| Chronic obstructive pulmonary disease is a heterogeneous pulmonary condition characterized by chronic respiratory symptoms,due to persistent airflow obstruction due to airway abnormalities and/or alveolar abnormalities.COPD is a common and frequent disease,and is one of the major disease burdens of chronic diseases in China.The ’three yin and three yang’ physiques theory was developed from the Treatise on Febrile Diseases by Professor Zhao Jinxi.And the identification method of three yin and three yang physique can cover the basic physique of the population,and has universal guiding significance for the clinical diagnosis and treatment of a variety of diseases.T lymphocyte subsets play an important role in mediating the immune response involved in the pathogenesis of COPD.Objective:Based on the ’three yin and three yang physique theory’,this study explores the distribution characteristics of three yin and three yang physique in patients with stable COPD,and initially explored the correlation between three yin and three yang physique type and T lymphocytes in patients with stable COPD.In order to be able to carry out individualized diagnosis and treatment and ’preventive treatment’ intervention for COPD patients from the perspective of three yin and three yang physique.Method:A total of 70 stable COPD patients who attended the outpatient clinic of the respiratory department of Dongzhimen Hospital of Beijing University of Chinese Medicine from November 2019 to December 2021 were collected.After signing the informed consent form,collect the subjects’ Traditional Chinese Medicine(TCM)clinical data,including basic information,general conditions,laboratory tests,past medical history and scoring scales.According to the evaluation results of the ’three yin and three yang physique test’ program,and combined with the clinical judgment of the supervisor,the patient’s physique type was obtained.And 10ml of the patient’s peripheral blood was taken for T lymphocyte subset related detection,including the number and proportion of CD4+,CD8+,Th1,Th2,Th17 and Treg.The data were processed and statistically analyzed using Excel and SPSS23.0,with P<0.05 as a statistically significant marker.Results:1 General Information:A total of 70 patients were included in this study,including 48 male patients,accounting for 68.6%;There were 22 female patients,accounting for 31.4%,and the male to female ratio was about 2.18:1.The age of the patients was between 26～90 years old,the average age was 63.73±11.88 years,of which the highest age group was over 70 years old,60-69 years old and 50-59 years old.The proportion of BMI is:overweight>normal weight>obese>underweight.Among the smoking cases,62.9%of patients had a history of smoking.And among patients with a history of smoking,97.7%were men,and the average smoking index was 854.43.2 The distribution of three yin and three yang physiques in patients with stable COPD is as follows:22 cases of the Shaoyang physique,accounting for 31.4%,20 cases of the Jueyin physique,accounting for 28.6%,16 cases of the Yangming physique,accounting for 22.9%,8 cases of the Taiyang physique,accounting for 11.4%,3 cases of the Taiyin physique,accounting for 4.3%,and 1 case of the Shaoyin physique,accounting for 1.4%.3 Comparing the general information,examination results,scales and evaluation results of patients with stable COPD with different three yin and three yang physiques,it can be seen that:In terms of general data,there were no significant differences in gender,age,BMI,smoking history and smoking index of different physique patients.Among them,the number of patients with each physique is more male than female.Among them,the number of patients with each physique is more male than female,and all have a history of smoking≥ no smoking history.In terms of examination results,there were no significant differences in lung function and blood routine among patients with different physiques.Among them,the FEV1%Pred of the Taiyang physique patients was higher than that of the other three physiques,and the FEV1/FVC was lower than that of the other three physiques.And the EO#and EO%of patients with the Yangming physique were higher than those of the other three physiques.In terms of scale and assessment,there were no significant differences in mMRC score,CAT score,GOLD grade and comprehensive assessment of COPD among patients with different physiques.Among them,in the comprehensive assessment of COPD,the number of patients was group A>group B>group E.4 Comparing the T lymphocytes of COPD patients with different three yin and three yang physiques,it can be seen that:In terms of CD4+,CD8+,CD4+/CD8+,CD8+:the Taiyang physique>the Yangming physique>the Jueyin physique>the Shaoyang physique.There was no significant difference between different physiques.In terms of Th1,Th2,Th1/Th2,Th1:the Shaoyang physique>the Jueyin physique>the Taiyang physique>the Yangming physique.The Th1/Th2 of the Shaoyang physique was higher than that of the other three physiques,and the difference between the Shaoyang physique and the Yangming physique was statistically significant in Th1/Th2(P<0.05).In terms of Th17,Treg,and Th17/Treg,the proportion of Th17 cells in the Jueyin physique was higher than that of the other three physiques,and the difference between the Jueyin physique and the Yangming physique in the proportion of Th17 cells was statistically significant(P<0.05).The Th17/Treg of the Jueyin physique was higher than that of the other three physiques,and the difference between the Jueyin physique and the Yangming physique was statistically significant in Th17/Treg(P<0.05).At the level of Treg,the differences between different physiques were not statistically significant.5 Binary logistic regression analysis of related T lymphocyte subsets and three yin and three yang physiques showed that:There was a significant positive correlation between the Shaoyang physique and Th1/Th2,and there was no significant correlation with others.The Jueyin physique was significantly positively correlated with Th17 level,and there was no significant correlation.The Yangming physique and the Taiyang physique were not significantly correlated with various T lymphocyte subsets.Conclusion:1 The general data on patients with stable COPD included in this study had the following characteristics:There were more men than women.The age of onset was older,mainly patients over 50 years old,and the incidence tends to increase with age.BMI was high,predominantly overweight and normal weight.Most had a history of smoking,predominantly male,and had a high average smoking index.2 Among the three yin and three yang physiques,people with the Shaoyang physique,the Jueyin physique and the Yangming physique were more susceptible to chronic obstructive pulmonary disease.3 There were no significant differences in general information(sex,age,BMI,smoking status),related examinations(lung function,blood routine),scales and assessments(mMRC score,CAT scale,GOLD grade,comprehensive assessment of COPD)among patients with stable COPD with different three yin and three yang physiques.4 Patients with stable COPD with different physiques had different characteristics in terms of T lymphocyte subsets.The Th1/Th2 imbalance was more obvious in patients with the Shaoyang physique,and they mainly have Th1 type immune response.The imbalance of Th17/Treg in patients with the Jueyin physique is more obvious,mainly reflected in its Th17-mediated pro-inflammatory effect enhancement.5 For patients with stable COPD with elevated peripheral Thl/Th2,the possibility of the Shaoyang physique can be prioritized.For patients with stable COPD with elevated peripheral Th17 levels,the possibility of the Jueyin physique can be prioritized. |
PDF Full Text Request