| Purpose:To discuss the differences between different TCM constitution types in patients with stable COPD period by detecting theirs pulmonary ventilation function,symptom index,related immunological indicators and endocrine indicators,5o as to provide a basis for the treatment mode of“constitution differentiation-disease differentiation-syndrome differentiation,and the development of personalized TCM prevention and treatment programs for patients,and to give play further to the unique role of TCM in the comprehensive management of COPD.Methods:According to China’s 2018 guidelines for primary diagnosis and treatment of COPD and the TCM constitution classification and determination self-test table issued by the constitution branch of China Association of Chinese Medicine,stable COPD patients of Qi-deficiency consititution,Yang-deficiency consititution,Phlegm-dampness consititution and peaceful consititution with were collected.The differences between the four groups of patients with stable COPD were observed through pulmonary ventilation function,the assessment test,acute exacerbations,Peripheral T lymphocyte subsets,immunoglobulin,related inflammatory factors,leptin and thyroid hormones.Results:In this study,81 patients with stable COPD were finally included.There was no significant difference in gender,age,disease course,height and weight of the four groups(P>0.05).(1)Pulmonary ventilation function:The FEV1 of both the Qi-deficiency consititution group and the Yang-deficiency consititution group were lower than those of the peaceful consititution group(P<0.05).The FEV1%Pred of the Qi-deficiency consititution group and the Yang-deficiency consititution group were lower than those of the phlegm-dampness group(P<0.05),and the FEV1%Pred of the Qi-deficiency consititution group and the Yang-deficiency consititution group were lower than those in the peaceful consititution group(P<0.05).(2)The CAT score:Yang-deficiency consititution group were significantly higher than those of the Qi-deficiency consititution group,the phlegm-dampness consititution group and the peaceful group(P<0.05).(3)The number of acute exacerbations:Qi-deficiency consititution group and Yang-deficiency consititution group were higher than those of phlegm-dampness group(P<0.05).And the number of acute exacerbations of Qi-deficiency consititution group and Yang-deficiency consititution group were also higher than those of peaceful consititution group(P<0.05).(4)Peripheral T lymphocyte subsets:CD4+of both the Qi-deficiency consititution group and the Yang-deficiency consititution group were lower than those of the peaceful consititution group(P<0.05).CD4+/CD8+of the Qi-deficiency consititution group,the Yang-deficiency consititution group and the phlegm-dampness consititution group were all lower than those of the peaceful consititution group(P<0.05).(5)Immunoglobulin:The IgG of the Qi-deficiency consititution group,the Yang-deficiency consitiltutioin group and phlegm-dampness consititution group were significantly lower than those of the peaceful consititution group(P<0.01).The IgA of the Qi-deficiency consititution group and the Yang-deficiency consititution group were significantly lower than those of the phlegm-dampness consititution group and the peaceful consitution group(P<0.01).The IgA of the phlegm-dampness consititution group were significantly lower than those of the peaceful consitution group(P<0.01).The IgM of the Qi-deficiency consititution group,the Yang-deficiency consititution group and the phlegm-dampness consititution group were significantly lower than those of and the peaceful consitution group(P<0.01).The C3 of the Qi-deficiency consititution group,the Yang-deficiency consititution group and the phlegm-dampness consititution group were lower than those of and the peaceful consitution group(JP<0.05).The C4 of the Qi-deficiency consititution group and the Yang-deficiency consititution group were lower than those of and the peaceful consitution group(P<0.01).And the C4 of the Yang-deficiency consititution group were lower than those of and the phlegm-dampness consititution group(P<0.01).(6)Related inflammatory factors:the levels of INF-α and il-6 in the Qi-deficiency consititution group,the Yang-deficiency consititution group and the phlegm-dampness consititution group were higher than those in the smooth-quality group(P<0.05).(7)Leptin:Qi-deficiency consititution group,the Yang-deficiency consititution group and the Peaceful group were all lower than those in phlegm-dampness group(P<0.05).(8)Thyroid hormones:the TT3 of both the Qi-deficiency consititution group,the Yang-deficiency consititution group was lower than those of the phlegm-dampness constitution group(P<0.05).The TT3 of both the Qi-deficiency consititution group,the Yang-deficiency consititution group was lower than those of the peacefuls group(P<0.05).Conclusion:Pulmonary ventilation function,number of acute exacerbations,CAT score,T lymphocyte subsets,immunoglobulin series,associated inflammatory factors,leptin and thyroid hormone levels were different in patients with stable COPD with different constitutions.Patients with Yang-deficiency consititution and Qi-deficiency consititution were more severely restricted in airflow,more prone to acute exacerbation,and significantly lower in t-lymphocyte subsets and thyroid hormone levels.Patients with Yang-deficiency constitution had higher CAT scores and poorer quality of life.The levels of immunoglobulin in patients with qi-deficiency constitution,yang-deficiency constitution and phlegm-dampness constitution were lower and the levels of related inflammatory factors were higher.The level of leptin was high in patients with phlegm and dampness constitution.This provides a certain basis for the application of the diagnosis and treatment mode of "constitution differentiation-disease differentiation-syndrome differentiation" and the development of personalized and targeted standardized medical intervention programs for the stable COPD. |
PDF Full Text Request