| Background:The prevalence and mortality rates of bronchial asthma are increasing,anxiety and depression are also a global problem,and psychological comorbidity is more common in people with asthma than in other diseases.T lymphocytes play an important role in this process as an important mediator of asthma immune response and brain neuroinflammation.TCM physique is also linked with various inflammatory factors related to T lymphocytes.Objective:Taking patients with chronic persistent bronchial asthma as objects,to explore the incidence,risk factors,immune characteristics and three-yin and three-yang physical distribution of asthma co-morbid anxiety and depression,and further study the immune differences of patients with different physical conditions of asthma.From the perspective of regulating emotions and regulating physique,so as to find out the new ideas of preventing and treating bronchial asthma.Methods:This study included 101 patients with chronic persistent bronchial asthma who visited the respiratory clinic of Dongzhimen Hospital of Beijing University of Traditional Chinese Medicine from November 2019 to December 2021,and after signing the informed consent,10 ml of peripheral blood was drawn from the patients,and peripheral blood immune cells were detected by flow cytometry,including the number and proportion of CD3+,CD4+,CD8+,Th1,Th2,Th17 and Treg,and the data were statistically analyzed.The clinical data of the subjects were also collected,including general clinical information,laboratory test results,gastrointestinal symptoms,mood and body mass score scales.The patients’ emotional state and physique type were determined according to the scale score results and the three-yin and three-yang physique identification software.Results:1.Analysis results of anxiety-depression group and no anxiety-depression group:(1)Basic situation analysis:a total of 101 asthma patients,45 males and 56 females,were included,including 49 patients(48.51%)in the anxiety-depression group,17 males and 32 females,with an average age of 53.6±5.08 years;52 patients(51.49%)in the no anxiety-depression group,28 males and 24 females,mean age 52.64±15.13 years,no statistical difference between the two groups in terms of gender and age(P>0.05).There were 53 cases(52.48%)with allergic rhinitis,30 cases(56.60%)in the anxiety-depression group and 23 cases(43.40%)in the no-anxiety-depression group;there were 48 cases without allergic rhinitis,19 cases(39.58%)in the anxiety-depression group and 29 cases(60.42%)in the no-anxiety-depression group.Regarding smoking 32 cases(31.68%)had a history of smoking,13 cases(40.62%)in the anxiety-depression group,with a smoking index of 124.9±290.28;19 cases(59.38%)in the no-anxiety-depression group,with a smoking index of 235.12±399.15;a total of 69 cases werenon-smokers,including 36 cases(52.17%)in the anxiety-depression group and 33 cases in the no-anxiety-depression group(47.83%).(2)Analysis of the scores of each scaleand blood results:The average BMI of the anxiety-depression group was significantly higher than that of the non-anxiety-depression group(P<0.05);asthma control was poorer in the anxiety-depression group,and the ACT score was significantly lower than those in the the non-anxiety-depression group(P<0.01);gastrointestinal symptoms were prominent,and the score of gastrointestinal symptoms was significantly higher than that of the non-anxiety-depression group(P<0.01);white blood cell count and neutrophil count were significantly higher than those without anxiety and depression(P<0.05);Th1,Th17 and Th17/Treg were significantly higher in the anxiety-depression group than in the non-anxiety-depression group(P<0.05),with a highly significant difference in Th17/Treg(P<0.01).(3)Immune cell analysis of male and female patients in the anxiety-depression group:CD4+and CD4+/CD8+ were extremely significantly lower in male patients than in female(P<0.01),while CD8+was extremely significantly higher than in female(P<0.01).2.Correlation analysis of gastrointestinal symptom scores:gastrointestinal symptoms cores were positively correlated with Th1,Th1/Th2,Th17,Th17/Treg,anxiety-depressio n(P<0.05)and negatively correlated with ACT scores(P<0.05).3.Results of the analysis of the correlation between asthma co-morbid anxiety and depression and the three-yin and three-yang physique:(1)Distribution of physiques:among 101 asthma patients,there were 57 cases(56.43%)in the Jueyin physique,including 30 cases(52.63%)in the anxiety and depression group and 27 cases(47.37%)in the non-anxiety-depression group;23 cases(22.77%)in the Shaoyang physique,including 14 cases(60.87%)in the anxiety anddepression group and 9 cases(39.13%)in the non-anxiety-depression group;19 cases(18.81%)of Yangming physique,including 5cases(26.32%)of anxiety-depression group,14 cases(73.68%)of non-anxiety-depression group;1 case(0.995%)of Taiyang physique and 1 case(0.995%)of Shaoyin physique,all of which were classified as non-anxiety-depression group and were not involved in the comparative analysis because the number was too small.(2)Analysis of the data of the three physique types in the anxiety-depression group:the proportion of female patients in the Shaoyang physique was significantly higher than that in the Jueyin physique and Yangming physique(P<0.05);the lymphocyte counts in the Jueyin physique and Shaoyang physique were extremely significantly lower than Yangming physique(P<0.01).No statistical differences were seen for the remaining results.(3)Analysis of the data of the three physique types in the non-anxiety-depression group:eosinophil counts were significantly higher in the Shaoyang physique than Yangming physique(P<0.05)and extremely significantly higher in the Jueyin physique(P<0.01);Th1 was extremely significantly higher in the Yangming physique than in the Shaoyang physique(P<0.01),and Th2 was significantly higher than in the Jueyin physique and Shaoyang physique(P<0.05).Conclusion:1.Asthma patients have a high prevalence of anxiety and depression,and women and obesity are important risk factors.Anxiety-depression group have prominent gastrointestinal symptoms and poorer asthma control and more severe immune imbalance,especially related to immune indexes Thl and Th17.In addition,female patients also show more severe immune dysfunction than male patients.2.The imbalance of homeostasis in the gastrointestinal tract is not conducive to asthma control and is prone to anxiety and depression and immune imbalance.3.Asthma co-morbid anxiety and depression are more likely to occur in the Jueyin physique,shaoyang physique,and yangming physique.The immune cell levels of asthma patients differ between physiques without the influence of emotional factors,if under the influence of anxiety and depression,the difference in immune function between different physique is not significant.Therefore,regulating the physique,improving the internal environment state,and relieving anxiety and depression should be important directions to improve the prevention and treatment of asthma. |
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