| Objective:Yin and Yang is a concept of ancient Chinese philosophy.They are in a state of continuous changing to achieve dynamic balance,namely the growth and decline of Yin and Yang.According to the theory of correspondence between heaven and man,?Huang Di Nei Jing?puts forward some rhythms of human physiological and pathological activities with the growth and decline of yin and Yang in nature,so as to guide health preservation and treatment.In this study,the changes of Yin and Yang include the changes in the four seasons and in the day and night.Clinically,it is found that the symptoms of patients with asthma often attack and aggravate at night and in the early morning,which seriously affects the patient's condition control and quality of life.The purpose of the study is to explore the seasonal and circadian rhythms of asthma attack or exacerbation,and reveal the correlation between the above time rhythms,peripheral blood eosinophil,and indicators of airway response,so as to provide a method to reveal the clinical characteristics of bronchial asthma,and provide clinical basis for the treatment and care on time.Method:A retrospective and prospective research method was selected to sort out the case data of asthma patients,who met the exclusion criteria and had complete lung function report and eosinophil record in outpatient and ward of the second Department of lung disease of traditional Chinese medicine in China-Japan Friendship Hospital from September 2015 to September 2019.Their name,gender,age,admission time,onset solar term,disease stage,complications,main symptoms,time of attack or aggravation of main symptoms,eosinophil value and percentage,pulmonary function index are entered into excel to establish a database.They were grouped according to the season and hour of the onset or aggravation of the main symptoms.Using SPSS22.0 for data analysis,chi-square test was used for comparison of counting data,one-way analysis of variance was used for normal distribution data,and Kruskal-Wallis test was used for non-normal distribution data,multiple comparisons were conducted for all of them.Result:1.156 asthmatics were included in this study.There were more women than men,the proportion was about 2:1,the majority of middle-aged and elderly patients.The top ten of the complications were allergic rhinitis,fatty liver,hyperlipidemia,hypertension,liver cysts,reflux esophagitis,thyroid nodules,type 2 diabetes,atherosclerosis,helicobacter pylori infection.The order from high to low of main symptom frequency is wheezing,cough,suffocation,expectoration,shortness of breath and chest distress.The disease stages includeding acute attack stage and chronic duration stage,and the proportion of people is about 2.12:1.2.Group by seasonal rhythm of attack or exacerbation of asthma,the number of patients with asthma onset or aggravation is the most in autumn and winter,but less in spring and summer.There was no significant difference in sex,age,disease stage,eosinophil value and percentage between four groups(P>0.05).FEV1/FVC and MEF25%of the data between groups were statistically significant in different seasons(P<0.05).After multiple comparisons,it was found that in terms of FEV1/FVC,autumn group and winter group were lower than the spring group,and the MEF25%winter group was lower than the spring group.3.Group by attack or aggravation of asthma with or without circadian rhythm,there was no significant difference in gender,age and disease stage between the two groups.There were statistically significant differences between the two groups in the value and the percentage of eosinophils,FVC%,FEV1%,FEV1/FVC,PEF%,MEF75%,MEF50%and MEF25%(P<0.05).One day was divided into four subgroups,the attack or aggravation time of 89 asthmatic patients with circadian rhythm was night>moring>dusk>day.Age,sex,disease stage,and eosinophil were not statistically significant among the subgroups,and the differences between FEV1%and FEV1/FVC had statistically significance(P<0.05).After multiple comparisons,the average value of FEV1/FVC in the day group was higher than other three groups,and the average value of FEV1%in the day group was higher than that in the evening group and the night group.Conclusion:1.With the change of Yin and Yang in the natural world,the onset or aggravation of bronchial asthma presents a certain time rhythm,including the seasonal rhythm with high incidence in autumn and winter and the circadian rhythm with high incidence in night and dener.In this research,the clinical characteristics of the fluctuation of Yin and Yang(time rhythm)in asthma were theoretically discussed,concluded that the pathological key lies in the dysfunction of viscera with lung and spleen as the core.2.There was no correlation between eosinophil in peripheral blood and the seasonal pattern of changes in bronchial asthma.The indexes of FEV1/FVC and MEF25%were relatively low in autumn and winter,which were consistent with the seasonal pattern of high incidence of changes in bronchial asthma in autumn and winter.3.Peripheral blood eosinophils were not associated with the circadian rhythm of changes in bronchial asthma,and the lower average levels of FEV1/FVC and FEV1%in the night group were consistent with the higher incidence of changes in bronchial asthma at night. |
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