Clinical Analysis On Pathogeny And Inflammatory Features Of Chronic Obstructive Pulmonary Disease Combined With Community-acquired Pneumonia In Patients With Heat-phlegm Syndrome And Cold-phlegm Syndrome

Objective:This paper aims to observe the pathogeny and inflammatory features of chronic obstructive pulmonary disease(COPD)combined with community-acquired pneumonia in patients with heat-phlegm syndrome and cold-phlegm syndrome and to further compare the similarities and differences between these two.This paper is to analyze the relationship of syndrome intergral between heat-phlegm syndrome,cold-phlegm syndrome and inflammati-on index,and to provide new ideas for clinical differential therapy.Methods:Information of patients with COPD comebined with CAP enrolled from January 2016 to January 2017 in the department of Pulmonary Disease in the People's Hospital affiliated to Fujian University of Traditional Chinese Medicine were collected The data of sex,age,height,weight,duration of disease,smoking index and other general information were collected according to TCM syndrome differentiation criteria of heat-phlegm and cold-phlegm syndrome.The blood samples were collected and the Hs-CRP,PCT,respiratory pathogens(anti-respiratory syncytial virus IgM antibody,anti-adenovirus IgM antibody,anti-influenza virus type A IgM antibody,anti-influenza virus type B IgM antibody,anti-parainfluenza virus IgM antibody,anti-mycoplasma IgM antibody,Anti-Chlamydia pneumoniae IgM antibody,anti-Legionella IgM antibody),sputum culture,pulmonary function(FEV1/FVC%,FEVi%pred),FeNO and other indicators.This paper compares the differences in the above indicators between heat-phlegm syndrome group and cold-syndrome group and analyzes the correlation between the above indexes the syndrome intergral of the heat phlegm syndrome group and the cold phlegm syndrome group respectively.Results:This study participants included 60 patients with COPD combined CAP:30 cases of heat-phlegm syndrome group and 30 cases of cold syndrome group.?There were no statistical difference(P>0.05)in these two groups of patients with gender,age,course,BMI,smoking index,so they were comparable.?The positive rate of sputum culture in heat-phlegm syndrome group was higher than that in cold-syndrome group,but the positive rate of respiratory pathogen spectrum was lower than that of cold-syndrome group.While the difference was not statistically significant(P>0.05).?The levels of NE%,Hs-CRP and PCT were higher in heat-phlegm group than in cold-syndrome group,while LY%was lower than that in cold-syndrome group(P<0.05).The differentiation is of statistical meaning.There was no significant discrepancy in FeNO transformation(P>0.05).?FEVi%pred in heat-phlegm group was higher than that in cold-phlegm group(P<0.05).The differentiation also matters in statistical way.·?There was a positive correlation between the syndrome intergral of heat-phlegm syndrome and Hs-CRP and PCT.The syndrome intergral of cold-phlegm syndrome was negatively correlated with WBC and NE%,and the difference is also statistica-lly significant(P<0.05).Conclusion:?The inflammation degree of COPD combined with CAP in patients with heat-phlegm was higher than that with cold one.?The airflow limitation was significantly affected for COPD combined with CAP in patients with heat-phlegm syndrome than that with cold one.?There is a correlation between the severity of the syndrome intergral and the degree of inflammation for COPD combined with CAP in patients with heat-phlegm syndrome and cold-phlegm syndrome.Hs-CRP and PCT can help determine the severity of the intergral of COPD combined with CAP in patients with heat-phlegm syndrome;on the other hand,WBC and NE%could be conducive to cold-phlegm syndrome in the same regard.