Study On The Correlation Between TCM Syndromes Of Bronchial Asthma And FeNO And Other Inflammatory Indexes

Objectives:Bronchial asthma is a chronic airway inflammatory disease involving a variety of cellular and cellular components,accompanied by airway hyperresponsiveness and airway remodeling.Recently,the incidence of asthma has been increasing,and it has become a global concern.How to control symptoms of patients effectively as soon as possible and delay the aggravation or further development of the disease is a key issue for physicians.Airway allergic inflammation is the most important characteristic change in all stages of asthma.It’s important to monitor the severity of airway inflammation in patients so as to guide the prevention and treatment of asthma.Physicians mainly evaluated the conditions according to the symptoms,signs and lung function in the past.The lack of airway inflammation monitoring indicators make it difficult to treat asthma accurately.Studies have found that the exhaled nitric oxide,blood eosinophils and serum total immunoglobulin E could be used to assess the degree of airway inflammation in asthma,and can also be used to guide the treatment of glucocorticoids.At the same time,it has certain clinical values for the diagnosis,disease prediction and efficacy evaluation of asthma.Traditional Chinese Medicine(TCM)has advantages in the treatment of asthma.In recent years,the objective researches on the syndrome differentiation of asthma have made certain progresses,but it still have some problems such as has not selected the standardized syndrome differentiation standards,the selections of biochemical indicators were relatively simple.It affects the applicabilities of the results.In order to improve the system of syndrome differentiation of asthma,this subject takes bronchial asthma patients as the research objects,uses the standardized syndrome differentiation standards,and selects the exhaled nitric oxide,blood eosinophils and serum total immunoglobulin E levels as observed indexes,which can reflect the airway inflammation.It is expected to provide an objective basis for clinical treatment of TCM by analyzing the correlation between these indicators and syndrome differentiation of asthma.Methods:Adopted a cross-sectional investigative study,this research select patients with bronchial asthma which with mild and moderate syndrome as the objects,during April 2018 to February 2019 in dongzhimen hospital respiratory outpatient and otolaryngology outpatient clinic.Researches choose exhaled nitric oxide,blood eosinophils and serum total immunoglobulin E levels as biochemical indicators to analyze the correlation between theseindicators and common syndrome types of asthma.Results:1.General situation analysis:59 cases had been screened,including 25 men and 34 women,their ages distribute from 22 to 75 years old,mean age is 51.15±14.34(years old).The shortest course of bronchial asthma patients is 1 month,the longest is 31 years,and the average disease duration is 113.15±134.82(months).Among them,the patients with the disease course of 1-5 years account for the highest proportion,respectively,33.9%.Patients with adisease duration of less than 1 year account for 18.6%,patients with 6-10 years account for 16.9%,and patients with more than 10 years acount for 30.6%.In 59 subjects,there are 33 subjects belong to stage of acute asthma,inluding 6 subjects of mild,47 subjects of moderate.6 subjects belong to stage of chronic asthma,inluding 5 subjects of mild,1 subjects of moderate.2.Distribution of TCM syndrome types:There are 20 subjects of cold-asthma sydrome,18 subjects of wind-asthma sydrome,15 subjects of hot-asthma sydrome and 6 subjects of vacuity-asthma sydrome in 59 cases.There was no significant difference in age(years)and duration(months)between the patients(P>0.05).3.Results of inflammatory indexes of different syndromes:The average FeNO of patients with cold-asthma syndrome was 48.00±28.32(ppb),the blood EOS counts were 0.63±0.35(×109/L),and the total serum IgE level was 120.81±114.36(IU/ml).The average FeNO value of patients with wind-asthma syndrome was 84.61±42.61(ppb),the blood EOS counts were 0.47±0.37(×109/L),and the total serum IgE level was 181.18±178.37(IU/ml).The average FeNO value of patients with hot-asthma syndrome was 23.40±12.58(ppb),the blood EOS counts were 0.21±0.15(×109/L),and serum total IgE level was 48.98±50.13(IU/ml).The average FeNO value of patients with vacuity-asthma syndrome was 29.50±10.98(ppb),the blood EOS counts were 0.50±0.22(×109/L),and the total serum IgE level was 65.07±65.83(IU/ml).4.Correlation analysis between TCM syndrome types and inflammatory indexes of asthma:4.1 The level of exhaled nitric oxide in patients with wind-asthma syndrome was the highest(84.61±42.61 ppb).The levels of FeNO in patients with wind-asthma syndrome had significant difference compared with patients with cold-asthma syndrome,heat-asthma syndrome and virtual-asthma syndrome(P<0.01).It is suggested that the level of exhaled nitric oxide can be used as a microscopic diagnosis index of wind-asthma syndrome..4.2 The level of blood eosinophil counts were the highest in patients with cold-ashtma syndrome(0.63±0.35 ×109/L).The difference of EOS count between patients with cold-asthma syndrome and heat-asthma syndrome was statistically significant(P<0.05).It suggests that the level of blood eosinophils can be used as a diagnostic indicator for the differentiation of cold-asthmasydrome and hot-asthma sydrome in patients.4.3 There was no significant difference in serum total immunoglobulin E levels among the four syndrome types(P>0.05).Conclusion:In this study we examined the levels of inflammatory indexes(exhaled nitric oxide,blood eosinophils,and serum total immunoglobulin E)of asthma patients,and summarized whether there are differences among the patients with different TCM syndrome types,and discussed the correlation between different syndrome types and inflammatory indicators.The results showed that the levels of exhaled nitric oxide and eosinophils in TCM syndrome types were different.The exhaled nitric oxide level in patients with wind-asthma syndrome was higher than other syndromes and the difference was statistically significant.It is suggested that the exhaled nitric oxide can be used as an objective diagnostic reference indicator for wind-asthma syndrome.The differences in blood eosinophil counts between patients with cold-asthma syndrome and hot-asthma syndrome is statistically significant,it suggests that EOS can be used as a diagnostic indicator for the differentiation of cold-asthma syndrome and hot-asthma syndrome in patients.There was no significant difference in serum total immunoglobulin E levels among the four syndrome types.The results of this study preliminarily shows that the exhaled nitric oxide and blood eosinophil levels can be used as objective indicators for the diagnosis of TCM sydromes differentiation of asthma,and it is expected to provide a scientific basis for the objective differentiation of asthma.In the future,a more rigorous and scientific large-sample,multi-center high-quality study should be carried out for further confirm whether the above indicators can be used as an indicator for evaluating the efficacy of TCM in order to guide the clinical treatment of asthma better.