Study On The Correlation Between The Clinical Data Of Phlegm-damp Obstructing Lung And Phlegm-heat Congesting Lung In AECOPD

Objective:By studying the correlation between the clinical data of AECOPD patients with phlegm-damp obstructing lung syndrome and phlegm-heat congesting lung syndrome,the theoretical basis of traditional Chinese and Western medicine is provided for standardizing AECOPD’s syndrome differentiation treatment,disease evaluation,clinical prevention and treatment.Method:A retrospective investigation and research was adopted to select patients who were diagnosed with AECOPD in the Department of Traditional Chinese Medicine of our hospital from January 2017 to December 2020.According to the Chinese medicine COPD guidelines,the patients with the syndrome of phlegm-damp obstructing lung and the syndrome of phlegm-heat congesting lung were included.Collect basic information,blood routine,biochemical routine,blood gas analysis,lung function,cost and other data,and compare the correlation between the data and the two syndrome types.Result:A total of 114 patients were included,including 50 cases of phlegm-damp obstructing lung syndrome and 64 cases of phlegm-heat congesting lung syndrome:(1)There were no statistically significant differences in gender and age distribution between the two groups(P>0.05).The hospitalization period of patients with phlegm-heat congesting lung syndrome was longer than that of patients with phlegm-damp obstructing lung syndrome(P<0.01).(2)Blood routine:The WBC count and the Neut%in the phlegm-heat group were both higher than those of the phlegm-dampness group(P<0.01),but the LYM%and the EOS were lower than those in the phlegm-dampness group(P<0.05),the difference in the LYM and PLT between the two groups was not statistically significant(P>0.05).(3)Biochemical and inflammatoryindicators:the TC and LDL-C in the phlegm-damp group were bothhigher than those of phlegm-heat group(P<0.05),and the Hs-CRP and PCT in the phlegm-heat group was higher than that in the phlegm-damp group(P<0.05),but the difference in TC and HDL-C between the two groups was not statistically significant(P>0.05).(4)Blood gas analysis:the PaO2 and Lact in the phlegm-heat group were lower than those in the phlegm-damp group(P<0.05).There was no significant difference in the pH,PaCO2,and HCO3-between the two groups(P>0.05).(5)Lung function:FVC measured/predicted,FEV1 measured,FEV1 measured/predicted,FEV1/FVC of the phlegm-heat group was higher than that of the phlegm-damp group(P<0.05),but there was no significant difference in FVC measured,PEF measured,PEF measured/predicted between the two groups(P>0.05);the airflow limitation assessment grades and the pulmonary insufficiency grades of the two groups were statistically different(P<0.05).(6)Expenses:The total cost,antibacterial drug cost,and western medicine cost of the phlegm-heat group were significantly higher than those of the phlegm-damp group(P<0.01);and the hospitalization times of the phlegm dampness group were higher than those of the phlegm heat group(P<0.05).Conclusion:(1)There are differences in inflammatory indicators,blood lipids,blood gas analysis,and lung function between AECOPD patients with phlegm-heat congesting lung syndrome and phlegm-damp obstructing lung patients,which can be used as one of the clinical dialectics;(2)Patients with phlegm-heat congesting lung syndrome have more serious infections,longer treatment cycles,and more economic expenditures;(3)The blood lipid level of patients with phlegm-heat congesting lung syndrome is higher than that of phlegm-heat accumulating lung type group;(4)Patients with phlegm-heat congesting lung syndrome are more likely to have hypoxemia,and tissue hypoxia of phlegm-heat congesting lung is more common;(5)The pulmonary function of patients in the phlegm-damp obstructing lung group was more severe than that in the phlegm-heat group in terms of airflow limitation,airway obstruction and damage degree.(6)Patients in the phlegm-dampness group progressed in the overall course of COPD compared with patients with phlegm-heat,the two most common syndromes of AECOPD,phlegm-damp obstructing lung syndrome and phlegm-heat congesting lung syndrome,are cosely related to the interaction of various pathological factors.The most critical difference between the two should be the existence of heat pathogen.When dialecting phlegm-heat,attention should be more paid to the use of antibacterial drugs and oxygen therapy,and the management of phlegm-damp group should be strengthened during stable period.