Changes Of Immune Indexes In Chronic Obstructive Pulmonary Disease And Correlation With TCM Syndrome Types

ObjectiveThe changes of immune function and humoral immunity of patients with chronic obstructive pulmonary disease(COPD)and acute exacerbation of chronic obstructive pulmonary disease(AECOPD)were detected in order to understand the changes of immune indexes in patients with chronic obstructive pulmonary disease and to study the correlation between them and TCM syndrome types so as to diagnose and treat the chronic obstructive pulmonary disease in a comprehensive clinical period.MethodsAccording to the inclusion criteria and exclusion criteria,the COPD and AECOPD patients in the hospital and outpatient department were selected and divided into different TCM syndrome types as the observation group,and the healthy persons were selected as the control group,and six items of serum humoral immunity(IgA,IgG,IgM,IgE,C3,C4)and T lymphocyte immune function(lymphocyte,The total number,absolute value of T lymphocyte,absolute count of CD4+T lymphocyte,absolute count of CD8+T lymphocyte,and/Ts lymphocyte ratio of Th lymphocyte)were detected respectively.A database was established to analyze the changes of immune function between COPD and AECOPD patients with different syndromes and relatively healthy people.Results1.General data comparison:there were 67 cases in group AECOPD,including 55 male and 12 female,with an average age of 73.4 years.There were 54 cases in group COPD,including 44 men and 10 women,with an average age of 71.4 years,and 30 cases in the control group,including 24 men and 6 cases,average age 71.2 years.Chi square test showed that there was no significant difference in sex composition ratio of each group.There was no significant difference in age between groups in t test.2.The distribution characteristics of TCM Syndrome Type:the acute exacerbation of chronic obstructive pulmonary disease is mainly divided into phlegm heat obstructing lung(40 cases,accounting for 59.7%in group AECOPD)and phlegm obstructing lung(27 cases,accounting for 40.3%in group AECOPD).The stable period is mainly divided into lung and spleen qi deficiency(31 cases,accounting for 57.4%in group COPD),the lung and kidney qi deficiency(23 cases,accounting for 42.6%in group COPD).3.AECOPD group,COPD group and control group T lymphocyte immune function comparison:AECOPD group and control group serum Lym,T cell,Th Cell,Tc Cell difference is statistically significant(P<0.05),there is no significant difference between the two groups of Th/Ts(P>0.05).The difference of Cell was statistically significant(P<0.05);there was no statistically significant difference between the two groups of Th/Ts(P>0.05),There was a significant difference in serum Lym,T cell,Th Cell and Tc Cell between COPD group and control group(P<0.05).There was no significant difference in Th/Ts between the two groups(P>0.05).The difference of serum Lym,Tc Cell and Th/Ts between AECOPD group and COPD stable phase group was statistically significant(P<0.05).There was no significant difference in T cell and Th Cell between the two groups(P>0.05).4.The humoral immune function of AECOPD group,COPD group and control group were compared:AECOPD group and control group serum IgA,IgG,IgM,IgE,C3,C4 compared,IgA,IgG,IgM and C3 were statistically different(P<0.05),there was no significant difference in IgE and C4 between the two groups(P>0.05).IgA,IgG,IgM,IgE,C3 and C4 were compared between the COPD group and the control group,IgG,IgM and C3 were statistically different(P<0.05).there was no significant difference in IgA,IgE and C4 between the two groups(P>0.05).IgA,IgG,IgM,IgE,C3 and C4 were compared between the COPD group and the AECOPD group,IgA,IgM,C3 and C4 were statistically different(P<0.05),and there was ino significant difference in IgG and IgE between the two groups(P>0.05).5.The immune function of each type of T lymphocyte:compared with the T cell immune function of the AECOPD phlegm dampness Obstructing Lung Group and the phlegm heat obstructing group,the level of lym in the phlegm dampness obstructive pulmonary group was higher than that of the phlegm heat accumulation group(P<0.05),and the T cell,Th Cell,Tc Cell,and Th/Ts difference were not statistically significant(0.05).COPD group lung spleen qi deficiency and lung kidney qi deficiency T cell immune function comparison,between the two groups of lym,T cell,Th Cell,Tc Cell,Th/Ts difference is not statistically significant(P>0.05).6.Comparison of the body fluid inmune function of each syndrome type:AECOPD phlegm dampness Obstructing Lung Group and phlegm heat obstructing group serum humoral immune function,phlegm dampness obstructive pulmonary group IgM higher than phlegm heat congestion group,IgA,IgG lower than phlegm heat congestion group,the contrast difference has statistical significance(P<0.05).There was no significant difference in IgE,C3 and C4 between the two groups(P>0.05).Compared with the serum humoral immune function of lung and kidney qi deficiency in the COPD groups,the difference of IgA,IgG,IgM,IgE,C3 and C4 between the two groups was not statistically significant(P>0.05),Conclusion1.The serum T lymphocyte immune function of COPD group and AECOPD group was compared with that of control group,the Lym,T cell,Th Cell and Tc Cell in COPD and AECOPD group were significantly lower than those in the control group,but there was no significant difference in Th/Ts.It suggested that COPD patients had T lymphocyte immune function in both stable phase and acute exacerbation stage.Compared with the immune function of T lymphocyte in COPD group and AECOPD group,Lym and Th/Ts in group AECOPD were significantly lower than those in COPD group,Tc Cell was higher than that in COPD group.It is suggested that there is a further decline in immune function and imbalance of T lymphocyte immune function in AECOPD.2.The serum humoral immune function of COPD group and AECOPD group was compared with that of control group,IgG,IgM,C3 in COPD group,IgA,IgG,IgM and C3 in AECOPD group were significantly different from those in control group,suggesting that there were humoral immune dysfunction in AECOPD patients.The serum humoral immune function of group AECOPD and COPD group was compared with that of IgA,IgM,C3 and C4,suggesting that the AECOPD is related to the reaction of antigen and antibody and the activation of complement system.3.Compared with the immune function of T lymphocyte in different TCM syndromes,the level of lym in AECOPD group was lower than that in phlegm heat obstructing lung group.It suggests that the immune function of the phlegm heat Obstructing Lung Group is poor,and it is more susceptible to infection and aggravation.The level of lym was significantly correlated with the pattern of phlegm heat obstructing lung in TCM Syndromes of AECOPD,and the level of lym could assist TCM differentiation.However,there was no significant correlation between the changes of T lymphocyte imnune function in COPD stable phase and TCM syndromes.4.In group AECOPD,the serum humoral immune function of different TCM syndrome types was compared.The IgM of phlegm dampness obstructing lung group was higher than that of phlegm heat accumulation group,IgA and IgG were lower than that of phlegm heat obstructing lung group.The difference of humoral immunity between the two groups could be used as a reference for TCM syndrome differentiation.However,there was no significant correlation between serum humoral immune function and TCM syndromes in COPD stable phase.