, the anterior6factor of92.564%were retained, so delete the development of the evaluation criteria in the "slow" BMI≥21this indicator.(3) clinicians Kappa consistency test criteria, Kappa value=0.84, theDelphi method worked out evaluation criteria has better reliability, judgment based on itscontent as to distinguish between the different pace of development in patients.(4)single-factor analysis results show that the development of "fast" group "slow" group inage, professions, physical fitness of simple or chief clip were of significance with P0.003,0.003,0.020, respectively.(5) Multivariate Logistic regression analysis showed: age,smoking, physical fitness of simple or chief clip, these three variables were eventually intothe model because of their corresponding P values0.000,0.024and0.013.Conclusions: the experts involved in the investigation come from different part of china,with a good representation. The views of high reliability, better coordination, predictionresults were desirable. The "fast" and "slow" the framework of evaluating COPDprogression has been recognized by experts. The controversial indicators through the useof factor analysis and Kappa consistency test, scientific entry screening, the final decision:disease duration≤5years, lung function≥III level, years of acute exacerbation of≥3times the annual number of hospitalizations≥2, dyspnea index≥3, CAT score>20≥15years duration is divided into the judgment of the evaluation criteria for the developmentof "fast"; lung function≤II level, the annual number of acute exacerbation of≤2≤1, theannual number of hospitalizations, dyspnea index≤2CAT score≤20is divided into theevaluation criteria to determine the development of the "slow". It demonstrated that as theage of the COPD patients increased, the speed of progression of the disease tend to slow;the less smoking, the slower of the pace of development; physical type more simple, the pace of development tend to be fast; physical type of chief clip, the pace of developmenttend to slow. To some extent, it provides a new research direction of forecasting directionof the disease’s development, and prevention and treatment to the diseases.