Study On TCM Syndrome Of Chronic Obstructive Pulmonary Disease And Its Relationship With Northwest Dryness Syndrome In Different Nationalities In Kizilsu Kirgiz Autonomous Prefecture, Xinjiang Uygur Autonomous Region

Objective:Summarizing the incidence of Chronic Obstructive Pulmonary Disease (COPD) with Northwest Dryness Syndrome in different nationalities, gender, age, disease stage, to analyze and discuss the pathogenesis, syndromes, and the relationship between Traditional Chinese Medicine (TCM) syndromes of COPD and Northwest Dryness Syndrome of patients with COPD in Kizilsu Kirghiz Autonomous Prefecture in Xinjiang province through collecting the general information, symptom information and syndrome elements information, so as to provide guidance and theoretical basis for clinical treatment of COPD.Methods:Questionnaire items were compiled by means of clinical investigation, literature review, relevant experts consultation, with Cronbach a=0.904, which showed a good reliability. After the questionnaires were confirmed, the relative Investigators were trained. Then the questionnaires were sent out for the patients in the county hospitals of Kizilsu Kirghiz Autonomous Prefecture in Xinjiang province. The entire database of patient information was established after data input, check and error correction. The data was sorted and screened independently by two people. Questionnaires which did not conform to the requirements or not answer in accordance with the relevant provisions were excluded. The data was analyzed after divided into four groups according to the patients’whole condition, the condition in acute exacerbation phase, the condition in stable phase, and the COPD patients with the Northwest Dryness Syndrome, to investigate the pathogenesis, syndrome distribution, and the relationship between COPD and Northwest Dryness Syndrome.Results:There were more female patients with COPD than male patients in Han nationality, while more male patients than female patients in Uyghur nationality and Khalkhas nationality; In the acute exacerbation phase, there were less male patients than female in Han, Uyghur and Khalkhas nationalities, while in stable phase, there were more male patients than female in Han and Khalkhas nationalities, and there were less male patients than female in Uyghur nationality; there were more male patients than female with Northwest Dryness Syndrome in Han and Khalkhas nationalities, and there were less male patients than female in Uyghur nationality. In general, there were more women with the syndrome of cold outside and fluid-retention inside, the syndrome of wind-cold attacking the lung and the syndrome of phlegm and blood stasis obstructing the lung. There were more men with the syndrome the syndrome of wind-heat invading the lung and the syndrome of liver-fire invading the lung. At acute exacerbation phase, more women than men suffered from COPD with the syndrome of wind-cold attacking the lung, the syndrome of liver-fire invading the lung, the syndrome of phlegm and blood stasis obstructing the lung and the syndrome of cold outside and fluid-retention inside, while there were more men with the syndrome of wind-heat invading the lung. At the stable stage, more men suffered from COPD with the syndrome of wind-cold attacking the lung, the syndrome of liver-fire invading the lung, the syndrome of phlegm and blood stasis obstructing the lung and the syndrome of cold outside and fluid-retention inside, while the number of patients with the syndrome of wind-heat invading the lung was not significant different between female and male. For grade Ⅰ, Ⅱ and Ⅳ lung function patients, there were more women than men, while there were more men than women whose lung function was at grade Ⅲ. According to different ages, there were more women than men between 40 and 79 overall and at the acute exacerbation phase, but there were more male patients than female ones over 80 years old. At the stable period, between 40 and 49 years old, there were more female COPD patients than male ones, and there were more male between 50 and 80 years old. Between 40 and 80 years old, Kirgiz are the most, especially between 40 and 50 years old, and between 60 and 80 years old. According to nationalities, in general, for the syndrome of wind-cold invading the lung, the syndrome of liver-fire invading the lung and the syndrome of cold outside and fluid-retention inside, the number of patients appeared as Kirgiz> Han> Uyghur; for the syndrome of wind-heat invading the lung, the syndrome of phlegm and blood stasis obstructing the lung, it appeared as Kirgiz> Uyghur> Han. At the acute exacerbation phase, for the syndrome of wind-heat invading the lung, the number of patients appeared as Kirgiz> Han> Uyghur; for the syndrome of wind-heat invading the lung, the syndrome of phlegm and blood stasis obstructing the lung and the syndrome of cold outside and fluid-retention inside, it appeared as Kirgiz> Uyghur> Han; for the syndrome of liver-fire invading the lung, it appeared as Han> Uyghur> Kirgiz. At the stable phase, for the syndrome of wind-heat invading the lung, the number of patients appeared as Kirgiz> Han and Uyghur; for the syndrome of cold outside and fluid-retention inside, Kirgiz and Han> Uyghur. COPD patients with Northwest Dryness Syndrome of Kirgiz nationality were the most among all the nationalities. Most patients with grade Ⅲ lung function were of Kirgiz and Uyghur nationality. Compared different syndromes, for patients with the syndrome of wind-cold invading the lung, the syndrome of wind-heat invading the lung, the syndrome of liver-fire invading the lung, the syndrome of phlegm and blood stasis obstructing the lung and the syndrome of cold outside and fluid-retention inside, most patients’lung function was grade Ⅲ. The TCM syndromes of COPD patients were complex. Although syndrome differentiation was based on five core syndromes, they usually combined with other syndromes. Western medicine symptoms questionnaire referred to the modified version of mMRC and CAT, mainly collecting symptoms of cough, wheezing, breathing, sleep, energy, and so on. But TCM symptoms questionnaire collected all the signs and symptoms of patients. Therefore, western medicine symptoms scores emphasized the main symptoms while TCM symptom scores reflected the patient’s overall symptoms. Compared the western medicine symptoms scores and TCM symptoms scores at different disease phases, there were differences between them for the patients at different ages, gender, nationalities, TCM syndromes, and different lung function. But their overall development trends were consistent, which was more men than women, and more elderly patients than young patients. Analysising the COPD patients with the Northwest Dryness Syndrome’s other syndrome through the Northwest Dryness Syndrome Differentiation Method, the most was the syndrome of lack of essence and blood in liver and kidney, followed by the yin deficiency of heart and kidney syndrome, the lung, heart and spleen of wind-fire-dryness syndrome.Conclusion:In general, the female patients with COPD were higher than male in Kizilsu Kirghiz Autonomous Prefecture in Xinjiang province, but for the prevalence of COPD with Northwest Dryness Syndrome, male patients were higher than female. But there were respective differences in the nationality distribution. Male patients were more vulnerable to heat evil invading, while female were more to cold evil. Female were vulnerable to be affected by all kinds of factors, leading to the acute attack of COPD. While in the stable stage of COPD, there were more male than female. Female had an earlier onset than male, but with the increasing age, there were more male than female. There were nationality differences in different syndromes of COPD, most of whom were Khalkhas nationality, which was related to the Khalkhas nationality residents living in the Kizilsu Kirghiz Autonomous Prefecture. Most parts of Xinjiang province are dry and cold, and Kizilsu Kirghiz Autonomous Prefecture is in the south part of Xinjiang province, with a large area of desert, so the weather is mutable, with dry, cold and hot in combination in a year. The complication of the COPD patients’ syndrome was induced by cold, hot, dry, phlegm, dampness and emotion, etc. The syndrome differentiation was the five main syndromes, with several other syndromes. There were many positive correlations between TCM syndromes of COPD and Northwest Dryness Syndrome, with a little of negative correlations.