Correlation Between Plasma Cortisol Level And TCM Syndrome Types In Patients With Acute Attack Of Bronchial Asthma

OBJECTIVE: Bronchial asthma is a common and frequently occurring disease in respiratory medicine.In recent years,the role of hypothalamic pituitary adrenal(HPA)axis in bronchial asthma has been paid more and more attention.Endogenous glucocorticoids have an important regulatory role in asthma.Cortisol(Cor)is a common indicator of HPA axis function,which can predict the body state of asthmatic patients.Using TCM theory to explain the mechanism of HPA axis in asthma and explore the correlation between cor and other modern medical indicators and TCM syndrome types has important clinical significance.The purpose of this study is to observe the plasma cor level of patients with acute attack of bronchial asthma and analyze the correlation between cor level and TCM syndrome types.Immunoglobulin E(Ig E),eosinophil absolute value(EOS),lung function related indexes(FEV1,FEV1 / FVC,PEF,MMEF),Fe NO and other indexes were collected to analyze the correlation between cor and them.To explore the feasibility of using cor level to evaluate the body state of patients with bronchial asthma,and provide modern index basis for syndrome differentiation of bronchial asthma,so as to guide clinical practice.METHOD:119 patients with acute attack of bronchial asthma hospitalized in the lung department of the Affiliated Hospital of Shandong University of traditional Chinese medicine from June 2020 to December 2021 were selected as the research object.The information of patients’ age,gender,smoking history,course of disease,TCM syndrome type,cor,Ig E,EOS,Fe NO,lung function and other examination indexes were collected in detail,and the distribution characteristics of cor among TCM syndrome types were analyzed;Correlation between cor and each inspection index;According to the statistical difference of various indexes between TCM syndrome types,draw a conclusion.RESULT:1.General information: among the patients with acute attack of bronchial asthma,women accounted for a large proportion(60.5%);The age distribution was concentrated in the range of 8 ~ 53 years old;The distribution of syndrome types is more empirical(57.1%),and the syndrome of phlegm heat blocking the lung and the syndrome of wind phlegm blocking the lung account for a large proportion;There are more patients without smoking history.Among the smokers,the smoking index is in the range of 400 ~ 799(44.4%).2.Laboratory indicators: in the analysis of the correlation between cor and general data,it was found that the level of cor was negatively correlated with the course of disease and age;There was no correlation with smoking index and gender distribution.In the correlation analysis between cor and laboratory indexes,it was found that the level of cor was negatively correlated with Ig E(r =-0.302,P = 0.001);It was negatively correlated with Fe NO(r =-0.307,P = 0.001);It was positively correlated with pulmonary function indexes(FEV1,FEV1 / FVC,PEF);There was no significant correlation with EOS level.3.Correlation analysis of TCM syndrome types: in this study,the distribution of syndrome types of patients with acute attack of bronchial asthma is mainly empirical,including wind phlegm blocking lung syndrome and phlegm heat blocking lung syndrome.Among them,wind phlegm blocking lung syndrome has the largest number,and deficiency syndrome types include lung Spleen Qi deficiency syndrome and lung and kidney deficiency syndrome.There were significant differences in age,course of disease,cor,EOS,lung function and other indexes among syndrome types(P < 0.05): there were significant differences in age distribution between lung and kidney deficiency syndrome and phlegm heat blocking lung syndrome;From the course of disease,the course of lung and kidney deficiency syndrome is the longest,followed by lung spleen qi deficiency syndrome,phlegm heat blocking lung syndrome and wind phlegm blocking lung syndrome;There was no significant difference in cor level between phlegm heat blocking lung syndrome and wind phlegm blocking lung syndrome,but there was significant difference between phlegm heat blocking lung syndrome and lung spleen qi deficiency syndrome and lung and kidney deficiency syndrome respectively(P < 0.05);There was significant difference in pulmonary function indexes between positive syndrome and deficiency syndrome(P < 0.05);There was no significant difference in Ig E and Fe NO among syndrome types(P > 0.05).CONCLUSION:1.The TCM syndrome type of patients with bronchial asthma attack is mainly wind phlegm blocking lung syndrome,followed by phlegm heat blocking lung syndrome.Deficiency syndrome mainly includes lung spleen qi deficiency syndrome and lung and kidney deficiency syndrome.2.The level of cor in patients with bronchial asthma is related to many factors,such as the course of disease,age and so on.At the same time,it has correlation with multiple laboratory indexes,such as Ig E,Fe NO and pulmonary function indexes.3.HPA axis function affects the body state of bronchial asthma.The lower the COR,the worse the lung function and the higher the levels of Fe NO and Ig E.4.The level of cor in different TCM syndrome types has significant differences,and the level of cor in lung and kidney deficiency syndrome is the lowest.