Study On Clinical And Pathogenic Characteristics Of Traditional Chinese And Western Medicine In 387 Patients With Tuberculosis Associated Obstructive Pulmonary Disease

Objective: By reviewing the inpatient medical records of 387 cases of tuberculosis associated obstructive pulmonary disease(TOPD)and 359 cases of chronic obstructive pulmonary disease(COPD),we analyzed and summarized the clinical characteristics and pathogenesis characteristics of Chinese and Western medicine in the TOPD group,providing theoretical support for clinical early diagnosis and differential diagnosis of TOPD.Methods: The medical records of 387 TOPD patients and 359 COPD patients hospitalized in the Fourth Clinical School of Xinjiang Medical University from January 2018 to November 2020 were retrospectively studied.According to the patient ’ s previous medical history,imaging characteristics,medication and other information,the patients with chronic obstructive pulmonary disease with pulmonary tuberculosis history were classified into the TOPD group.359 patients with chronic obstructive pulmonary disease who denied the history of pulmonary tuberculosis were randomly selected as the control group(COPD group).The general data of patients(gender,age,hospitalization date,hospitalization days,smoking history),laboratory test results,lung function test results,imaging data,and TCM syndrome differentiation rules were collected.The clinical characteristics of patients in the TOPD group were summarized by statistical methods such as t test,X2 test,and rank sum test,and the similarities and differences between the two groups were statistically analyzed.Results: 1.This study preliminarily found that the smoking rate of TOPD group was low,but the onset age was earlier.2.In the laboratory tests of the two groups,the erythrocyte sedimentation rate in the TOPD group was higher than that in the COPD group,and the difference was statistically significant.There was no significant difference in other inflammatory indexes,blood gas analysis and acid-base balance between the two groups.3.In the comparison of lung function,FEV1 and FEV1 % pre in TOPD group were lower than those in COPD group,severe and very severe patients in TOPD group were more than those in COPD group,the difference was statistically significant(P < 0.05).4.In terms of imaging findings,tuberculosis scars in patients with TOPD were more common in the upper and lower lobes of the right lung.There was no significant difference in the incidence and location of emphysema and bronchiectasis between the two lungs of TOPD patients.5.There was no significant statistical difference in TCM syndrome differentiation between TOPD group and COPD group.Conclusion: 1.On the characteristics of the disease,TOPD patients onset age is relatively early,the degree of complexity and airflow limitation is more serious.Therefore,early diagnosis and intervention therapy are of great significance to improve the prognosis of TOPD patients.2.The difference in erythrocyte sedimentation rate(ESR)between the TOPD group and the COPD group was statistically significant.However,considering that ESR lacked sufficient specificity and had many influencing factors,it was not considered that there was a causal relationship between TOPD and the increase of ESR.3.TOPD has both the imaging characteristics of old pulmonary tuberculosis and the imaging characteristics of chronic obstructive pulmonary disease.The imaging data can help clinicians to diagnose and differential diagnose TOPD.4.TOPD in the process of diagnosis and treatment of traditional Chinese medicine should take into account the pathogenic characteristics of tuberculosis,specimens,both pay attention to the’ phlegm,turbidity,blood stasis ’ treatment,but also take into account the ’ lung qi deficiency,spleen qi deficiency,kidney qi deficiency ’ and other viscera deficiency problems.