Discussion On The Correlation Between TCM Syndromes Of Bronchial Asthma And Peripheral Blood EOS And Serum IgE Based On The Theory Of Constitution

OBJECTIVE:By observing the results of the constitution type,TCM syndrome type,peripheral blood EOS and serum total IgE inflammatory index of patients with bronchial asthma(BA),the correlation between the constitution,TCM syndrome type,peripheral blood EOS and serum total IgE of patients with bronchial asthma was analyzed,providing theoretical support and clinical reference for the constitutional research,TCM dialectical classification,prevention and treatment of bronchial asthma.METHODS:90 adult patients with bronchial asthma who met the inclusion and exclusion criteria and were hospitalized in the Department of Respiratory and Critical Care Medicine(Department of Pulmonary Diseases)of the Affiliated Hospital of Shandong University of Traditional Chinese Medicine from December 2021 to January 2023 were selected as the research object.The patient’s age,sex,course of disease,TCM syndrome type,constitution and other information,as well as the total serum IgE,peripheral blood EOS count and other indicators were collected in detail.Conclusion was drawn from analyzing the correlation between the syndrome type and inflammatory index,constitution and inflammatory index,syndrome type and constitution of patients with bronchial asthma.RESULTS:1.General information:Women accounted for a larger proportion of patients with bronchial asthma(58.9%),and the main distribution age range was 51 to 70 years old(61.1%).The duration of the patient varies:the shortest was 1 month,and the longest was 40 years.The highest proportion of patients with a disease course was 1 to 5 years(44.44%).2.The distribution of TCM Syndromes:The distribution of syndromes in 90 patients with bronchial asthma was as follows:37 cases of cold asthma,23 cases of heat asthma,22 cases of deficiency asthma,and 8 cases of wind asthma.There was no statistically significant difference in age(years)and duration(months)among different syndromes.3.Test results of inflammatory indicators of different TCM syndromes:The average serum total IgE level and the blood EOS count of patients with wind asthma syndrome were 588.64±2.80(IU/ml)and 0.44±0.51(× 109/L),respectively.The average serum total IgE level and the blood EOS count of patients with cold asthma syndrome were 689.37±2.47(IU/ml)and 0.59±0.32(×109/L),respectively.The average serum total IgE level and the blood EOS count of patients with heat asthma syndrome were 1104.41±1.98(IU/ml)and 0.31±0.29(× 109/L),respectively.The average serum total IgE level and the blood EOS count of patients with deficiency asthma were 281.96±4.54(IU/ml)and 0.41±0.17(×109/L),respectively.4.Correlation analysis of TCM syndromes and inflammatory indicators in asthmatic patients:4.1 Correlation between TCM syndromes and serum total IgE in asthmatic patients:Among the four syndromes,the highest serum total IgE level of patients was heat asthma syndrome(1104.41±1.98 IU/ml).The differences of serum total IgE level(IU/ml)between cold asthma and deficiency asthma were statistically significant(P<0.05).The differences of serum total IgE level(IU/ml)between heat asthma and deficiency asthma were statistically significant(P<0.05).4.2 Correlation between TCM syndromes and peripheral blood EOS in asthmatic patients:The peripheral blood EOS count was the highest in the cold asthma syndrome,and there was a statistically significant difference between the cold asthma syndrome and the hot asthma syndrome(P<0.05).There were no significant differences among the other syndromes.5.Distribution of asthmatic patients constitutions and test results of inflammatory indicators:The main constitutions of the enrolled patients were inherited special constitution(ISC),yang-deficiency constitution(YADC),qi-deficiency constitution(QDC).The average serum total IgE level and the blood EOS count of inherited special constitution were 1335.11±1386.16(IU/ml)and 0.48±0.44(×109/L),respectively.The average serum total IgE level and the blood EOS count of yang-deficiency constitution were 827.32±733.38(IU/ml)and 0.58±0.24(×109/L),respectively.The average serum total IgE level and the blood EOS count of phlegm-dampness constitution were 379.29±218.04(IU/ml)and 0.45±0.23(×109/L),respectively.The average serum total IgE level and the blood EOS count of yin-deficiency constitution were 182.73±109.18(IU/ml)and 0.26±0.19(×109/L),respectively.The average serum total IgE level and the blood EOS count of qi-deficiency constitution were 168.3±179.18(IU/ml)and 0.47±0.12(±109/L),respectively.The average serum total IgE level and the blood EOS count of qi-deficiency constitution were 153.12±148.29(IU/ml)and 0.49±0.31(±109/L),respectively.The average serum total IgE level and the blood EOS count of balanced constitution were 76.85±133.71(IU/ml)and 0.29±0.17(×109/L),respectively.6.Correlation analysis of asthmatic patients between constitution and inflammatory indexes:6.1 Correlation between constitution and serum total IgE in asthmatic patients:The serum total IgE level of asthmatic patients with different constitutions was different,among which the serum total IgE level of inherited special constitution was higher than that of other constitutions.The differences between inherited special constitution and balanced constitution were statistically significant(P<0.05).The differences between inherited special constitution and qi-deficiency constitution were statistically significant(P<0.05).The differences between qi-deficiency constitution and yang-deficiency constitution were statistically significant(P<0.05).6.2 Correlation between constitution and peripheral blood EOS in asthmatic patients:The blood EOS count(×109/L)of patients with different constitution was different,but there were no significant differences between the blood EOS count(×109/L)of patients with different constitution.7.Correlation analysis of constitutions and syndromes:Among the 90 asthmatic patients,the deficiency asthmatic syndrome was most common in the balanced constitution,the deficiency asthmatic syndrome was also commonly seen in the qi-deficiency constitution,the heat asthmatic syndrome was most common in the inherited special constitution,the cold asthmatic syndrome was most common in yang-deficiency constitution,and the heat asthmatic syndrome was also commonly seen in the yin-deficiency constitution.There was a positive correlation between wind asthmatic syndrome and inherited special constitution;Cold asthmatic syndrome was positively correlated with phlegm-dampness constitution and yang-deficiency constitution,and was negatively correlated with qi-deficiency constitution and yin-deficiency constitution;Heat asthmatic syndrome was positively correlated with inherited special constitution and yin-deficiency constitution,and was negatively correlated with qi-deficiency constitution;Deficiency asthmatic syndrome was positively correlated with the balanced constitution and the qi-deficiency constitution,and was negatively correlated with the inherited special constitution and yang-deficiency constitution;The correlations were not founded between various syndrome and qi stagnation constitution.CONCLUSION:1.There was some correlation between TCM syndromes and inflammatory indicators(total serum IgE and peripheral blood EOS count)in patients with bronchial asthma.The serum total IgE level was different in different TCM syndromes.The differences of serum total IgE level between cold asthma and deficiency asthma were statistically significant.The differences of serum total IgE level between heat asthma and deficiency asthma were statistically significant.The EOS count of peripheral blood in different TCM syndromes was different,and the differences of the peripheral blood EOS count between cold asthma and heat asthma were statistically significant,the peripheral blood EOS count could be used as one objective indicator to distinguish cold syndrome from heat syndrome in asthma.2.There was some correlation between the constitution of patients with bronchial asthma and the serum total IgE level.The serum total IgE level could provide some objective theoretical basis for the constitutional study of asthma.3.The constitution and syndrome of patients with bronchial asthma were closely related.There was a positive correlation between wind asthmatic syndrome and inherited special constitution;Cold asthmatic syndrome was positively correlated with phlegm-dampness constitution and yang-deficiency constitution;Heat asthmatic syndrome was positively correlated with inherited special constitution and yin-deficiency constitution;Deficiency asthmatic syndrome was positively correlated with the balanced constitution and the qi-deficiency constitution.