Study On The Distribution Characteristics Of TCM Syndromes In Bronchial Asthma During Acute Exacerbation And The Differences Of NLR And Other Inflammatory Indexes Among Different Types Of TCM Syndromes

Objective:To understand the distribution characteristics of TCM syndromes in bronchial asthma during acute exacerbation,and to investigate the differences of NLR,EOS,CRP,total Ig E and Fe NO levels among different types of TCM syndromes,so as to provide a reference basis for the objectivity of the diagnosis and to better guide the clinical diagnosis and treatment of asthma.Methods:One hundred and twenty patients who met the inclusion criteria for acute exacerbation of asthma were collected,and all of them were tested for blood routine,CRP,total Ig E,Fe NO,and recorded information on general data,TCM classification and examination results,which were statistically analyzed using SPSS26.0.Results:1.Basic information: 120 patients with acute exacerbation of asthma were collected in this study,of whom the oldest was 75 years old and the youngest was 24 years old,with the highest percentage(35.00%)being 71-75 years old;74 cases(61.67%)were female and 46cases(38.33%)were male;the median interquartile range of disease duration was 7.50(2.00,15.75)years,with the highest percentage(26.67%)being 1-5 years.The median disease interval was 7.50(2.00,15.75)years,with the highest percentage(26.67%)in the 1-5 years.2.The distribution of TCM syndromes in the 120 patients with acute asthma attack was from highest to lowest: phlegm-heat congestion of lung(44.17%)> wind-phlegm obstruction of lung(28.33%)> phlegm-disturbance of lung(17.50%)> external cold and internal drinking(10.00%).3.Distribution and comparison of general data among the TCM syndromes:in terms of gender,female patients were predominant in all four groups.In terms of age,the four groups were mainly middle-aged and elderly,with 41-50 years old in the group with external cold and internal drinking evidence,71-75 years old in the group with phlegm and heat obstructing the lung evidence,and 61-70 years old in the group with wind and phlegm obstructing the lung evidence.In terms of disease duration,6-10 years were predominant in the group with external cold and internal drinking and the group with phlegm-heat congestion;1-5 and 11-20 years were predominant in the group with phlegm-deficiency obstructing the lung;and 1-5years were predominant in the group with wind-phlegm obstructing the lung.In terms of body mass index(BMI),the BMI of each group was mainly normal.In terms of allergy history,no allergy history was predominant in each group.In terms of precipitating factors,temperature change was the main cause in the group with external cold and internal drinking and the group with wind and phlegm obstructing the lung;no obvious precipitating factor was the main cause in the group with phlegm obstructing the lung;and respiratory tract infection was the main cause in the group with phlegm-heat obstructing the lung.The family history of asthma was mainly in the group with no family history of asthma.There was no difference in the distribution of gender,age,disease duration,BMI,triggers and family history during acute asthma attacks(P > 0.05).There was a difference in the distribution of allergy history between the wind-phlegm blocking lung evidence group and the other three groups(P <0.0083).There was a difference in the distribution of smoking history between the phlegm-heat congestion lung evidence group and the other three groups(P < 0.0083).4.Comparison of inflammatory indexes among the evidence types: the peripheral blood NEUT levels were significantly higher in the group with phlegm-heat congestion than in the other groups(P < 0.05);the NLR levels were significantly higher in the group with phlegm-heat congestion than in the group with phlegm-phlegm obstruction(P < 0.01).The EOS level in the wind-phlegm blocking lung evidence group was higher than that in the phlegm clouding lung evidence group and the phlegm-heat congestion lung evidence group(P< 0.05),and the EOS level in the external cold internal drinking evidence group was higher than that in the phlegm-heat congestion lung evidence group(P < 0.05).The CRP level was higher in the phlegm-heat-congested lung group than in the other groups(P < 0.05).The serum total Ig E level was significantly higher in the wind-phlegm blocking lung evidence group than in the other three groups(P < 0.01).The distribution of the severity of FENO levels among the different types of evidence: Fe NO levels were mainly mild in the group with external cold and internal drinking evidence,the group with phlegm and turbidity obstructing the lung evidence,and the group with phlegm and heat obstructing the lung evidence,and mainly severe in the group with wind and phlegm obstructing the lung evidence;there was no significant difference in the composition ratio of the grading of Fe NO severity among the types of evidence(P > 0.05);Fe NO levels were significantly higher in the group with wind and phlegm obstructing the lung than in the other three groups(P < 0.05).Conclusion:1.The distribution of TCM syndromes in 120 patients with acute asthma attack was from highest to lowest: phlegm-heat congestion of lung(44.17%)> wind-phlegm obstruction of lung(28.33%)> phlegm-disturbance of lung(17.50%)> external cold and internal drinking(10.00%),with phlegm-heat congestion of lung being the most common.2.The effects of gender,age,disease duration,BMI,triggers,and family history on the distribution of asthma acute exacerbations were relatively small;the presence of allergy and smoking history had some influence on the distribution of asthma acute exacerbations.3.The levels of NLR,EOS,CRP,total serum Ig E and Fe NO differed among different TCM syndromes,and NLR,EOS,CRP,total Ig E and Fe NO can be used as objective indicators for differential TCM syndromes diagnosis among some of the asthma acute exacerbations.