Distribution Of TCM Syndrome And Related Factors In Patients With Stable COPD Complicated With Functional Constipation

Objective:This study aimed to summarize the distribution of Traditional Chinese Medicine(TCM)syndrome in patients with stable chronic obstructive pulmonary disease(COPD)complicated with functional constipation,with the goal of providing evidence-based medicine for the development of TCM prevention and treatment plans.Furthermore,correlation analysis was conducted to explore the possible influencing factors in patients with stable COPD complicated with functional constipation and provide reference for the identification and evaluation of this disease.Methods:A cross-sectional survey method was adopted,and a total of 224 patients with stable COPD complicated with functional constipation were included in this study for the collection of their TCM four diagnostic information.Multivariable statistical analysis was conducted to analyze the data.Initially,factor analysis was conducted to extract the basic syndromes from the TCM four diagnostic information,which had undergone standardized processing,using common factors.Subsequently,a systematic cluster analysis was employed to obtain the distribution of commonly observed TCM patterns.Based on the results of factor analysis,systematic cluster analysis,and expert opinions,the distribution of TCM patterns in patients with stable COPD complicated with functional constipation was determined.In addition to collecting the TCM four diagnostic information,the general information of patients,including gender,age,duration of COPD,body mass index(BMI),smoking history,smoking index,alcohol consumption,as well as respiratory difficulty assessment(mMRC),pulmonary function grading(FEV1%),comprehensive evaluation,and constipation symptom score(CSS),were also collected for correlation analysis to explore the possible influencing factors of this disease.Results:1.Correlation analysis:The results showed that age,duration of COPD,mMRC score,pulmonary function grading,and comprehensive evaluation were positively correlated with CSS score(r/rs were 0.284,0.216,0.313,0.263,and 0.327,respectively,all P<0.01),while BMI and FEV1%were negatively correlated with CSS score(r/rs were-0.138 and-0.292,respectively,all P<0.05).No significant associations were found between gender,smoking history,smoking index,alcohol consumption,and CSS score(all P>0.05).2.Based on multivariate statistical analysis,TCM syndrome analysis was conducted:The KMO and Bartlett’s sphericity test were performed on the 44 TCM four diagnostic information in patients with stable COPD complicated with functional constipation,with the KMO value being 0.617(>0.5)and Bartlett’s sphericity test resulting in a chi-square value of 4128.361 and a P value of 0.000(<0.01),indicating that factor analysis was appropriate for this data set.Based on characteristic roots larger than 1,a total of 16 common factors were extracted using factor analysis.The location of TCM syndromes in patients with stable COPD complicated with functional constipation was found to be primarily in the lungs,colon,spleen,and kidneys,followed by the heart and liver.The pathological factors were identified as both deficiency and excess syndromes,with deficiency syndromes such as qi deficiency,yin deficiency,and yang deficiency being more common.Excess syndromes were mainly characterized by phlegm,blood stasis,dampness,and qi stagnation,while these two types of syndromes could also coexist.The 16 common factors were used as variables in systematic cluster analysis,combined with expert suggestions,and four TCM patterns were ultimately identified in patients with stable COPD complicated with functional constipation based on their factor scores:lung-spleen-kidney qi deficiency syndrome with phlegm turbidity,lung-kidney qi-yin deficiency syndrome with phlegm-heat,phlegm-blood stasis syndrome,and spleen-kidney yang deficiency syndrome.3.The characteristics of distribution of TCM syndrome types:The distribution of TCM syndrome was as follows:lung-spleen-kidney qi deficiency syndrome with phlegm turbidity in 70 cases(31.25%)>lung-kidney qi-yin deficiency syndrome with phlegm-heat in 63 cases(28.13%)>phlegm-blood stasis syndrome in 60 cases(26.79%)>spleen-kidney yang deficiency syndrome in 31 cases(13.84%).The distribution of the four TCM syndrome with respect to age,duration of COPD,pulmonary function grading,comprehensive evaluation,and CSS score showed statistically significant differences(P=0.00<0.05),while there were no statistically significant differences in terms of gender,BMI,smoking history,and alcohol consumption(P>0.05).Conclusions:1.Age,duration of COPD,BMI,mMRC score,pulmonary function grading,and comprehensive evaluation were found to be correlated with CSS score in patients with stable COPD complicated with functional constipation.This suggests that the severity of constipation in these patients may be related to age,duration of COPD,BMI,mMRC score,pulmonary function,and comprehensive evaluation.2.The main Chinese Medicine syndrome in patients with stable COPD complicated with functional constipation were identified as qi deficiency,yin deficiency,yang deficiency,phlegm,dampness and blood stasis.The location of TCM syndrome was characterized by involvement of the lungs,colon,spleen,and kidneys.3.Patients with stable COPD complicated with functional constipation could be classified into four TCM patterns:lung-spleen-kidney qi deficiency syndrome with phlegm turbidity,lung-kidney qi-yin deficiency syndrome with phlegm-heat,phlegm-blood stasis syndrome,and Spleen-kidney yang deficiency syndrome.Lung-spleen-kidney qi deficiency syndrome with phlegm turbidity is characterized by whitish and viscous phlegm that is difficult to expectorate,abundant phlegm,pale tongue,no thirst and dry mouth with a desire to drink,clear and watery phlegm with lots of foam that is easy to cough up,palpitations,chest tightness,sore and weak waist and knees,thin and submerged pulse,and insomnia.Lung-kidney qi-yin deficiency syndrome with phlegm-heat is characterized by scanty yellow and viscous phlegm that is difficult to expectorate,night sweats,wheezing and shortness of breath,little coating on tongue,tinnitus,and spontaneous sweating.Phlegm-blood stasis syndrome is characterized by a dark purplish tongue,with or without petechiae,dizziness,epigastric distension,bitter taste,sticky mouth,headache,red tongue,poor appetite,hot flashes,yellow coating,and dark purple lips.Spleen-kidney yang deficiency syndrome is characterized by abdominal distension,abdominal pain,slippery pulse,deep and slippery pulse,frequent urination,nocturia,aversion to cold and cold extremities,yellowish complexion,susceptibility to catching a cold,lower limb edema,pale and enlarged tongue with teeth marks on the edges,and cough.4.Distribution of TCM syndrome of patients with stable COPD complicated functional constipation:Among the four syndrome types,lung-spleen-kidney qi deficiency syndrome with phlegm turbidity is the most common,followed by lung-kidney qi-yin deficiency syndrome with phlegm-heat,and spleen-kidney yang deficiency syndrome is the least common.The distribution of the four different TCM patterns in patients with stable COPD complicated with functional constipation showed statistically significant differences with respect to age,duration of COPD,mMRC score,pulmonary function grading,comprehensive evaluation,and CSS score.However,there were no statistically significant differences in terms of gender,BMI,smoking history,and alcohol consumption,which require further research and analysis.