Study On The Characteristics Of TCM Syndromes Of Common Interstitial Pulmonary Disease Based On Cluster Analysis

Idiopathic pulmonary fibrosis(IPF) and connective tissue disease related interstitial lung disease(CTD-ILD) is the most common and highly characteristic types of interstitial lung disease,so they have received the widespread attention both at home and abroad.Objective:This research summarizes the common TCM symptoms and TCM syndromes of IPF and CTD-ILD and the main symptoms about each TCM syndrome based on the result of four diagnostic information study about 122 IPF patients and 81 CTD-ILD patients.This research explore IPF and CTD-ILD TCM syndrome and symptom characteristics through the study so that we can provide some help for clinical practice.Method:This research used survey research method to collect four diagnostic information of the patients who can meet the inclusion criteria of IPF and CTD-ILD by designing the form of Chinese medicine clinical observation of the pulmonary interstitial disease in advance.And we used the collected four diagnostic information to establish two databases respectively based on the the presence or absence(1,0) of the symptom.We used Excel 2007 count the frequency of symptoms about the patients of two groups.We used SPSS20.0 software to cluster the two groups of patients by the K-means clustering analysis.Chinese clinical doctor(Su Huiping chief physician、Wu Huayang deputy chief physician、Li Deying attending doctor) established the classification and name of each TCM syndrome by discussing the initial clustering analysis model based on the result.Results:1.The four TCM syndromes of 122 IPF patients by clustering analysis:(1) Deficiency of both qi and yang,blood and phlegm stasis in the interior:(32.8%):The average age of the patients was 66.78 years, of which 29 (72.5%) were male,11 (27.5%) were female,6 (15%) were treated with hormone.(2) Blood and phlegm stasis in the interior,and deficiency of qi (31.1%):The average age of the patients was 65.39 years, of which 27 (71.05%) were male,11 (28.95%) were female,4 (10.53%) were treated with hormone.(3) Deficiency of both qi and yin,accumulation phlegm-heat in the interior (20.5%):The average age of the patients was 60.84 years, of which 12 (48.0%) were male,13 (52.0%) were female,10(40.0%) were treated with hormone.(4) Blood stasis due to qi deficiency, phlegm and wet stasis in the interior (15.6%):The average age of the patients was 66.63 years, of which 8(42.11%) were male,11 (57.89%) were female,1 (5.26%) were treated with hormone.2.The three TCM syndromes of 81 CTD-ILD patients by clustering analysis:(1) Deficiency of both qi and yin,accumulation phlegm-heat in the interior (39.5%):The average age of the patients was 59.59 years, of which8 (25.0%) were male,24 (75.0%) were female,14(43.75%) were treated with hormone.(2) Blood stasis due to qi deficiency, phlegm stasis in the interior (34.6%):The average age of the patients was 61.82 years, of which 8 (28.57%) were male,20 (71.43%) were female, 13 (46.43%) were treated with hormone.(3) Accumulation phlegm-heat in the interior (25.9%):The average age of the patients was 60.95years, of which 7 (33.33%) were male,14 (66.67%) were female,6 (28.57%) were treated with hormone.3.Symptoms of the top 20 in 122 IPF patients were(according to the frequency from high to low):shortness of breath、cough、feeble、gasp、white fur、white phlegm、cyanosis、 dispiritedness and talking laziness、easy to expectorate、thin fur、purple or dark tongue、easy to catch a cold、dilute phlegm、weak pulse、bulgy tongue、slippery pulse、little phlegm、 much phlegm、spontaneous perspiration、insomnia.Symptoms of the top 20 in 81 CTD-ILD patients were(according to the frequency from high to low):shortness of breath、cough、gasp、 white phlegm、red tongue、yellow fur、glutinous phlegm、little phlegm、easy to expectorate、 feeble、cyanosis、white fur、easy to catch a cold、bulgy tongue、thin fur、spontaneous perspiration、insomnia、dispiritedness and talking laziness、deep pulse、dreaminess.Conclusions:1.The results of IPF clustering mainly include four TCM syndromes:Deficiency of both qi and yang,blood and phlegm stasis in the interior、blood and phlegm stasis in the interior,and deficiency of qi、Deficiency of both qi and yin,accumulation phlegm-heat in the interior、 Blood stasis due to qi deficiency, phlegm and wet stasis in the interior, and Deficiency of both qi and yang,blood and phlegm stasis in the interior accounted for 32.8% percent among the types.The results of CTD-ILD clustering mainly include three TCM syndrome types: Deficiency of both qi and yin,accumulation phlegm-heat in the interior、Blood stasis due to qi deficiency, phlegm stasis in the interior accumulation phlegm-heat i in the interior,and Deficiency of both qi and yin,accumulation phlegm-heat in the interior accounted for 39.5% percent among the types.2. According to the results of clustering analysis,the basic pathogenesis of IPF、CTD-ILD is actual situation mixed,and IPF mainly performed deficiency,CTD-ILD is much empirical.Blood stasis、phlegm and phlegm-heat are the common pathogenic factors of IPF、 CTD-ILD.Among them,phlegm and blood stasis is the most common pathological factor of IPF,phlegm-heat is the most common pathological factor of CTD-ILD.3.15 symptoms in IPF patients and CTD-ILD patients’s top 20 symptoms are the same.Shortness of breath and cough are the highest frequency symptoms in both groups,which reflect symptomatic features of interstitial lung disease. There are certain differences between IPF and CTD-ILD in the top 20 symptoms,and the same symptoms also have different order.These are the symptomatic difference of IPF and CTD-ILD,which can regard as a basis for distinction.4.According to the analysis of age, the proportion of men and women and whether take hormone,we found that IPF deficiency of both qi and yang,blood and phlegm stasis in the interior patients have characteristics of maximum average age and highest male proportion, IPF Deficiency of both qi and yin,accumulation phlegm-heat in the interior patients、 CTD-ILD Deficiency of both qi and yin,accumulation phlegm-heat in the interior patients have characteristics of smaller average age and more hormone intake.