| ObjectiveTo explore the relationship between TCM syndrome types of COPD and Th1/Th2,inflammatory markers,analyze the distribution characteristics of TCM syndrome types,and understand the laws of TCM syndrome types,so as to make TCM syndrome types objective and quantitative.MethodsSelect a total of 450 COPD patients met the inclusion criteria who consulted in Shenzhen Traditional Chinese Medicine Hospital from January 1,2017 to December 30,2020.There were 64 patients with stable COPD and 386 patients with AECOPD.General information,IL-2,IL-4,IL-6,IL-10,IFN-y,TNF-α,white blood cell count,percentage of neutrophils,percentage of lymphocytes,ESR,procalcitonin,chinese medicine diagnostic information were collected.Spss20.0 and Excel software were used for statistical analysis.Results(1)The COPD ratio of males and females is significantly different,and the proportion of males is 86.22%,which indicates that COPD is a high incidence rate of males.The incidence rate is related to age,and the proportion of patients aged 60-80 years is 67.5%.(2)There were differences in inflammatory factors and inflammatory markers between COPD and AECOPD.IL-6,neutrophil percentage,lymphocyte percentage,red blood cell volume distribution width were correlated with COPD stage(P=0.00<0.05).By comparison,the median of IL-6,neutrophil percentage,red blood cell volume distribution width CV in acute exacerbation stage was significantly higher than that in stable stage,and the percentage of lymphocyte was significantly higher than that in stable stage But it decreased significantly.(3)The percentage of neutrophils and the distribution width of red blood cell volume could predict the stable phase of COPD and AECOPD.The model could correctly classify 85.5%of the subjects.The model showed that the probability of acute exacerbation increased by 1.069 times with the increase of neutrophil percentage and 2.5 times with the increase of red blood cell volume distribution width.(4)According to ROC curve analysis,percentage of neutrophils and red blood cell volume distribution width CV had significant diagnostic value for COPD patients in acute exacerbation stage(P=0.000,0.000).When percentage of neutrophils was greater than 71.5%,the accuracy rate of diagnosis in acute exacerbation stage was 65.1%.When red blood cell volume distribution width CV was greater than 12.875%,the accuracy rate of diagnosis in acute exacerbation stage was 76.2%.(5)The syndrome types of COPD in stable stage are mainly distributed in lung qi deficiency(31.25%),lung spleen qi deficiency(31.25%)and lung kidney qi deficiency(28.13%),while the syndrome types of AECOPD are mainly concentrated in phlegm heat obstructing lung(49.48%).(6)In the stable stage of COPD,30-60 years old patients with lung qi deficiency syndrome were the most,60-70 years old patients with lung spleen qi deficiency syndrome and lung kidney qi deficiency syndrome were the most,and most patients concentrated in lung Kidney Qi Yin deficiency syndrome were more than 80 years old..(7)In AECOPD syndrome types,there were differences in IL-6,IL-10,white blood cell count,neutrophil percentage,lymphocyte percentage,red blood cell volume distribution width CV and calcitonin(P=0.000,0.000,0.011,0.018,0.012,0.005,0.000<0.05).IL-6 in phlegm heat obstructing lung syndrome was significantly higher than that in phlegm dampness obstructing lung syndrome,wind cold attacking lung syndrome,external cold and internal drink syndrome(adjusted P=0.000,0.000,0.000<0.05),and there was no significant difference compared with phlegm confuses the mind syndrome(adjusted P=1.00>0.05).IL-10 in wind cold attacking lung syndrome was significantly lower than that in phlegm heat obstructing lung syndrome and phlegm confuses the mind syndrome(adjusted P=0.000,0.013<0.05).Leukocyte count in phlegm heat obstructing lung syndrome was significantly lower than that in wind cold attacking lung syndrome and phlegm confuses the mind syndrome(adjusted P=0.000,0.013<0.05).The percentage of neutrophils in phlegm dampness obstructing lung syndrome was significantly lower than that in phlegm confuses the mind syndrome(P=0.022<0.05).The percentage of lymphocytes in phlegm confuses the mind syndrome was significantly lower than that in phlegm heat obstructing lung syndrome,phlegm dampness obstructing lung syndrome,wind cold attacking lung syndrome,external cold and internal drink syndrome(P=0.043,0.008,0.025,0.021<0.05).The red blood cell volume distribution width in external cold and internal drink syndrome was significantly lower than that in phlegm dampness obstructing lung syndrome and wind cold attacking lung syndrome(adjusted P=0.006,0.038<0.05).PCT in wind cold attacking lung syndrome was significantly lower than that in phlegm heat obstructing lung syndrome,phlegm dampness obstructing lung syndrome,external cold and internal drink syndrome and phlegm confuses the mind syndrome(adjusted P=0.000,0.036,0.015,0.032<0.05),and it was significantly higher than that in phlegm heat obstructing lung syndrome(after adjustment,P=0.001<0.05).(8)Compared with COPD in stable phase,WBC count in lung qi deficiency syndrome was significantly lower than that in lung qi deficiency syndrome(P=0.049<0.05).Conclusion1.COPD is a high incidence rate of male,and the age of 60-80 is high incidence.2.The inflammatory factors and inflammatory markers in AECOPD patients were higher than those in stable COPD patients.3.Neutrophil percentage and red blood cell volume distribution width can predict COPD stable phase and AECOPD.When percentage of neutrophils was greater than 71.5%,the accuracy rate of diagnosis in acute exacerbation stage was 65.1%.When the red blood cell volume distribution width is more than 12.875%,the accuracy rate is 76.2%.4.The syndrome types of COPD in stable stage are mainly distributed in lung qi deficiency,lung spleen qi deficiency and lung kidney qi deficiency,while the syndrome types of AECOPD are mainly concentrated in phlegm heat obstructing lung.Compared with other syndromes,IL-6,leukocyte count,neutrophil lymphoid ratio and calcitonin in patients with phlegm heat stagnation syndrome and phlegm confuses the mind syndrome were higher than other syndromes,suggesting that the bacterial infection possibility of patients with phlegm heat obstructing lung syndrome syndrome and phlegm confuses the mind syndrome was the highest;and the percentage of lymphocytes in patients with phlegm confuses the mind syndrome was low,indicating low immunity and heavy infection degree. |
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