Study On The Differentiation Of Yin-Yang Deficiency And Excess, Cold And Heat In The Stable Stage Of COPD Based On The Holistic View Of Lung And Spleen As The Core And Heart Organ

BackgroundChronic obstructive pulmonary disease(COPD)is a common,preventable and treatable chronic airway disease,which is characterized by persistent airflow limitation and corresponding respiratory symptoms.At present,western medicine has a clear understanding of the etiology,risk factors,pathology,pathogenesis and pathophysiological changes of COPD.The use of antagonistic or local action means and drugs have played a role in the remission or improvement of the disease.The process of chronic pathological injury of COPD has not been fundamentally suppressed,and there is no way to completely change the influence of multiple complex factors on respiratory function.It provides the necessity of TCM for the prevention and treatment of COPD in stable period,and supports the objective correctness of TCM in understanding COPD in stable period under the guidance of holism.Ancient doctors and modern scholars have many discussions on the etiology and pathogenesis of stable COPD,such as cold and heat,deficiency and excess,Yin and Yang.The concept of holism is an important theoretical basis and criterion in the guiding ideology of traditional Chinese medicine.Under the guidance of the holistic concept of traditional Chinese medicine,it is of great significance to study the ancient and modern literature of COPD in stable period based on the six key points of cold and heat,deficiency and excess,Yin and Yang,which enriches the theoretical connotation of lung and spleen as the core viscera syndrome differentiation of pulmonary diseases and expands the clinical syndrome differentiation thinking of COPD in stable period.Based on the six key points of cold and heat,deficiency and excess,Yin and Yang,data mining research on patients with stable COPD is of great significance for forming the syndrome differentiation rules of Yin and Yang,deficiency and excess,cold and heat in stable COPD based on the holistic concept of lung and spleen as the core viscera,and improving the prevention and treatment of stable COPD.Objective1.Literature review on syndrome differentiation of Yin and Yang deficiency and excess cold and heat in stable COPDBy combing the ancient literature and modern literature,this paper enriched and improved the theoretical connotation of COPD stable period syndrome differentiation with lung and spleen as the core zangfu holism,and consolidated the theoretical basis for the study of Yin and Yang,deficiency and excess,cold and heat syndrome differentiation rules of COPD stable period with lung and spleen as the core zangfu holism.2.Based on the holistic view of lung and spleen as the core viscera,the syndrome differentiation law of Yin and Yang deficiency and excess cold and heat in stable COPDTaking COPD patients in stable period as the research object,based on data mining technology,this paper studied the syndrome differentiation of cold and heat,deficiency and excess,and yin-yang in COPD in stable period with lung and spleen as the core viscera,and revealed the syndrome differentiation rules of cold and heat,deficiency and excess,and yin-yang in COPD in stable period with lung and spleen as the core viscera.Method1.Literature review on syndrome differentiation of Yin and Yang deficiency and excess cold and heat in stable COPD1.1 Ancient literature researchBased on the database of Chinese Basic Ancient Books,the Database of Chinese Classical Ancient Books,the Four-Department Series and the Four-Library Complete Works,"lung distension","cough" and "asthma syndrome" were used as search terms.From the Qin and Han Dynasties to the Republic of China,a total of 3912 books were retrieved.Among them,130 books had 578 sentences involving symptoms similar to those of stable COPD.A total of 130 books with 578 examples were extensively read,and a total of 43 books were included in the text database.The examples of COPD in stable period were read and summarized.The representative examples of Yin and Yang,deficiency and excess,cold and heat are selected for analysis and interpretation.1.2 Modern literature researchBased on the database of CNKI,Wanfang data and VIP Chinese Journal Platform,with"stable chronic obstructive pulmonary disease" as the "key word",the literature discipline belongs to traditional Chinese medicine,and the source category is "Peking University core".A total of 830 articles were retrieved,covering the period from 1992 to 2023.After extensive reading of 830 literatures,57 literatures were included in the text database.Innovative viewpoints and representative academic achievements were selected for analysis and discussion.2.Based on the holistic view of lung and spleen as the core viscera,the syndrome differentiation law of Yin and Yang deficiency and excess cold and heat in stable COPDPatients with stable COPD were collected from the Key Laboratory of Pulmonary Disease(Chronic Cough and Asthma)of the National Administration of Traditional Chinese Medicine from September 2020 to February 2023.Following the principles and methods of clinical epidemiology and evidence-based medicine,an observational study was conducted.Paper Case Report Forms(CRF),namely "Clinical information collection form for lung and related allergic diseases based on the holistic function view of viscera with lung and spleen as the core",were used to collect the information of the patients with the inclusion and exclusion criteria.The collected CRF tables were input into EXCEL to construct a database of patients with stable COPD.Quality control was strictly implemented during the period.Constituent ratio analysis was used to clarify the clinical characteristics of patients with stable chronic obstructive pulmonary disease.Factor analysis and cluster analysis were used to substitute the representative symptoms of cough,expectoration,chest tightness,shortness of breath,and wheezing in the stable stage of COPD,and the symptoms and signs of cold and heat,deficiency and excess,and Yin and Yang were respectively substituted to analyze.Result1.Literature review on syndrome differentiation of Yin and Yang deficiency and excess cold and heat in stable COPDThe understanding of ancient and modern doctors on the stable period of COPD is gradually improved,including etiology,pathogenesis,syndrome differentiation,prevention and treatment,health preservation and so on.Yin and Yang,deficiency and excess,cold and heat run through etiology,pathogenesis,syndrome differentiation,prevention and health preservation.The deficiency of Yin and Yang in many zangfu organs results in the dysfunction of zangfu organs,resulting in the pathological products of phlegm and blood stasis.The pathological products are also the damage factors leading to the dysfunction of zangfu organs.According to the understanding of sputum,the loss of blood circulation in the lung,the loss of blood circulation in the spleen,the dysfunction of the main water and fluid in the kidney,the dysfunction of the main blood vessels in the heart,and the dysfunction of the liver can lead to the abnormal water and fluid metabolism,resulting in the pathological products of sputum.The understanding of cough,chest tightness,shortness of breath,wheezing,lung loss of xuanshu,spleen loss of clearance,kidney loss of intake and intake,heart main blood vessels promotion disorders,liver loss of dispersion will lead to qi qi disorder.Qi and blood use each other,qi deficiency leads to abnormal blood supply,resulting in the appearance of phlegm and blood stasis.Internal and external cold and heat are both pathogenic factors and pathological manifestations.2.Based on the holistic view of lung and spleen as the core viscera,the syndrome differentiation law of Yin and Yang deficiency and excess cold and heat in stable COPD2.1 Basic information of patients with stable chronic obstructive pulmonary diseaseBased on the results of constituent ratio analysis,the typical symptoms of 337 patients with stable COPD in this study were cough,expectoration,shortness of breath,chest tightness,and wheezing.Among them,the color of sputum was mainly sputum white,the nature of sputum was mainly sputum sticky,the amount of sputum was mainly sputum amount,and the difficulty of sputum was mainly sputum easy to spit.The accompanying symptoms included fatigue,soreness and weakness of waist and knee,tepid hands and feet,dry mouth,insomnia,frequent urination at night,spontaneous sweating,tinnitus,thirst and polydipsia,thirst for hot drinks,dry throat,bitter mouth,chills,night sweats,loss of appetite,loose stool,and dry stool.The tongue texture was mainly red,dark,and light.The tongue coating was mainly white,greasy,thin white and yellow.The main pulse patterns were thin pulse,heavy pulse,smooth pulse,thin pulse,smooth pulse and thin pulse.2.2 Based on the holistic view of lung and spleen as the core viscera,the study on cold and heat syndrome differentiation in stable COPDAs a result of factor analysis,10 common factors F1-F10 were extracted from the 25 variables.F1:thirsty like hot drink,thirsty,thirsty polydipsia,dry mouth,dry throat;F2:cough,phlegm,phlegm white,phlegm thick,phlegm amount less;F3:runny,runny blue;F4:white,yellow;F5:high sputum volume,low sputum volume;F6:chest tightness,shortness of breath,wheezing;F7:white phlegm,yellow phlegm;F8:thin phlegm and irritability;F9:nausea;F10:Fear of cold,cold limbs.The results of cluster analysis showed that 25 variables clustered into two categories.The first category:thin phlegm,yellow phlegm,phlegm,thin mucus,blue mucus,thirst,thirst and drink,thirst like hot drink,dry mouth,dry throat,dry stool,irritability,fear of cold,yellow moss.The second category:cough,expectoration,wheezing,chest tightness,shortness of breath,phlegm thick,phlegm white,less phlegm,white fur,cold limbs,red tongue.2.3 Based on the holistic view of lung and spleen as the core viscera,the study on the syndrome differentiation rule of deficiency and excess in stable COPDAs a result of factor analysis,16 common factors F1-F16 were extracted from 42 variables.F1:dry mouth,dry throat,thirsty,thirsty polydipsia,thirsty like hot drink;F2:cough,phlegm,phlegm white,phlegm thick,phlegm amount less;F3:pulse thin,pulse string,pulse slip,pulse string slip,;F4:greasy,white greasy;F5:white coating,yellow coating;F6:sputum is easy to spit out,sputum is difficult to spit out;F7:frequent nocturia,cold limbs,fatigue;F8:high sputum volume,low sputum volume;F9:pulse string,pulse string thin;F10:wheezing,spontaneous sweating,night sweats;F11:white and yellow phlegm;F12:thin sputum;F13:chest tightness,loose stool;F14:red tongue,dark tongue;F15:runny nose;F16:Palpitations.The results of cluster analysis showed that 42 variables clustered into two categories.The first category:thin phlegm,yellow phlegm,much phlegm,phlegm hard to cough,dry mouth,thirst,dry throat,thirst polydipsia,thirst like hot drink,spontaneous sweat,night sweat,palpitations,chest pain,abdominal pain,abdominal distension,loose stool,moss greasy,moss yellow,moss white greasy,pulse slippery,pulse heavy,pulse string,pulse string slippery,pulse string thin.The second type:cough,wheezing,chest tightness,expectoration,phlegm thick,phlegm white,less phlegm,phlegm easy to cough,fatigue,waist and knee soreness,night urinary frequency,cold limbs,red tongue,dark tongue,white fur,thin pulse.2.4 Research on yin-yang syndrome differentiation in stable COPD based on the holistic view of lung and spleen as the core visceraAs a result of factor analysis,14 common factors F1-F14 were extracted from the 35 variables.F1:thirsty,thirsty polydipsia,thirsty hot drink,dry mouth;F2:insomnia,difficult to fall asleep,easy to wake up;F3:abdominal distension,thin pulse and heavy pulse;F4:waist and knee soreness,tinnitus,fatigue;F5:cough and expectoration;F6:white,yellow;F7:nasal congestion,sneezing;F8:sputum is easy to spit out,sputum is difficult to spit out;F9:spontaneous sweats,night sweats;F10:chest tightness,shortness of breath,wheezing;F11:Many dreams;F12:loss of appetite;F13:cold limbs,red tongue;F14:Palpitations.The results of cluster analysis showed that 35 variables clustered into three categories.The first category:cough,expectoration,chest tightness,shortness of breath,wheezing,waist and knee soreness,cold limbs,fatigue,white fur,thin pulse.The second category:phlegm easy to cough,dry mouth,thirst,thirst polydipsia,thirst like hot drinks,insomnia,difficulty falling asleep,tinnitus,red tongue.The third category:difficult to cough phlegm,nasal congestion,sneezing,palpitations,abdominal distension,loss of appetite,spontaneous sweating,night sweats,chills,loose stool,easy to wake up,difficult to fall asleep after waking up,more dreams,yellow hair,heavy pulse,thin pulse.Conclusion1.Literature review on syndrome differentiation of Yin and Yang deficiency and excess cold and heat in stable COPDThe theory of "lung and spleen are the core two viscera deficiency in the stable stage of chronic obstructive pulmonary disease" not only highlights the characteristics of COPD in the stable stage,but also covers the characteristics of zangfu function in this stage.Yin and Yang,deficiency and excess,cold and heat run through the etiology,pathogenesis,syndrome differentiation and treatment of stable COPD.2.Based on the holistic view of lung and spleen as the core viscera,the syndrome differentiation law of Yin and Yang deficiency and excess cold and heat in stable COPDThe pathogenesis of patients with stable COPD is characterized by deficiency of essential organs and excess of normal organs,deficiency of lung and spleen and deficiency of multiple organs as deficiency of essential organs,phlegm-heat,phlegm-heat and blood stasis as standard excess,and Yin and Yang,deficiency and excess,cold and heat can better explain the symptoms and signs of this period.Chronic obstructive pulmonary disease(COPD)in stable stage can be divided into two types of syndromes:mixed cold and heat,true heat and false cold;Cold and hot mixed,hot on the cold.Based on deficiency and excess as the key point of syndrome differentiation,it can be divided into two types of syndromes:deficiency of essence and excess of phlegm and heat;The deficiency of the original is marked as excess,and phlegm and blood stasis as the standard.The syndrome differentiation based on Yin and Yang can be divided into three types of syndromes:Yang deficiency of all zang organs;Yang damage and Yin,deficiency Yang floating more;Yin and Yang always lose.