Analysis Of Related Factors In Patients With Chronic Cough With Increased FENO And Study On The Regularity Of Traditional Chinese Medicine Treatment

Objective1.Analyze the general data,personal history,physical and chemical indexes,rating scale,current medical history and four diagnostic data of patients with chronic cough with increased FENO,and compare them with patients with subacute cough with increased FENO to explore the related risk factors of chronic cough with increased FENO.2.Collect the Clinical Prescriptions of the Second Affiliated Hospital of Tianjin University of TCM for the treatment of chronic cough with increased FENO,and use modern data mining methods to summarize the clinical medication characteristics and prescription rules of traditional Chinese medicine for the treatment of chronic cough with increased FENO,so as to provide reference for clinical prescription medication.Methods1.Design the data collection form for patients with subacute / chronic cough with increased FENO.Collect the patients with subacute and chronic cough with increased FENO level in the outpatient department of respiratory and critical care of the Second Affiliated Hospital of Tianjin University of TCM from November 2020 to October 2021 as the research object.Investigate and record the general data,personal history,physical and chemical indexes,scoring scale,current medical history and four diagnostic date of traditional Chinese medicine,etc.IBM SPSS statistics 24.0 statistical software was used for statistical analysis.2.Collect the Clinical Prescriptions of experts with senior professional titles in the respiratory department of the Second Affiliated Hospital of Tianjin University of traditional Chinese medicine from November 2020 to October 2021 for the treatment of patients with chronic cough with increased FENO level.The drug dosage form can be decoction or granule.Use IBM SPSS modeler 18.0,IBM SPSS statistics 24.0 and other software for data mining,To summarize the clinical characteristics and prescription rules of traditional Chinese medicine in the treatment of chronic cough with increased FENO.Results1.Analysis of related factors of chronic cough with increased FENO(1)In terms of general data,there was no significant difference between subacute cough with increased FENO level and chronic cough in gender,age,height,weight and BMI index(P > 0.05).(2)In terms of personal history,there was no significant difference between the two groups in smoking history,contact history,history of allergic diseases,dietary preference and personal emotion ratio(P > 0.05);The proportion of patients with allergic history in chronic cough group with increased FENO was significantly higher than that in subacute cough group(P < 0.05).(3)In terms of physical and chemical indexes,the median FENO in chronic cough group was 50(37,102)ppb,which was significantly higher than 36.5(30.75,72.5)ppb in subacute cough group(P < 0.05).The proportion of patients with severe increase of FENO in chronic cough group was higher,while the proportion of patients with mild increase of FENO in subacute cough group was higher,which was statistically significant(P < 0.05);There was no significant difference in the indexes of pulmonary function between the two groups(P > 0.05);Compared with the blood routine indexes,the median EO% index in chronic cough group was4.050(1.950,6.075),which was higher than that in subacute cough group 2.000(1.025,6.775),the difference was statistically significant(P < 0.05);The median EO# index in chronic cough group was 0.260(0.128,0.455),which was significantly higher than that in subacute cough group 0.140(0.073,0.408)(P < 0.05).(4)In terms of scoring scale,the median daytime cough score was 2(1,2)and the median nighttime cough score was 2(1,3)in subacute cough group;The median of daytime cough score in chronic cough group was 1(1,2),and the median of nighttime cough score in chronic cough group was 2(1,3).There was no significant difference between the two groups(P >0.05).The median cough VAS score of subacute cough group was 60(50,80),and that of chronic cough group was 60(45,80).There was no significant difference between the two groups(P > 0.05).(5)In terms of current medical history,patients with subacute cough had a higher incidence of cough during the day,while patients with chronic cough had a higher incidence of cough at night or in the early morning(P < 0.05).The rate of patients with chronic cough in winter was higher,and the difference was statistically significant(P < 0.05).The rate of patients with cough induced by respiratory tract infection and active expectoration in subacute cough group was higher,and the difference was statistically significant(P < 0.05);The rate of patients with cough induced by pungent smell and cold air in chronic cough group was higher,and the difference was statistically significant(P < 0.05).(6)In terms of the four diagnostic data of traditional Chinese medicine,the subacute cough group showed a higher proportion of patients with yellow white phlegm,yellow phlegm,sore throat,yellow turbid nose,sticky mouth,red tongue,yellow fur and pulse number(P < 0.05);The proportion of patients with white phlegm,shortness of breath,fatigue,insomnia,chest tightness,white fur and pulse string in chronic cough group was higher than that in subacute cough group(P < 0.05);The rate of patients with chronic cough involving liver and stomach was higher,and the difference was statistically significant(P < 0.05).Compared with the syndrome types of traditional Chinese medicine,the main syndrome types of chronic cough were “acute wind contracture syndrome” and “phlegm retention in the lung”,and the main syndrome types of subacute cough were “lung syndrome of wind heat Commission” and “phlegm heat Yu lung syndrome”(P < 0.05).2.Study on medication rule of TCM for chronic cough with increased FENOA total of 104 prescriptions that met the inclusion and exclusion criteria,involving 129 herbs of traditional Chinese medicine,were included in the study,for a total of 1645 times.The high-frequency traditional Chinese medicines(TCM)were,in turn,liquorice,cicadidym,bitter almond,stiff silkworm,ephedrine,Scutellaria baicalensis,anterior Hu,Platycodon grandiflorum,melem alba,etc;The selection of drug efficacy is mainly based on cough,phlegm and asthma,surface solving,and clearing heat;The medicinal meridian choice is based on lung meridian,stomach meridian,spleen meridian,and liver meridian;The selection of medicinal herbs was mainly based on Xin,Bitter and Gan;The selection of drug properties was based on Wen,Han,and Ping;The association rule analysis resulted in 44 high-frequency pairs with 100% confidence,which were mainly presented as interactive combinations of high-frequency drugs;Systematic clustering analysis resulted in 4 commonly prescribed prescriptions.The first prescription: fritillaria thunbergii,honey cortex mori radicis,scutellaria baicalensis,medicinal silkworms,cicada slough,glycyrrhiza uralensis,platycodon grandiflorum,aster,peucedanum root,and radix stemonae;Prescription 2: coltsfoot flower,earthworm,ephedra and bitter almonds;Prescription 3: belamcanda Chinensis,perilla leaves,radix scrophulariae,lepidium seed,forsythia,houttuynia cordata,flos magnoliae and perilla frutescens seed;Prescription 4: pinellia ternata,tangerine peel,schisandra chinensis and endothelium corneum gigeriae galli.ConclusionThe chronic cough patients with increased FENO had a higher rate of history of allergy,higher FENO level,peripheral blood EO%,higher EO% level,more nocturnal and early morning or winter preferentially than the subacute cough patients with increased FENO,and were more likely to have cough induced by irritating odors and cold air.The patients presented more often with white sputum,shortness of breath,fatigue,insomnia,chest tightness,lichen white,pulse chords,The TCM disease location involves more spleen and stomach,and syndrome differentiation in TCM is more defined as the syndrome of “acute wind contracture syndrome” and “phlegm retention in the lung”.These results suggest that a history of allergy,FENO level,peripheral blood eosinophil level,cough predilection time,cough inducing factors,data from the four Chinese medicine clinics,TCM disease location,and TCM syndrome differentiation may be relevant factors for the progression of subacute cough with increased FENO to chronic cough.The efficacy options of traditional Chinese medicine are mainly drugs for antitussive phlegm,drugs for antiasthmatic,drugs for treating exterior syndromes,and drugs for antipyretic;The medicinal meridian choice is based on lung meridian,stomach meridian,spleen meridian,and liver meridian;The selection of medicinal herbs was mainly based on Xin,Bitter and Gan;The selection of drug properties was based on Wen,Han,and Ping;The core therapeutic basis for chronic cough associated with increased FENO is based on fritillaria thunbergii,honey cortex mori radicis,scutellaria baicalensis,medicinal silkworms,cicada slough,glycyrrhiza uralensis,platycodon grandiflorum,aster,peucedanum root,and radix stemonae,and the whole prescription is combined with the functions of relieving cough and spasm,clearing heat and resolving phlegm;To add herbs when cough is heavier,including coltsfoot flower,earthworm,ephedra and bitter almonds;To add herbs when phlegm and heat images are heavier,including belamcanda Chinensis,perilla leaves,radix scrophulariae,lepidium seed,forsythia,houttuynia cordata,flos magnoliae and perilla frutescens seed;When the spleen and stomach are out of tune,when phlegm condenses or when food accumulates,to add pinellia ternata,tangerine peel,schisandra chinensis and endothelium corneum gigeriae galli.