| Objective:1.Through the collation and analysis of TCM literature about acute exacerbation of chronic obstructive pulmonary disease(AECOPD)in recent 15 years,this paper discusses the disease name,disease location,etiology,pathogenesis and TCM syndrome regularity of acute exacerbation of AECOPD,so as to provide diagnosis and treatment ideas for TCM clinic.2.Based on the analysis of TCM Syndrome Distribution and related influencing factors in 107 patients with AECOPD,the characteristics of TCM Syndrome Distribution in AECOPD patients and the factors influencing the distribution of TCM syndrome were preliminarily summarized,providing theoretical basis for TCM syndrome differentiation and treatment of AECOPD.Methods:1.Through the retrieval of CNKI,VIP and Wanfang Data,the retrieval period is from January 1,2005 to December 31,2019,“acute exacerbation of COPD + TCM”,"acute exacerbation of COPD + TCM","acute exacerbation of COPD + TCM","acute exacerbation of COPD + TCM","acute exacerbation of COPD + TCM","AECOPD + traditional Chinese and Western medicine" and "pulmonary distention + traditional Chinese and Western medicine" are the subject words for retrieval.After the literature is obtained,it is screened according to the criteria of inclusion and exclusion.The effective literature is classified according to the disease name,disease location,etiology,pathogenesis and syndrome of traditional Chinese medicine,and four related folders are established,among which the literature on syndrome of traditional Chinese medicine is screened out for clinical research of traditional Chinese medicine.Use Excel software to make statistics,establish database and import Excel data into SPSS23.0Software,using SPSS 23.0 software for frequency,frequency statistical analysis.2.From March 1,2019 to December 31,2019,107 patients with acute exacerbation of chronic obstructive pulmonary disease(COPD)were collected in the respiratory ward of the Second Affiliated Hospital of Tianjin University of traditional Chinese medicine.The patientswere collected with four diagnostic data of traditional Chinese medicine and filled in the "AECOPD four diagnostic data collection form of traditional Chinese medicine".The clinicians with more than two years of relevant clinical work experience made TCM syndrome differentiation.Record the clinical data of patients,establish a database,and use SPSS23.0statistical analysis to get the characteristics of AECOPD syndrome distribution,and to analyze the relevant indicators affecting the distribution of syndrome Results:1.Study on TCM Syndromes literature of AECOPD(1)AECOPD mainly belongs to the category of "lung distention"(100%),asthma syndrome(88.21%),cough(68.87%)and phlegm drink(36.8%)in traditional Chinese medicine;(2)The main positions of AECOPD in TCM were lung(100%),spleen(83.56%),Kidney(80.82%),heart(61.64%),large intestine(32.88%),liver(20.55%);(3)AECOPD in traditional Chinese Medicine The etiology and pathogenesis of the disease mainly include: deficiency of the original,excess of the standard(89.32%),deficiency of the lung,spleen and kidney,later stage and heart(brain)(86.52%)six cases of attack(82.58%),prolonged lung disease(73.03%),phlegm retention(57.3%),phlegm turbidity +water drinking + blood stasis(44.94%),internal injury of 25.28% emotions(25.28%),daily life(23.03%),phlegm turbid + heat evil + blood stasis(17.98%),fatigue injury(16.85%),sputum drinking and feeling(10.11%);(4)the frequency of common TCM syndromes is high.The lower order was: phlegm heat stagnation of lung(89.32%),phlegm turbid stagnation of lung(82.52%),deficiency of lung and kidney qi(54.37%),phlegm stasis of lung(48.54%),deficiency of lung and spleen qi(38.83%),wind cold attacking lung(36.89%),external cold and internal drink(33.98%),blood stasis syndrome(30.1%),deficiency of lung and Qi(29.13%),deficiency of both qi and Yin(29.13%),Yang deficiency and water flooding(23.3%),phlegm blinding the mind and body(21.36%),spleen and Qi deficiency(29.13%)Deficiency(21.36%).In the clinical literature study,it was found that 65.63% of patients with AECOPD had positive diagnosis,10.99% had deficiency syndrome,and 23.38% had mixed deficiency and excess syndrome.2.Analysis of TCM Syndrome Distribution and influencing factors of AECOPD(1)General information of the patients: 74 male(69.16%),33 female(30.84%),Male:female = 2.24:1,age between 47-89 years old,average age 69.82 ± 8.88 years old,including37 cases of phlegm heat stagnation lung syndrome(34.58%),26 cases of phlegm turbidity stagnation lung syndrome(24.30%),23 cases of lung kidney qi deficiency syndrome(21.50%),10 cases of wind cold invasion lung syndrome(9.35%),7 cases of external cold and internal drink syndrome(6.54%),and 7 cases of Yang cold invasion lung syndrome There were 4 cases(3.74%)of asthenic flooding.(2)The correlation between TCM Syndromes of AECOPD and its influencing factors:(1)the age of patients with lung and kidney qi deficiency syndrome was significantly higher than that of patients with wind and cold syndrome,phlegm and turbid syndrome,phlegm and heat syndrome and external cold syndrome(P < 0.01);the duration of patients with lung and kidney qi deficiency syndrome was significantly longer than that of patients with wind and cold syndrome,phlegm and turbid syndrome,phlegm and heat syndrome and external cold syndrome(P < 0.05);g of patients with lung and kidney qi deficiency syndrome Lu was significantly higher than Glu in the patients with the syndrome of wind cold invading the lung,phlegm turbidity blocking the lung,phlegm heat stagnation of the lung,external cold and internal drink,Yang deficiency and water flooding.Pa O2 of the patients with lung and kidney qi deficiency syndrome was significantly lower than that of the patients with wind cold attacking lung and phlegm turbid lung syndrome(P < 0.01)Pa CO2 was significantly higher than that of the patients with the syndrome of wind cold invading the lung,phlegm turbid damming the lung,phlegm heat stagnating the lung,external cold and internal drink,Yang deficiency and water flooding(P < 0.01);FEV1% PRED in the lung function of the patients with the syndrome of lung and kidney qi deficiency was significantly lower than that of the patients with the syndrome of wind cold invading the lung,external cold and internal drink,Yang deficiency and water flooding(P < 0.01);FEV1% PRED in the lung and kidney qi deficiency FEV1 / FVC of patients with lung qi deficiency syndrome was significantly lower than that of patients with lung qi deficiency syndrome(P < 0.05);RV / TLC of patients with lung and kidney qi deficiency syndrome was significantly higher than that of patients with wind cold,phlegm stagnation,phlegm heat stagnation and yang deficiency syndrome(P <0.01);DLCO% of patients with lung and kidney qi deficiency syndrome was significantlylower than that of patients with wind cold,phlegm stagnation,phlegm heat stagnation,external cold and internal drink,and yang deficiency DLCO(P < 0.01);(2)wind The hospitalization days of the patients with cold invading lung and phlegm heat stagnation lung syndrome were significantly higher than that of the patients with phlegm turbid lung syndrome(P < 0.05);the difference of MMRC score before and after treatment in patients with wind cold attacking lung syndrome was significantly higher than that in patients with phlegm turbid lung,phlegm heat stagnation lung,external cold and internal drink,lung and kidney qi deficiency syndrome before and after treatment;(3)the difference of MMRC score before and after treatment in patients with Yang deficiency and water flooding syndrome was significantly higher than that in patients with external cold and internal drink syndrome before and after treatment(Before and after(P < 0.05);(4)WBC and neut% of patients with phlegm heat stagnation lung syndrome were significantly higher than those with wind cold attacking lung,phlegm turbid damming lung,external cold and internal drink,Yang deficiency and water flooding,lung and kidney qi deficiency syndrome(P < 0.01);The Sa O2 of phlegm heat stagnation lung syndrome was significantly higher than that of phlegm turbid stagnation lung syndrome and external cold and internal drink syndrome;(5)The Sa O2 of patients with external cold and internal drink syndrome is significantly higher than that of patients with Yang deficiency and water flooding syndrome.Conclusion:Literature research and clinical research have found that: the top three TCM Syndromes of AECOPD are phlegm heat stagnation lung syndrome,phlegm turbid stagnation lung syndrome and lung kidney qi deficiency syndrome in turn;the characteristics of AECOPD patients are the mixture of deficiency and excess,mainly empirical.Patients with lung and kidney qi deficiency syndrome are older,have longer course of disease,have worse pulmonary ventilation function,diffusion function,blood gas and Glu;patients with wind cold invading lung and phlegm heat stagnation lung syndrome have longer hospitalization time than those with phlegm stagnation lung syndrome;patients with wind cold invading lung syndrome have more obvious relief of dyspnea after treatment;patients with phlegm heat stagnation lung syndrome have higher inflammation index in blood routine.There is a certain correlation between AECOPD syndromes and clinical related factors,which can provide objective basis for clinical syndrome differentiation and treatment... |
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