Clinical Study On Distribution Regularity Of TCM Syndromes In Acute Exacerbation Of Chronic Obstructive Pulmonary Disease

ObjectiveThrough studying TCM Syndromes factors of patients with AECOPD,summarized the distribution characteristics of AECOPD TCM syndromes,provide a theoretical basis for the treatment based on syndrome differentiation,improve clinical dagnosis andtreatment effect.MethodThis study used questionnaire method,developed the scale which to identify the syndrome of TCM through clinical symptoms.This study collected 105 cases of AECOPD patients which hospitalized in the second affiliated hospital of Beijing University of Chinese Medicine during April 2013 to February 2015.By means of Collection the information of patient symptoms,signs,tongue and pulse manifestations,and conducted data analysis to summarize the distribution characteristics of AECOPD.The collected syndromes According to Zhu Wenfeng’s Scale of "differentiation of syndrome factors",Diagnostic weights shall be calculated in cases of acquisition candidates syndrome diagnosis weights, determining factors AECOPD cases involving TCM based diagnostic threshold,extracted syndrome factors to obtian descriptive statistics,and to use cluster analysis method to observe syndrome factors combinations,resulting in AECOPD syndrome factors distribution of cases and syndrome distribution characteristics.ResultsSymptoms distribution:The frequency of occurrence of AECOPD clinical symptoms and signs more than 50% of the total is 15,including Chronic coughing and wheezing, cough,shortness of breath,Lung moist Rale,greasy fur,slippery pulse,white Sputum, emphysematous chest,sticky sputum difficult to cough,yellow fur,Dark red tongue,A lot of sticky phlegm,wiry pulse,cyanotic lips,insomnia.The frequency of occurrence of more than 10% of the total is 43,reflecting the main symptoms,signs,tongue and pulse manifestations of AECOPD.Which cough,asthma,shortness of breath,sputum is the main performance of this disease.In respiratory clinical symptoms and signs,the frequency of occurrence of AECOPD more than 20% are:Chronic coughing and wheezing, cough,shortness of breath,Lung moist Rale,white Sputum,emphysematous chest,sticky sputum difficult to cough,A lot of sticky phlegm,Lung dry Rale,A small amount of phlegm,slippery and easy to cough sputum,yellow Sputum,can’t lay down because of Wheezing.In general symptoms and signs,the frequency of occurrence of AECOPD more than 15% are:cyanotic lips,insomnia,edema,newly catch cold,inappetence,thirst,deep and harsh voice,lusterless complexion,constipation, fingers bruising, dim complexion,Obesity ,faint low voice,Chest tightness,sonorous voice,long turm frequency of urinatior,fatigue, fever,frequent urination at night,sweating,bitter taste.dark red tongue appeared most frequently in tongue manifestation,accounting for 58.1%,yellow fur(59.0%)and greasy fur(72.4%)are the main fur,wiry pulse(55.2%)and slippery pulse(64.8%)are main pulse.which indicated that AECOPD with dark red tongue, yellow and greasy fur,wiry and slippery pulse is the most common pattern.Syndrome factors distribution:In this study,the highest ratio of disease viscera Syndrome factor is the lung,100.0% of the total number of cases,followed by kidney,61.9%;again spleen,accounting for 34.3%,a smaller proportion of the mind,only 0.9%.In Pathological Syndrome factors,sputum and Qi deficiency are the highest ratio of all, respectively 99.0%,95.2%,followed by Yang deficiency and Yin deficiency,each with 80.0%, 74.3%,heat,fluid retention,blood stasis share the proportion is also higher, respectively,43.8%, 36.2%,25.7%.The characteristics of syndrome manifestations:viscera Syndrome factor only in lung is 65 cases,which is 61.9%.Two factors (lung and kidney, lung and spleen) is 38 cases,36.2%,and three factors is a minority, accounting for only 1.9%.Pathological Syndrome factors are combined into two,three,four Syndrome factors,respectively accounting for 20.9%,32.4%, 28.6%.Syndrome factors combine to phlegm,sputum+qi deficiency+yang deficiency,Phlegm+ Qi deficiency and Yin deficiency,sputum+qi deficiency+yang deficiency+yin deficiency, sputum+heat+qi deficiency+yang deficiency+yin deficiency are the most,the ratio is 8.6%,19.0%,10.5%,20.0% and 6.7%. AECOPD major viscera Syndrome factors are lung and kidney,Pathological Syndrome factors are sputum,heat,qi deficiency,yang deficiency,yin deficiency.Combined Syndrome factors are three,four,five and six factors,the ratio respectively,20.0%,19.0%,25.7%,22.9%;two,seven,eight,nine factors are fewer,15 cases, accounting for 14.3%.The basic syndrome is phlegm syndrome,Qi deficiency syndrome,qi and yin deficiency syndrome,blood stasis syndrome.cluster analysis show that if clustered into four categories, the Class 1 are:lung, sputum,qi deficiency,yin deficiency;Class 2:kidney,yang deficiency;Class 3:spleen, mind, blood stasis,cold,fluid retention,dampness, wind, qi stagnation; Class 4 heat.Conclusion①The pathological nature of hospitalized patients with AECOPD is intermingled deficiency and excess,The major viscera Syndrome factor is lung and kidney,Pathological Syndrome factors are sputum,heat,qi deficiency,yang deficiency,yin deficiency.The basic syndrome is phlegm syndrome,Qi deficiency syndrome,qi and yin deficiency syndrome.②phlegm,heat,fluid retention,blood stasis,dampness are the common pathological factors of hospitalized patients with AECOPD.