| Objective: To study the correlation between TCM syndrome differentiation and TCM physique in patients with COPD in stable period,and at the same time,to discuss the rational use of traditional Chinese medicine in patients with COPD by the physical identification of TCM.To promote the effective combination of "syndrome differentiation" and "differentiation and treatment" in the diagnosis and treatment of COPD patients in stable period,to improve the qualified rate of the use of traditional Chinese patent medicine,to reduce the occurrence of adverse reactions,and to reduce the medical expenses.To provide some theoretical guidance for the rational use of Chinese patent medicine in patients with COPD at stable stage.Method : 1.Thirty doctors of western medicine were randomly selected from our hospital(affiliated traditional Chinese Medicine Hospital of Southwest Medical University)and divided into two groups: the control group and the experimental group.There was no difference in the distribution of professional titles between the two groups(P > 0.05).2.From January 2017 to December 2017,two groups of western medicine doctors were selected to treat COPD stable patients in outpatient clinic.The gender,age composition,TCM syndrome type and TCM constitution distribution were compared had no difference(P >0.05).3.The patients treated by the two groups of doctors undergo TCM syndrome differentiation and TCM physique identification prior to the visit.The TCM syndrome results are hidden from the physician and the physical identification results are hidden from the control group physicians and open to the experimental group physicians.4.At the end of the visit,370 prescriptions that met the inclusion criteria were selected for evaluation,including the qualified rate of the use of traditional Chinese patent medicine,the price of prescriptions,and the physical health guidance of the patients.5.After one week of treatment,the patients' satisfaction and adverse drug reactions were investigated by telephone.Results: 1.the distribution of TCM syndromes in patients: a survey of 370 people of stable COPD patients with lung and kidney qi deficiency(39.73%)majority,followed by qi deficiency(33.51%),lung spleen deficiency syndrome(15.41%),lung and kidney yin deficiency syndrome in two(11.35%).There was no significant difference between the gender and age of different syndromes(P >0.05).2.The distribution of TCM constitutions: treatment of 370 people with COPD in stable period,Qi deficiency accounted for the largest proportion,qi stagnation accounted for the smallest proportion,which is in the order of qi deficiency(39.19%),phlegm(16.76%),Yang deficiency(14.86%),blood stasis(11.35%),yin asthenia(7.84%),damp heat,Qi Stagnation(7.30%)(2.70%).There was no difference in sex and age composition of patients with different physique(P >0.05).3.There is a certain correlation between TCM syndrome type and TCM constitution type in stable COPD patients: lung qi deficiency syndrome and qi deficiency syndrome;lung qi deficiency syndrome and phlegm wet substance;lung and kidney qi deficiency syndrome and qi deficiency and yang deficiency;lung and kidney qi and yin deficiency syndrome and yin deficiency syndrome are closely related to yin deficiency(P < 0.05).4.Compared to the experimental group and control group in the prescription joint usage,proprietary Chinese medicine control group combination of 1-6 kinds of proprietary Chinese medicine prescription,proportion,in turn,were 30.27% 25.95%(1),(2),27.03%(3 kinds),9.73%(four),4.86%(5),2.16%(6).In the experimental group,only 1 to 4 drugs were used in the prescription,accounting for 67.03%(1),26.49%(2),5.95%(3)and 0.53%(4).The combined use of traditional Chinese patent medicine was compared between the two groups(P<0.001).The variety of combined use of traditional Chinese patent medicine in the experimental group was less than that in the control group.5.Compared with two groups,the qualified rate of Chinese patent medicine in the two groups was 91.89%,the experimental group was 96.75%,and the qualified rate of Chinese patent medicine in the experimental group was better than that in the control group(P<0.05).6.Comparing the prescription prices of the two groups of physicians,the average prescription price in the control group was 532.61 plus or minus 341.17 yuan,and the average price of the Chinese medicine was 271.23 or 243.93 yuan.The average prescription price of the experimental group was 261.35 + 136.72 yuan,and the average price of Chinese medicine was 103.87 + 75.99 yuan,indicating that the experimental group Chinese medicine physician at the price lower than the control group(P<0.05).7.The incidence of adverse drug reactions in two groups was compared.The results showed that the adverse drug reaction rate in the experimental group was 4.32%,which was 9.72% in the control group.The incidence of adverse reactions in the experimental group was lower than that in the control group(P< 0.05).8.The satisfaction degree of patients in two groups was compared.The satisfaction rate of the control group was 80.54%,and the satisfaction rate of the experimental group was 89.73%.The satisfaction rate of the patients in the experimental group was higher than that in the control group(P<0.05).Conclusion: 1.The distribution of TCM syndromes in patients with COPD is mainly based on the deficiency of lung and kidney qi,followed by lung qi deficiency syndrome,spleen qi deficiency syndrome,and lung kidney qi deficiency syndrome.2.Patients with COPD were characterized by qi deficiency,phlegm-dampness and Yang deficiency.3.There is a correlation between TCM syndrome type and TCM constitution in patients with COPD stable period: lung qi deficiency syndrome is related to qi deficiency.The deficiency of pulmonary spleen is related to the phlegm-dampness.The deficiency of lung kidney qi is related to qi deficiency and Yang deficiency.Lung kidney qi Yin deficiency syndrome is related to Yin deficiency.4.Adding TCM physique identification in the course of outpatient diagnosis and treatment of COPD stable patients can reduce the amount of combined use of traditional Chinese patent medicine,thus improve the qualified rate of Chinese patent medicine use,reduce the price of Chinese patent medicine prescription,and improve the patient satisfaction.5.Through the physique identification of traditional Chinese medicine(TCM),we can give guidance to the outpatients in the course of treating and treating the patients with COPD in stable period,so as to combine "syndrome differentiation and treatment" with "differentiation and treatment",promote the rational use of traditional Chinese patent medicine,and reduce the medical cost.It has certain guiding significance. |
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