Correlation Between Recurrence A Year And Moderate Stable Chronic Obstuctive Pulmonary Disease In Patients Of Lung Spleen And Kidney Deficiency

Objective:To follow-up study Urumqi region of 145 moderate stable chronic obstuctive pulmonary disease in TCM zang-fu deficiency patients in 1 year; investigatting the prognosis of moderat chronic obstructive pulmonary disease(COPD)in TCM zang-fu deficiency patients, and to evaluate the factors for recurringrate. Methods:From Jaranery 2008, a prospective cohort study was carried out,in which 145 zang-fu deficiency patients with moderate COPDwere recruied in Fifth Affiliated Hospital Xinjiang Medical University,New City District,Urumqi.The general health state,the types and symptom score of TCM zang-fu deficiency, triceps skinfold thickness(TSF), mid-upper arm muscle circumference(MAMC),body mass index(BMI)and electrocardiograph were recoded.The patients were followed for 1 year.Univeriate analysis of survival rate was performed by Kaplan-Meier method.The signifieance test was done by Log-rank method,and the baseline factors were analyzed using the COX regression model multiplicity.The interrelative test was done by X2 and Sepearman rank correlation between the types of TCM zang-fu deficiency and prognosis target. Results:During the 1 year of follow-up, one patient was lost because of migration.one patient died of non-COPD diseasea, while 129 recurrened,14 unrecurrended, the recurring rate was 36.6%(53/145)in half year,and 90.2%(129/143)in one year. Using the univeriate analysis in COX proportional hazard model to analysis the relationship among the time of recurrence,sex,age, clinical course, weight, BMI,TSF, MAC,MAMC, symptom volume of TCMzang-fu deficiency,FEV1.The result showed that the time of recurrence is relate with age(RR=1.032,95%Cl=1.011-1.052),clinical course(RR=1.035,95%Cl=1.016-1.053), weight(RR=0.952,95%Cl=0.931-0.973), body mass index(BMI, RR=0.961,95%Cl= 0.928-0.980), triceps skinfold thickness(TSF,RR=0.973,95%Cl=0.901-0.983), mid-upper arm circumference(MAC, RR=0.886,95%Cl=0.837-0.937), mid-upper arm muscle circumference(MAMC,RR=0.865,95%Cl=0.816-0.917), forced expiratory volume in one second (FEV1, RR= 0.996,95%Cl=0.996-0.997) besides sex (RR=0.985,95% Cl= 0.479-1.638). The result with COX multiplicity showed that the important factors for prognosis of the zang-fu deficiency patients was the force expired volume in one second(RR=0.997,95%Cl=0.996-0.998);and there were interrelative among FEV1 and BMI, MRC, symptom score of TCM zang-fu deficiency (P<0.05), which have interrelaionship in the comparison among the three types of TCM zang-fu deficiency.Then, there are negative correlation between TCM zang-fu deficiency and BMI(rs=-0.0212, P-0.000), also with FEV1 (rs=-0.9784, P=0.000);while positive correlation with MRC(rs=0.1036, P=0.030)and symptom volume of TCMzang-fu deficiency(rs=0.3582, P=0.000). Even more, there are positive correlation between FEV1 and BMI(rs=0.3535, P=0.000),while the positive crrelationship between FEV1 and MRC(rs=-0.2618, P=0.000),also with symptom volume of TCM zang-fu deficiency(rs=-0.9784, P=0.000). Conclusion:The important factors for prognosis of moderate COPD in FEV1(RR=0.997, 95%Cl=0.996-0.998).Comparing with develpment the symptom types of TCM zang-fu deficiency,which from Lung-Deficiency,Lung and spleen-Deficiency and Lung and kidney-Deficiency,MMRC was in the increase trend;on the other hand,BMI,FEV1 were in the decrease trend.with the reduce of FEV1,MRC and symptom volume of TCM zang-fu deficiency were in the increase trend;BMI was in the decrease trend.