Study On The Characteristics Of Chronic Duration Syndrome Of Bronchial Asthma And The Application Of "Syndrome Differentiation Of The Spleen As The Core Of Lung And Spleen"

Objective1 Exploring literature about distribution of syndrome,symptoms,signs,tongue coating and pulse of bronchial asthma in chronic persistent period for the past decade,combine with clinical data mining of multi-dimension and multi-angle analysis,in order to obtain syndrome characteristics of chronic duration.2 On the basis of literature study and clinical study,elaborated theory connotation about viscera holistic view of lung and spleen as the core.At the same time,explore application of viscera holistic view of lung and spleen as the core,in order to lay a foundation for the standardization of clinical diagnosis and treatment about bronchial asthma in chronic persistent period.Medthods1 Literature researchCollecting literature about syndrome,symptoms,signs,tongue coating and pulse of bronchial asthma in chronic persistent period by modern literature retrieve.And the symptoms,signs,name of syndrome are all standardized. IBM SPSS 20.0 is applied to analyze characteristics of syndrome,symptoms and signs.2 Clinical researchUnder the guidance of clinical epidemiology and evidence-based medicine,the multicenter,prospective,open,combinated supervised with unsupervised,the observational research was launched to collect information of syndrome,symptoms,signs,tongue coating and pulse of bronchial asthma patients in chronic persistent period.365 cases are collected,using descriptive statistics,cluster analysis,association rule and unconditioned Logistic regression analysis to proceed data mining,in order to multidimensionally disclose characteristics of bronchial asthma in chronic persistent.190 patients are treated with viscera holistic view of lung and spleen as the core,while 175 patients are treated with other methods.Curative effect are compared by T test or analysis of variance.Results1 Syndrome characteristics research about bronchial asthma in chronic persistent period1.1 Results of literature research(1) Four common syndromes of bronchial asthma in chronic persistent period were lung-spleen deficiency,lung-kidney deficiency,phlegm-heat accumulated in lung, phlegm-dampness obstructed in lung.(2) Common symptoms of bronchial asthma in chronic persistent period①The main symptoms and signs:coughing,wheezing,coughing up phlegm,chest tightness,wheezing sound;②Secondary signs and symptoms:fatigue,mental burnout,eating less,speaking less, white complexion, afraid of cold,spontaneous sweating,frequent urination.easy to catch a cold,loose stool,poor sleep,nasal itching,lumbar debility,pharyngeal itching,shortness of breath, sneezing, low voice, thirsty,abdominal distension,tinnitus,coughing up phlegm difficultly,irritability,chest pain,breathing difficultly,dizziness,depression,anxiety.(3) Common tongue coating of bronchial asthma in chronic persistent period:fat tongue with indentation,slippery tongue coating,greasy tongue coating,thick tongue coating,yellow tongue coating,dark tongue with ecchymosis.Common pulse:slippery pulse,sunken pulse,thin pulse,wiry pulse,weak pulse,rapid pulse,forceful pulse,hesitant pulse,feeble pulse,knotted pulse,soft pulse.Literature research suggested that multiple viscera function disorders in chronic persistent period of bronchial asthma,especially in lung and spleen as the core,phlegm and stasis which were pathology products,coexisted with deficiency.Day after day,patients would be weaker and weaker.1.2 Results of clinical research1.2.1 Distribution1.2.1.1 Distribution of syndromesAfter normalization,17 syndromes were obtained,according to the proportion of patients,from big to small,are lung-spleen deficiency,lung-kidney deficiency, phlegm-heat accumulated in lung, phlegm-dampness obstructed in lung,spleen-qi deficiency,spleen-kidney qi deficiency,wind-phlegm obstructed in lung, phlegm-stasis obstructed in lung,kidney-yang deficiency,stasis obstructed in lung,cold outside and phlegm in lung,cold-heat coexist in lung,kidney-qi deficiency,lung-spleen-kidney deficiency,Yin deficiency in lung,lung-qi deficiency and liver-qi stasis.1.2.1.2 Distribution of signs and symptomsThe main symptoms and signs of bronchial asthma in chronic persistent period, according to the proportion of patients,from big to small,are coughing, chest tightness,wheezing,coughing up phlegm and wheezing sound.Secondary signs and symptoms:shortness of breath,fatigue,afraid of cold, speaking less,poor sleep,breathing difficultly,eating less,frequent urination,mental burnout, loose stool,white complexion,sneezing,nasal itching,pharyngeal itching, low voice,lumbar debility,thirsty,tinnitus,abdominal distension,spontaneous sweating,easy to catch a cold,coughing up phlegm difficultly,chest pain,dizziness,irritability, anxiety,depression.1.2.1.3 Distribution of tongue coating and pulseCommon tongue coating of bronchial asthma in chronic persistent period,from biggest proportion to the smallest,are thick tongue coating;fat tongue with indentation;yellow tongue coating;slippery tongue coating;greasy tongue coating;dark tongue with ecchymosis.Common pulse:sunken pulse;thin pulse;rapid pulse;slippery pulse;hesitant pulse;knotted pulse;forceful pulse;weak pulse;soft pulse;wiry pulse; feeble pulse.Distribution of syndrome,symptoms,signs,tongue coating and pulse of bronchial asthma in chronic persistent period,is largely consistent with the results of literature research.Pathogenesis of bronchial asthma in chronic persistent period is multiple viscera function disorder,especially in lung and spleen as the core.And pathology products are phlegm and stasis,which coexisted with deficiency.1.2.2 Results of cluster analysisSymptoms and signs were clustered for five kinds.The first kind:white complexion, loose stool,mental burnout,eating less,fatigue,speaking less,afraid of cold;The second kind: coughing,chest tightness,coughing up phlegm,wheezing sound,wheezing;The third kind:abdominal distension,coughing up phlegm difficultly,chest pain,irritability,thirsty,anxiety,depression;The fourth kind:tinnitus, lumbar debility,dizziness, nasal itching,pharyngeal itching,sneezing,spontaneous sweating, easy to catch a cold,low voice,frequent urination.The fifth kind:breathing difficultly,shortness of breath.Tongue coating and pulse were clustered for five kinds.The first kind:yellow tongue coating,rapid pulse;The second kind:greasy tongue coating,slippery pulse,slippery tongue coating.The third kind:dark tongue with ecchymosis,knotted pulse,weak pulse,wiry pulse,feeble pulse,soft pulse,forceful pulse,hesitant pulse;The fourth kind:thin pulse;The fifth kind:fat tongue with indentation;sunken pulse;thick tongue coating.The main syndrome of bronchial asthma in chronic persistent period were lung-spleen deficiency,lung-kidney deficiency,phlegm-heat accumulated in lung,phlegm-dampness obstructed in lung.Lung-kidney deficiency did not have corresponding typical tongue coating and pulse,suggested that the main damaged zang-fu organs are lung and spleen,and kidney are involved.According to the third kind of cluster analysis about tongue coating and pulse,dark tongue with ecchymosis, knotted pulse,weak pulse,wiry pulse,feeble pulse,soft pulse,forceful pulse,hesitant pulse were clustered as one kind,suggested that stasis,coexist with deficiency and evil.1.2.3 Results of Logistic regression analysisAnalysed syndrome,symptoms,signs,tongue coating and pulse by Logistic regression,the results suggested that syndrome is associated with symptoms.Lung-spleen deficiency syndrome is associated with eating less,fatigue,speaking less,easy to catch a cold,loose stool;Lung-kidney deficiency syndrome is associated with dizziness,tinnitus,lumbar debility,easy to catch a cold;Phlegm-heat accumulated in lung syndrome is associated with thirsty,coughing up phlegm difficultly,yellow tongue coating.Phlegm-dampness obstructed in lung syndrome is associated with coughing up phlegm,chest tightness, greasy tongue coating, slippery pulse, eating less.1.2.4 Results of multifactor dimensionality reductionExplorying the association among syndrome,symptoms,signs,tongue coating and pulse of bronchial asthma in chronic persistent period with multifactor dimensionality reduction.Sunken pulse,fatigue,mental burnout,speaking less and thick tongue coating have great diagnostic significance to lung-spleen deficiency.And sunken pulse is associated with lung-spleen deficiency most closely.Dizziness,fatigue,mental burnout,speaking less and white complexion are important to diagnose as lung-kidney deficiency,and dizziness is the most important symptom of lung-kidney deficiency.Rapid pulse is associated with phlegm-heat accumulated in lung the most closely.Abdominal distension and rapid pulse are important characteristics of the phlegm-heat accumulated in lung.Greasy tongue coating is considered as the most significant sign of phlegm-dampness obstructed in lung.There is positive correlation between speaking less and greasy tongue coating.And speaking less is also associated with fatigue closely.2 Research of’viscera holistic view of lung and spleen as the core’2.1 Theoretical researchViscera holistic view of lung and spleen as the core captures the pathogenesis essence that there are multiple viscera function disorders in chronic persistent period of bronchial asthma,especially in lung and spleen as the core.And is conformed to the condition that evil coexists with deficiency.2.2 Clinical research2.2.1 Clinical curative effectIn improving clinical symptoms and physical signs,overall curative effect and efficiency of application of’viscera holistic view of lung and spleen as the core’were superior to other syndrome differentiation.There was no statistically difference in significant efficiency between two groups of patients.2.2.2 Improvement of typical symptoms and signsApplications of’viscera holistic view of lung and spleen as the core’and other syndrome differentiation both can improve of typical symptoms and signs.After treatment,coughing, wheezing,coughing up phlegm,chest tightness,wheezing sound of two groups were all improved.And’viscera holistic view of lung and spleen as the core’has more advantages than other syndrome differentiation.Conclusions1 Characteristics of TCM syndromeMany zang-fu organs, especially lung and spleen as the core,are disordered in chronic persistent period of bronchial asthma.And pathology products are phlegm and stasis,which coexisted with deficiency.By descriptive statistics,cluster analysis,association rule and unconditioned Logistic regression analysis,explored the connection among syndrome,symptoms,signs,tongue coating and pulse of bronchial asthma in chronic persistent period.Multi-dimension and multi-angle analysis were applied in order to summarize syndrome characteristics objectively and comprehensively.The results of clinical research are broadly in line with the literature research,and can support each other.2 Viscera holistic view of lung and spleen as the coreBased on the theoretical interpretation of the’viscera holistic view of lung and spleen as the core’,the application research was explored.The ’viscera holistic view of lung and spleen as the core’and other differentiation can improve the condition of patients.But to improve breathing,cough,coughing up phlegm,chest tightness,wheezing sound,’viscera holistic view of lung and spleen as the core’ is better than other differentiation.The results suggest that ’viscera holistic view of lung and spleen as the core’seizes the pathogenesis essence,and is the fundamental method.