Clinical Characteristics And T.C.M. Constitution Analysis On The Phenotype Of Frequent Exacerbation Of Chronic Obstructive Pulmonary Disease In Chengdu

Research Objective: This study collected the patients admitted to hospital with acute exacerbation of chronic obstructive pulmonary disease(COPD)in Chengdu area,divided into frequent acute exacerbation phenotype patients and non-frequency acute exacerbation phenotype patients according to their history,collected the clinical characteristics data of the two groups,TCM physique and other data,and compared the differences between the two groups to guide the individualized treatment of COPD with integrated Chinese and western medicine.Research Methods: To collect the clinical data of the patients with acute exacerbation of chronic obstructive pulmonary disease in Chengdu from June 2019 to December 2019 in the Department of Respiratory Medicine of Chengdu University of Traditional Chinese Medicine.the vital signs,some blood routine results,some biochemical results,DIC detection,blood gas analysis,C-reactive protein,erythrocyte sedimentation rate,sputum bacteria culture and lung function were collected retrospectively after discharge.the neutrophil/lymphocyte ratio,platelet/lymphocyte ratio,and endogenous creatinine clearance were calculated in the two groups.The hospitalization days and hospitalization cost information of the two groups were collected.applied statistical software to compare the differences between the two groups.Results: 1.Basic data comparison: a total of 120 patients with COPD were included in this study,including 57 in frequent group and 63 in non-frequency group.Frequent group had lower body mass index,higher smoking index and longer course of disease(all p<0.05);2.Comparison of vital signs at the time of admission: breathing and pulse in the frequent group were higher than those in the non-frequent group(both p <0.001),and the body temperature in the frequent group was higher(p <0.05);3.Comparison of laboratory tests: the white blood cell count,neutrophil percentage,neutrophil / lymphocyte ratio,platelet / lymphocyte ratio,and C-reactive protein in the frequent group were higher than those in the infrequent group(all p <0.001).The number of lymphocytes in the frequent group was less than that in the infrequent group(p <0.001),and the erythrocyte sedimentation rate in the frequent group was faster than that in the infrequent group(p <0.05);serum sodium,chlorine,and albumin in the frequent group were lower than those in the infrequent group(all p < 0.05),while the B-type natriuretic peptide and homocysteine were higher than those of the infrequent group(both p <0.05);the arterial oxygen pressure of the frequent group was lower than that of the infrequent group and the carbon dioxide partial pressure was higher than that of the infrequent group(both p <0.05);prothrombin time and fibrinogen were higher in the frequent group than in the non-frequent group(both p <0.05);4.Pulmonary function comparison: one-second forced expiratory volume,one-second forced expiratory volume as a percentage of the predicted value,and peak expiratory flow rate as a percentage of the predicted value were lower in the frequent group than in the infrequent group(both p <0.05);5.Comorbidity comparison: the age-adjusted Charlson comorbidity index was higher in the frequent group(p <0.05);6.Days of hospitalization and cost comparison: hospitalization days of frequent group were significantly longer than that of non-frequent group(p<0.001),and the total cost and daily cost of frequent group were higher than that of non-frequent group(p<0.001);7.Comparison of T.C.M.constitutions: T.C.M.constitution in frequent group was mainly qi deficiency and phlegm dampness,Phlegm dampness,damp heat and qi deficiency in non-frequency group,and the number of patients with qi deficiency in frequent group was significantly higher than that in non-frequency group(p<0.05).Conclusion:The clinical characteristics of patients with the frequent acute exacerbation phenotype of COPD differ significantly from those with the infrequent acute exacerbation phenotype.The frequent group had longer disease duration,a higher smoking index,a lower body mass index,and was admitted to the hospital with more severe disease due to acute exacerbations,more comorbidities.greater inflammation and more likely to be in a pre-thrombotic state;significantly higher health care costs in the frequent group;and a significant difference between the frequent and infrequent group There are differences in TCM body types.