Pulmonary Function In Patients With Bronchiectasis And Its Relationship With Phlegm And Qi Syndrome

ObjectiveTo understand the characteristics of pulmonary function and explore the relationship between pulmonary function changes and TCM phlegm and Qi syndromes in patients with bronchiectasis,which is aim to further clarify the characteristics of pulmonary changes and find new ideas for clinical treatment of patients with bronchiectasis.MethodsI gather the patients with bronchiectasis by HRCT that live at Respiratory department and clinic of the Fujian University of Traditional Chinese Medicine Affiliated People'sHospital from February 2017 to February 2018.? For all patients with bronchiectasis,measure their abnormal pulmonary ventilation function and abnormal pulmonary diffusion function(FEV1%,FVC%,FEV1/FVC,RV/TLC,DLCO%),then calculate their incidence,type and severity of pulmonary function abnormalities that based on criteria for impairment of pulmonary function.? For all patients with bronchiectasis,collecting their indices including sex,age,course of diseases,hospitalization history,smoking history,imaging characteristics,Pathogens feature(sputum smear,sputum culture),inflammatory cells(blood routine,sputum routine),inflammatory markers(PCT,hsCRP),blood gas analysis,etc.And comparing the difference of the above indexes between normal and abnormalpulmonary function group,which is to analyze the susceptibility factors of patients with abnormal pulmonary function.? For all patients with bronchiectasis,according to the syndrome differentiation criteria of TCM phlegm and Qi syndrome(heat-phlegm syndrome,cold-phlegm syndrome,arid-phlegm syndrome,damp-phlegm syndrome,Qi stagnation syndrome,Qi deficiency of pulmonary,Qi deficiency of spleen,Qi deficiency of heart,Qi defic-iency of kidney),the distribution patterns of syndromes in the normal pulmonary function g-roup and the abnormal pulmonary function group were analyzed.Resultsl.This study included 157 patients with bronchiectasis,of which 117 patients with abnormal pulmonary ventilation function accounted for 74.5%of the cases included;115 patients with abnormal pulmonary diffusion function accounted for 73.2%of the cases included.Among patients with abnormal pulmonary ventilation function,84 patients have obstructive ventilatory dysfunction(71.8%of patients with pulmonary ventilation dysfunction)and 13 patients have restrictive ventilation dysfunction(11.1%of patients with pulmonary ventilation dysfunction)and there are 20 patients of mixed ventilation dysfunction(17.1%of patients with pulmonary ventilation dysfunction).115 have abnormal pulmonary diffusion function and the abnormal rate is 73.2%.2.There are no significant differences in sex,age and smoking among patients with different degrees of obstructive pulmonary ventilation dysfunction(P>0.05)and there is a difference compared with the course of diseases(P<0.05).There is no significant difference in sex between normal and abnormal pulmonary diffusion function(P>0.05),but there are difference in age,course of diseases,smoking factors(P<0.05).3.The levels of FEV1%,FVC%,FEV1/FVC,RV/TLC and DLCO%in patients with different types of bronchiectasis were compared:columnar>varicose>mixed>cystic,which have significant differences(P<0.05).The impairment degree of pulmonary ventilation and diffusion function are positively correlated with the number of pulmonary lobes involved in bronchiectasis(P<0.05).4.The main bacteria in Sputum smear is Gram-positive bacteria in patients of bronchiectasis with pulmonary ventilation or normal diffusion function or mild obstructive pulmonary ventilation dysfunction.And the main bacteria in Sputum smear is Gram-negative bacteria in patients of bronchiectasis with moderate and severe pulmonary ventilation dysfunction or pulmonary diffusion dysfunction.They are dominant differences(P<0.05).5.In patients with moderate and severe pulmonary ventilation dysfunction or pulmonary diffusion function impairment,blood or phlegm neutrophils and PCT,hsCRP are higher than normal or mild group,which have statistical significance(P<0.05),but there is no difference in blood or phlegm eosinophils(P>0.05).6.There are no differences in pH,PO2,SaO2,PCO2 and HCO3-in patients with normal,mild or moderate pulmonary ventilation dysfunction(P>0.05),but severe patients are associated with the above indicators(P<0.05).7.There is no correlation between patients with bronchiectasis of pulmonary function changes and different phlegm syndrome(P>0.05).There is significant difference in pulmonary function chances among sputum syndrome,sputum syndrome with Qi stagnation,sputum syndrome with Qi deficiency syndrome(P<0.05),which has statistical significance.Conclusion1.Patients with bronchiectasis often appear abnormal pulmonary function,and obstructive ventilation dysfunction is more common among them,and most of them accompany decrease in diffusion function.2.The longer the course of diseases,the more the number of pulmonary lobes involved,the worse the pulmonary function;the older,the poorer the pulmonary diffusion function,and it is affected by smoking factors.3.The inpairment of pulmonary ventilation function is more severe in patients with cystic bronchiectasis and mixed bronchiectasis than those of columnar bronchiectasis.4.Patients with moderate and severe pulmonary ventilation dysfunction are often accompanied by bacterial infections and they have high inflammatory markers,mainly Gram-negative bacteria.5.There are regularities between the changes of pulmonary ventilation function in patients and the evolution of TCM phlegm and Qi syndrome.The patients with normal or mild pulmonary ventilation function impairment are mainly phlegm syndrome,patients with moderate pulmonary ventilation function impairment are mainly phlegm syndrome and Qi stagnation syndrome,patients with severe pulmonary ventilation function impairment most contain phlegm syndrome and Qi deficiency syndrome.