The Preliminary Study On The Regularity Of TCM Syndromes Of COPD With Pulmonary Heart Disease

ObjectiveA retrospective case study was used to explore the changes of TCM syndrome of chronic obstructive pulmonary disease with pulmonary heart disease,in order to provide literature,method and data support for clinical research and treatment in the future.Methods38 patients with COPD complicated with pulmonary heart disease was collected in January 2015 to December 2016,from Guangdong Province Traditional Medical Hospital of Respiratory inpatient and outpatient electronic medical record,who were in remission afer the treatment.All the cases included in this study were divided into the first day of admission,the third day of admission,the 7th day of admission and the 10th±3 days on a return visit in genernal department after discharge 4 points for medical records.The adjusted-data were import into SPSS17.0 database,and then were differentiated by the experience of clinical experts with reference to《chronic pulmonary heart disease TCM syndrome diagnostic criteria(2012 version)》.Finally,the statistical analysis of the syndromes at each time point was carried out,in order to approximate dynamically explore the regularity of TCM syndromes of COPD with pulmonary heart disease.Results1.The COPD patients with pulmonary heart disease who were included in this study were mainly concentrated in the age group of 70 to 80 years and older,and the proportion of male patients was higher than that of female.The proportion of patients with smoking history was more than 80%.The gender distribution of smoking history was statistically significant(P<0.05).There was no significant difference in gender distribution of all ages,hospital days and the course of disease(P>0.05).2.In this study,the COPD with pulmonary heart disease in acute period were mainly four syndromes of the turbid phlegm obstruction in lung,phlegm-heat obstruction in lung,cold fluid-retention in lung and Yang deficiency water pan.There were three syndromes of heart and lung qi deficiency,lung and kidney qi deficiency and lung and kidney qi-yin deficiency in remission.The course of lung and kidney qi deficiency syndrome is mainly concentrated in 5 years and above,heart and lung qi deficiency patients mainly in the course of 20 years and more;Pulmonary and kidney qi deficiency who were mainly concentrated in one times of the acute exacerbation per year,lung and kidney qi-yin deficiency patients were mainly concentrated in 2 times,heart and lung qi deficiency patients were mainly concentrated in 3 times and more.3.In this study,the COPD with pulmonary heart disease on the first day of the acute period were mainly four syndromes of the turbid phlegm obstruction in lung(34.2%),phlegm-heat obstruction in lung(31.6%),cold fluid-retention in lung(18.4%)and Yang deficiency water pan(15.8%).On the third day of admission,there were mainly two types of syndromes of the turbid phlegm obstruction in lung(73.7%)and phlegm-heat obstruction in lung(26.3%).On the 7th day of admission,the main distribution was the turbid phlegm obstruction in lung(100.0%).There were mainly three types syndromes of heart and lung qi deficiency(44.7%),lung and kidney qi deficiency(36.8%)and lung and kidney qi-yin deficiency(18.4%),lung kidney deficiency,and lung kidney gas on a return visit in genernal department after discharged from the hospital in the 10th±3 days.With the condition improved,the evils of heat,water,cold were gradually reduced,the turbid phlegm obstruction in lung,phlegm-heat obstruction in lung,cold fluid-retention in lung and Yang deficiency water pan were gradually transformed to the turbid phlegm obstruction in lung.The stable patients with heart and lung qi deficiency syndrome could be from the acute phase of phlegm-heat obstruction in lung,the turbid phlegm obstruction in lung and Yang deficiency water pan,but mainly concentrated in Yang deficiency water pan syndrome patients;Lung and kidney qi deficiency syndrome can be from the acute phase of the turbid phlegm obstruction in lung;lung and kidney qi deficiency syndrome can be from the acute phase of the phlegm-heat obstruction in lung,the turbid phlegm obstruction in lung,and the cold fluid-retention in lung,but mainly concentrated in the cold fluid-retentiond and the phlegm-heat obstruction in lung.ConclusionThe majority patients of COPD patients with pulmonary heart disease were older,weakness,long-term smoking history and easy to susceptible to exogenous pathogens,so that the lungs with the loss of the body,breathing out of adverse,recurrent,delayed healing,long course of disease.Early lesions in the lungs,and then affect the spleen and kidney,after the disease and in the heart,increasingly frequent,and even continued endless.COPD with pulmonary heart disease which the right qi is weakness and the evil is strongness.In the acute phase the evils of phlegm,phlegm-heat,cold,and water were more obvious,as the first day to the 3th day after admission could mainly cure the evils of phlegm,phlegm-heat,cold,and water;the 3th day to the 7th day could be treated phlegm and phlegm-heat;the 7th day as the main signs was phlegm,so phlegm could be cured.The stable period is to fill the deficiency of lung,kidney and heart qi.And patients with remission of heart and lung qi deficiency patients are mainly concentrated in the acute phase of Yang deficiency water syndrome patients;lung and kidney qi and yin deficiency patients are mainly concentrated in patients with phlegm obstruction lung syndrome;lung and kidney qi deficiency syndrome is mainly concentrated cold drink,Phlegm heat obstruct patients with lung syndrome.So in the acute phase of Yang deficiency in patients with pan-tilt at the same time pay attention to care for the heart and lung deficiency;phlegm turbidity lungs to care for lung and kidney deficiency.