Analysis And Validation Of The Outcome Indicators Of Acute Exacerbation Of Chronic Obstructive Pulmonary Disease In Adjuvant Treatment Of Chronic Obstructive Pulmonary Disease With Traditional Chinese Medicine Based On Principal Component Weight Analysis

ObjectiveIn this study,the principal component weighting method was used to analyze and summarize the current application status of clinical outcome indicators in the randomized controlled study（RCT）of Chinese medicine adjuvant treatment of acute exacerbation of chronic obstructive pulmonary disease（AECOPD）.Its weight,explore its practical value in clinical trials,and verify it through retrospective research,in order to provide a reference for the selection of subsequent AECOPD outcome indicators.Methods1 Status analysis of outcome indicators:through the China Academic Full-text Database（CNKI）,Wan Fang Data Knowledge Service Platform（Wan Fang Data）,VIP Chinese Periodicals Full-text Database（VIP）,China Biomedical Literature Database（Sin Med）,American Biomedical Journal Literature Database（Pub Med）and other databases to retrieve the literature on randomized controlled trials of traditional Chinese medicine adjuvant therapy for AECOPD,use Excel to build a database,count the frequency of use of each outcome index,and classify and summarize,and use principal component analysis to extract the principal components of all outcome indicators through SPSS statistics 25.0.The eigenvalues of the components,variance contribution table,initial factor loading matrix,eigenvector loading matrix and gravel plot were used to calculate the principal component weights and frequency weights of each outcome index to obtain comprehensive weights,and to explore the outcome indicators of adjuvant traditional Chinese medicine（TCM）treatment of AECOPD in multiple dimensions.2 Clinical validation:A retrospective study was used to screen AECOPD patients who were hospitalized in the respiratory department of The Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine from October 1,2019 to November 30,2021 as the research objects,and were divided into an experimental group and a control group.The experimental group was given traditional Chinese medicine decoction.Combined with conventional Western medicine treatment,the control group was given conventional Western medicine alone,the course of treatment was 1-2 weeks,based on the outcome indicators obtained in the first part of the article:including clinical efficacy,TCM syndrome scores,inflammatory infection,blood gas analysis,pulmonary function indicators,comprehensive Considering its clinical practical value,a retrospective clinical observation was carried out.Results1 Through multiple database literature searches and screening,a total of 260 RCT clinical studies on Chinese medicine adjuvant treatment of AECOPD were included,reporting139 outcome indicators with a total reporting frequency of 1,641 times.Principal component weights were applied to 70 outcome indicators with application frequency>2.Analysis method,further calculate the principal component weight and frequency weight of each outcome index,and perform multiplier synthesis and normalization to obtain the comprehensive weight of each outcome index.Western medicine symptom and sign score,FEV₁,Pa O₂,Pa CO₂,FEV₁/FVC,fatality rate,TCM syndrome score,FVC,CRP,safety index,PH value,WBC,the comprehensive weights are 0.062,0.048,0.047,0.038,0.037,0.034,0.027,0.027,0.025,0.021,0.021,0.021,and 0.019,these indicators were combined and classified according to the clinical reality.Therefore,the top 8 outcome indicators used in the RCT study of Chinese medicine adjuvant treatment of AECOPD in recent years were clinical patients.Efficiency,Western medicine clinical symptoms and signs scores,TCM syndrome scores,inflammatory indicators（WBC,CRP）,blood gas analysis indicators（Pa O₂,Pa CO₂,PH value）,pulmonary function indicators（FEV₁,FVC,FEV₁/FVC）,fatality rate,safety gender indicators.2 Validated by a clinical retrospective study,according to the inclusion and exclusion criteria,247 patients were finally included,200 in the experimental group and 47 in the control group.Cough,expectoration,shortness of breath,shortness of breath,constipation,dry mouth,fever,total score of TCM syndrome,inflammatory indexes（WBC,CRP）,blood gas analysis indexes（Pa O₂,PH value,Pa CO₂）in the experimental group after treatment,Lung function（FEV₁,FVC,FEV₁/FVC）had significant curative effect,and the difference was statistically significant（P<0.05）.The control group had cough,expectoration,wheezing,shortness of breath,shortness of breath,fever after treatment,and the total score of TCM syndromes,inflammatory index（CRP）,blood gas analysis index（Pa O₂,Pa CO₂）had significant curative effect,the difference was statistically significant（P<0.05）,there was no statistical significance in constipation,dry mouth single score,WBC,PH value（P>0.05）.Clinical efficacy,cough,expectoration,wheezing,shortness of breath,constipation,dry mouth single score,total score of TCM syndrome,inflammatory indexes（WBC,CRP）,blood gas analysis indexes（Pa O₂,PH value,Pa CO₂）after treatment in the two groups and pulmonary function index（FVC）were significantly different,and the difference was statistically significant（P<0.05）.The adjuvant treatment with traditional Chinese medicine had obvious advantages over the western medicine group,but there was no statistical difference in fever symptoms,FEV₁,and FEV₁/FVC between the two groups after treatment.significance（P>0.05）.Conclusion1 The top 8 outcome indicators selected in the current clinical research on Chinese medicine adjuvant therapy for AECOPD are clinical response rate,Western medicine clinical symptom and sign score,TCM syndrome score,inflammatory indicators（WBC,CRP）,blood gas analysis indicators（Pa O₂,Pa CO₂,p H value）,pulmonary function（FEV₁,FVC,FEV₁/FVC）,fatality rate,and safety indicators.The auxiliary measures in clinical research are mainly TCM decoction.The experimental study provides a certain reference for the selection of outcome indicators and the establishment of the clinical efficacy evaluation system.2 Combination of traditional Chinese medicine treatment and simple western medicine treatment can significantly improve the clinical efficacy,relieve the symptoms of cough,expectoration,wheezing,shortness of breath,shortness of breath,and fever in patients with AECOPD,reduce the total score of TCM syndromes and the level of inflammation,improve blood gas indicators,and improve lung function.The improvement was more obvious in the combined TCM group.The above outcome indicators can better reflect the changes in the clinical efficacy of TCM adjuvant therapy for AECOPD,and have good clinical practical value.