Causes And Effects Of Acute Exacerbation Chronic Obstructive Pulmonary Disease With Anemia And Its Relationship With The Deficiency Of Lung Spleen And Kidney In TCM

Objective:To understand the period with the incidence of anemia, anemia type and severity of acute exacerbations of chronic obstructive pulmonary disease, to observe the effect of anemia complication of AECOPD, analysis of risk factors of AECOPD patients, to explore the relationship between AECOPD patients with anemia and the deficiency of lung spleen and kidney in TCM, provide the basis for clinical prevention and treatment of AECOPD complicated with anemia.Methods:①Patients who met the inclusion criteria were measured blood, serum albumin (ALB)protein, iron, folic acid, vitamin B12, and divided into anemia and non anemia groups according to the diagnostic standard of anemia.②Use the modified MRC Dyspnea Scale (mMRC) and COPD assessment test (CAT) survey AECOPD patients in the first1week of acute exacerbation,then record the corresponding score; COPD patients who is in remission of disease will be measured lung function, and record FEV1%pred, FEV1/FVC and hospitalization time.Analyze the differences between the two groups.③Two groups of patients were recorded gender,age,height,weight,body mass index(BMI),course of disease,acute exacerbation time,ALB and hight-sensitivity C-reactive protein of who will be discharged from the hospital,then analyze the differences between the two groups.④Differ the deficiency syndrome of the two group patients,and analyze the type distribution of deficiency, explore the relationship between COPD patients with anemia and lung spleen kidney deficiency.Results:①Among the113AECOPD patients,28cases are anemia, anemia prevalence rate is24.78%,2cases are hemoglobin, the prevalence rate is1.77%; the type of anemia is normal cell anemia, some are small cell anemia,22cases are mild anemia,6cases are moderate anemia;the iron protein in anemia group is higher than non anemia group (P<0.01), and folic acid, vitamin B12have no significant difference between the two groups(P>0.05).②To AECOPD patients,FEV1%pred and FEV1/FVC are not significant between the anemia and non anemia groups (P>0.05).In anemia group, the mMRC and CAT scores are higher than the other group,as well as the hospitalization time.The differences are statistically significant(P<0.05).Through the analysis of linear correlation between Hb and mMRC,CAT score,acute hospitalization time in anemia group, it shows that there is a negative correlation between Hb and mMRC, CAT score,acute exacerbation of hospitalization time,the differences are statistically significant (P<0.05).③The sex, course of disease and acute exacerbation of the time of the two groups have no difference.(P>0.05); In anemia group, the age,and high sensitive CRP is higher than non anemia group, but BMI and ALB levels are lower than the other group,the differences are statistically significant (P<0.05); Through the analysis of linear correlation between Hb and age, BMI, ALB,high sensitive CRP,it shows that there is no linear correlation between Hb and age,and there is a positive correlation between Hb and BMI, ALB(P<0.05), but Hb is negatively correlated with high sensitive CRP (P<0.05) in anemia group.④The deficiency of AECOPD patients involves lung, spleen and kidney, the spleen kidney deficiency and lung spleen and kidney deficiency syndrome are most.The most deficiency of the two groups are spleen kidney deficiency, followed by the lung spleen kidney deficiency, spleen deficiency,lung kidney deficiency and kidney deficiency syndrome. Further to this virtual organs involved two groups of patients were analyzed, the deficiency in spleen of anemia patients is the most, to27cases, accounting for96.43%, followed by kidney deficiency syndrome,25cases, accounting for89.29%, non anemia group patients were related to the deficiency of kidney deficiency syndrome, accounting for100%,followed by the spleen deficiency syndrome for example,73, accounting for85.88%.Conclusions:①AECOPD associated anemia prevalence rate was24.78%,,and the type of anemia is normal cell mild anemia.②With the decline in hemoglobin levels in patients with COPD, the dyspnea is increased,exercise tolerance is reduced,hospitalization is prolonged, as well as Influence the patients’ remission and life quality.③Anemia in patients with COPD has relationship with age,nutritional status and inflammatory response.④the deficiency of AECOPD patients with anemia mainly relates to the spleen and kidney two dirty, its pathogenesis is closely related to the deficiency of spleen and kidney.