Study On TCM Syndrome Elements Of Asthma-GOPD Overlap

Objective:To explore the distribution rules of TCM syndrome elements and the correlation b etween syndrome elements and general data,laboratory examination in patients with asthma-COPD overlap,so as to provide a theoretical basis for achieving accurate syndrome differentiation.Methods:Using the method of retrospective study,by searching the electronic medical necord system of the Affiliated Hospital of Shandong University of Traditional Chinese Medicine,we selected patients who were hospitalized ib the pulmonary department from January 2015 to December 2019 and had the characteristice of bronchial asthma and chronic obstructive pulmonary disease.Collect the basic data of the patient,onset season,course of disease,predisposing factors of onset,clinical symptoms and signs,laboratory examination and other data through the electronic medical record system,develop and fill in the syndrome dfferentiation seale of asthma-COPD overlap,and use SPSS25.0 software for statistical analysis,summarize the distribution rules of TCM syndrome elements and the correlation between syndrome elements and general data,laboratory examination.Results:1.General information:In this study,95 effective cases were collected,53 males and 42 females,the ratio of males to females was 1.26:1;there were more elderly patients aged 60-79,accounting for 69.4%of the total number;the course of disease was mostly within 20 years,accounting for 54.8%of the total number;the incidence was mainly in summer and winter,accounting for 33 and 28 cases respectively.43.2%patients were induced by upper respiratory tract infection,48.4%patients had no obvious inducement.38.9%of the patients had smoking history,and the patients with smoking history in 21-30 years were the most,accounting for 14.7%of the total.37.4%of the patients had drug allergy and 14.7%had allergic rhinitis.There were 78 patients with rales in auscultation,58 with dry rales in auscultation,2 with wet rales,and 18 with both.2.Laboratory examination:The neutrophil count of peripheral blood was in the range of(0.43-17.35)×109/L,with an average value of(4.46±2.36)× 109/L.Among them,NEUT increaed in 15 patients,accounting for 15.8%of the total number,and decreased in 3 patients,accounting for 3.2%of the total number.The count of eosinophils in peripheral blood was in the range of(0-2.07)×10,/L,with an average value of(0.26±0.35)×109/L.Among them,there were 16 patients with elevated EOS,accounting for 16.8%of the total number,and 20 patients with decreasing,accounting for 21.1%.3.The distribution rule of TCM syndrome elements:In this study,six syndrome elements were summed up.According to the disease location,the frequency was lung,heart,surface,kidney,liver and spleen.The frequency of lung occurrence was 100%,indicating that the core disease location was lung,followed by heart and surface.The combination of disease location and syndrome element.was mainly composed of two disease location(45.3%)and three disease location(41.1%);the proportion of "lung+heart" and "lung+heart+surface" was the highest,44.2%and 23.2%respectively.There are 11 pathogenic syndrome elements,which are phlegm,drink,yin deficiency,Qi deficiency,Yang deficiency,blood stasis,dampness,blood deficiency,cold,heat and wind.The frequency of phlegm is 98%,which is the main pathogenic syndrome element.The disease syndrome element combination is mainly composed of three diseases(15.8%),four diseases(22.1%)and five diseases(16.8%);the proportion of "phlegm+drink" and "phlegm drink+Yin Deficiency" is the highest,6.3%and 5.3%respectively;there are 0 cases of deficiency syndrome,19 cases of demonstration,76 cases of mingling of deficiency and reality.4.Correlation between general information and TCM syndrome elements:With the increase of age,the possibility of diagnosis of Yang deficiency syndrome element is smaller(P<0.05,OR<1).As the course of the di sease increases,the oribabulity of the diagnosis of surface syndrome elomont is less likely(P<0.05,OR<1).Compared with spring,the diagnosi s of hopntic syndrome element is less likely in summer(P<0.05,OR<1);in autumn and spring,the diagnosis of cold and yang deficiency yndrome elements are less likely(P<0.05,OR<1);compared with spring,the diagnosis of cold syndrome element is less likely to be established(P<0.05,OR<1).Patients induced by upper respiratory tract infection,the diagnosis of surface,wind and cold syndrome elements are more likely to be established(P<0.05,OR>1).With the increase of smokinig history,the more likely the diagnosi s of Yin deficiency syndrome element is established(P<0.05,OR>1).In patients with a history of allergies,the diagnosis of Yin deficiency syndrome element is more liikely to bo established(P<0.05,OR>1).5.Correlation between laboratory examinations and TCM syndrome elements:neutrophil counts in peripheral blood were positively correlated with lung,heat and phlegm syndrome elements(P<0.05,r>0).Peripheral blood eosinophil count.was statistically negatively correlated with lung,liver,and Yang deficiency syndrome elements(P<0.05,r<0),and significantly negatively correlated with kidney,heart,and blood stasis syndrome.elements(P<0.01,r<0).Conclusion:There are more men with asthma-COPD overlap,more elderly patients,and the disease course is generally longer.The onset season is concentrated in summer and winter.There are certain hidden causes of the disease,but there are relatively many people induced by upper respiratory tract infection.Smoking history and allergy history are important risk factors.The disease i s mainly located in the lung and heart,involving the surface,kidney,liver,and spleen;the disease is based on deficiency(yin deficiency,qi deficienc.y,and yang deficiency),and phlegm,drinking,dampness,blood stasis,etc.Thus forming a complex disease syndrome wi th both the exterior and the interior,the phlegm is the core pathological factor Age affects Yang deficiency syndrome element,course of disease affects surface syndrome element,season of disease affects liver,yang deficiency and cold syndrome element,upper respiratory tract infection affects surface,wind and cold syndrome elements,smoking history and allergy history has an effect on Yin deficiency syndrome element.The higher the peripheral blood neutrophil count,the more severe the lung,heat,and phlegm syndrome elements the lower the peripheral blood eosinophil count,the more severe the lung,liver,kidney,heart,blood stasis,and Yang deficiency syndrome elements.