After A Cold Cough Syndrome Type And The Correlation Research

Objective1. By analyzing the literature of the past decade, the research will analyze the distribution of symptomsand syndromes of post-infectious cough (PIC) to provide a reference for clinical research and questionnaire.2. On the basis of theliterature and expert consensus results, using the methods of clinical epidemiology to research the syndrome distribution characteristics of PIC. A variety of data analysis methods will be used to mine the information of TCM syndrome and symptom,in order to discuss the common symptoms and TCM syndrome of PIC andthe relationship between them.3.Analyzing and comparing the clinical efficacy of common syndromes,toverify the clinical efficacy of TCM syndrome differentiation,and to explain the objective existence of syndrome and the correlation between formula and syndrome.Methods1.Theory researchThe researchcollected literature related to PICof the past decade and selected qualified literature to establish an information extraction table. SPSS13.0statistics software was used to analyze the frequency of the involved TCM symptoms, syndromes and basic information of literature.2. Clinical research2.1The research of syndrome types:On the basis of the literature results which involved the syndromes and symptoms,combined with the results of several rounds of expert consensus, the research drew a questionnaire to collect the information of four examinations and input the information into a collection andanalysis system.Observational study methods of prospective, multicentric, open, the combination of supervised and unsupervised were adopted.84Western medicine cases and419TCM cases were collected. The research applied SPSS13.0software to analyze the419TCM cases by using ratio analysis, factor analysis, cluster analysis and regression analysis.2.2The research of formula-syndrome and effectrelationship:First, comparing the efficacy between TCM syndrome differentiation and western medicine. On the basis of traditional Chinese medicine had advantage on efficacy, the research selected four common clinical syndromes which had similar therapy and formula to analyze and compare the inter-group and intra-group efficacy by applying SPSS13.0software.Results1. The results of theory research248qualified articles were included in the theory research, and there were106kinds of TCM syndromes through the process of standardization. There were7syndromes of which frequency was more than5%, including wind-cold attacking the lung syndrome, wind restraining the lung syndrome, phlegm-heat obstructing the lung syndrome, phlegm-dampness obstructing the lung syndrome, lung qi deficiency syndrome, wind-heat attacking the lung syndrome, lung-spleen qi deficiency.There were100TCM symptoms totally after normalization(not including tongue and pulse). The top ten main symptoms were dry cough,itchy throat,paroxysmal cough, white sputum, little sputum, sticky sputum, thin sputum, dry throat, dry mouth, cough-induced factors for the cold. The top five related symptoms were fatigue, spontaneous sweating, loss of appetite, chest tightness, and headache. There were34kinds of tongue characteristics, the common tongue (frequency>5%) including red tongue, pale tongue, pale-red tongue, white coating, yellow coating, thin coating, thick coating. And there were17kinds of pulse conditions, the common pulse (frequency>5%) including thready pulse, rapid pulse, floating pulse, wiry pulse, slippery pulse, weak pulse.2.The results of clinical epidemiology researchThere were132male and287female patients in419PIC cases. The number of female was2.17times of the male. The patients’average age was47.67±15.49years old and main component of the patients were young and middle-aged people.There were25kinds of main symptoms(frequency>10%), including sputum, white sputum or cough without sputum or slightly yellow sputum, sticky or thinsputum,sputum less or phlegm or sputum volume in general, coughing. with faint and low sound or with heavy sound, paroxysmal coughing,cough aggravating at night or in the morning, cough aggravating at day time or no significant time difference, inducing agent of the cough included cold-wind, fumes, odor, talk too much and air pollution, hoarse voice, chest tightness, shortness of breath and asthma while moving were all common symptoms.There were23kinds of associated symptoms(frequency>10%), as follows: itchy throat,painful throat, pharyngeal foreign body sensation, dry mouth, bitter taste, thirst with a desire to drink water, afraid of cold, afraid of wind, fatigue, easy to catch a cold, stuffy nose, sneezing, watery discharge, headache,spontaneous sweating,skin allergies, loose stools or dry tools, loss of appetite, abdominal distension, restlessness, insomnia and dream disturbed sleep,weakness in the lower back and knees occasionally.The common tongue characteristics(frequency>10%) and pulse conditions (frequency>5%)were totally15kinds, including bright red tongue,dark red tongue, pale-dark tongue, white coating, thin coating, yellow coating, dry coating, thick coating, greasy coating, enlarged and tooth-marked tongue. The pulse conditions included wiry pulse, thready pulse, deep pulse, slippery pulse and weak pulse.There were8kinds of TCM syndromes that were the most common to see(frequency>5%):wind restraining the lung syndrome,lung qi deficiency syndrome, accumulated heat in the lung syndrome, phlegm-dampness obstructing the lung syndrome,wind-heat attacking the lung syndrome,lung-spleen qi deficiency,lung qi and yin deficiency syndrome,phlegm-heat obstructing the lung syndrome.3. Through factor analysis, we divided47kinds of common symptoms into19classes. There were a series of syndrome classes that might be involved in the disease, including wind restraining the lung, lung qi deficiency, wind-cold attacking the lung, accumulated heat in the lung, yin deficiency, lung-defense qi deficiency, phlegm-dampness, spleen deficiency, exterior deficiency, qi stagnation, liver fire invasion of the lung, lung-kidney deficiency, lung heat and body fluid deficiency, defense qi deficiency. There were some symptoms that did not belong to any classes, such as the class of cough inducing factors, the time of cough aggravation, the characteristics of the sputum, the symptoms of the skin.4.Through cluster analysis, we got14categories of general symptoms and5categories of tongue and pulse related symptoms.Combiningboth of the results, the syndromes of PIC wereprompted, including wind restraining the lung, lung qi deficiency,yin and body fluid deficiency, spleen deficiency,accumulated heat in the lung,phlegm-dampness, phlegm-heat, wind-cold attacking the lung, lung-defense deficiency, liver heat hyperactivity and kidney deficiency.5. Through logistic regression analysis, we got a series of symptoms that related to the syndromes closely.Wind restraining the lung syndrome:paroxysmal coughing, sputum less, thinsputum, cough aggravating at day time.Lung qi deficiency syndrome:coughing with faint and low sound, afraid of wind. Accumulated heat in the lung syndrome:yellow sputum, thirst with a desire to drink water, painful throat, hoarse voice. Wind-heat attacking the lung:yellow sputum, painful throat, thirst with a desire to drink water and sneezing.The regression results showed that when cough lasted for less than3weeks, the common syndromes were accumulated heat in the lung and wind-heat attacking the lung, while lung-spleen qi deficiency was rare to see. When the cough lasted for3-8weeks, wind restraining the lung syndrome and phlegm-dampness obstructing the lung syndrome had more possibilities to exist, while accumulated heat in the lung syndrome was rare to see. When the cough lasted for more than8weeks, lung-spleen qi deficiency and lung qi and yin deficiency were the syndromes more possible to appear.6. The results of the efficacy comparison between syndrome differentiation and western medicineOn the overall efficacy, the significant efficiency rate and effective rate were22.64%and84.91%respectively, while those of the TCM group were43.23%and95.83%, higher than the western medicine group. There was significant difference (P<0.01) between the two groups in efficiency rates. The results showed that TCM syndrome differentiation was obviously superior to western medicine in promoting the efficiency rate of PIC.TCM groupwas significantly better than the western medicine group in improving the cough symptom score (P<0.01). In the visual analogue scale, there was no significant difference in the improvement of the daytime assessment (P>0.05), while compared with western medicine, TCM group had significant difference in the improvement of the nighttime assessment (P<0.01). The results of before-and-after showed that there were significant effect on the improvement in these indicators in both TCMgroup and western medicine group (P<0.01).The LCQ results showed that TCM group was better than the western medicine group in the physical dimension, psychological dimension as well as the total score (P<0.05). In the social dimension, the two groups had no significant difference (P>0.05). The results of before-and-after showed that both TCMgroup and western medicine group could increase the scores of each dimension and had statistical differentiation. But in the psychological dimension, the scoresof before-and-after in western medicine group was less than0.8, which suggested that the efficacy of western medicine in the psychological domain wasnot significant.7. The results of the efficacy comparison among the four common syndromesFour groups of common syndrome (frequency>10%)-wind restraining the lung syndrome, lung qi deficiency syndrome, accumulated heat in the lung syndrome and phlegm-dampness obstructing the lung syndrome were chosen to have a further observation of efficacy.On the overall efficacy, there were no significant differences among the four syndromes on both significant efficiency rate and effective rate(P>0.05). It indicated that the efficacy of the four groups were equal.There were no significant differences among the four groups on cough symptom score(P>0.05).In the visual analogue score, we found that lung qi deficiency group had the highest score in daytime assessment. It indicated that its improvement of the symptoms was the worst, and it had significant differences compared with wind restraining the lung syndrome group and phlegm-dampness obstructing the lung syndrome group (P<0.01, P<0.05). There were no significant differences among the four groups on nighttimesymptom score(P>0.05). The results of before-and-after showed that symptomsof the four groupsafter treatment significantly improved(P<0.01), indicating there was exactefficacy in syndrome differentiation.The LCQ results showed thatthe group of lung qi deficiency had the lowest scores in physical dimension, the psychological dimension, as well as the total score. Its scores were much lower than the wind restraining the lung syndrome group both in physiological dimension and the total score(P<0.01).It was lower than the lung syndrome group and accumulated heat in the lung syndrome in psychological dimension (P<0.05). There was no significant differenceamong the four groups in the social dimension(P>0.05).There was significant difference between before-and-after (P<0.01). It indicated thatthere was exactefficacy in syndrome differentiation.Conclusion1. Through theory research, we got the distribution law of syndromes and symptoms of PIC. The research revealed the basic status of the disease.2. The research adopted observational study methods of prospective, multicentric and open to acquire the basic information of PIC patients as well as the distribution of its symptoms and syndromes roundly. The results were basically consistent with the literature findings. Multivariate analysis methods such as factor analysis, cluster analysis and regression analysis were used in the research. The combination of supervised and unsupervised methods was used to investigate the common clinical syndromes and the correlation between syndromes and symptoms. The results of the research provided an objective and credible basis for syndrome differentiation.3. From an overall perspective, TCMsyndrome differentiationwas more effective than western medicine alone. After the syndrome differentiation therapy, the patients of different groups were improved significantly in efficacy, which proved the correlation between formula and syndrome. But it showed that qi deficiency syndrome is less effective than wind restraining the lung syndrome, accumulated heat in the lung syndrome and phlegm-dampness obstructing the lung syndrome in comprehensive efficacy, indicating there might be some differences in efficacy among different syndromes in a way.