Clinical Study On Correlation Between Fractional Exhaled Nitric Oxide And Syndrome Of TCM In Patients With Chronic Cough

Objective:To discuss and analyze the clinical data of Fractional exhaled nitric oxide(FeNO)of patients with chronic cough and correlation of syndrome of TCM in chronic cough,clinical symptoms,coated tongue and pulse condition,prescription and relevant auxiliary examination indexes with FeNO value,hoping to guide clinical combined treatment of traditional Chinese medicine and western medicine and improve diagnostic level.Methods:312 patients who were confirmed as chronic cough in the pneumology department of Jiangsu Provincial Hospital of Traditional Chinese Medicine from January 2017 to September 2018 were collected in this research.According to the FeNO value,hierarchy was conducted and these patients were divided into three groups:Low FeNO Group(FeNO<25ppb),Medium FeNO Group(25ppb?FeNO?50ppb)and High FeNO Group(FeNO>50 ppb).The statistical method analysis was used to analyze the correlation of syndrome of TCM in chronic cough,clinical symptoms,coated tongue and pulse condition,prescription and relevant auxiliary examination indexes with FeNO value.Results:(1)In 312 patients brought in this research,there were 197 patients in the Low FeNO Group,63 patients in Medium FeNO Group,and 52 patients in High FeNO Group.Females were obviously more than males for patients with chronic cough in three groups.In three groups,patients below 60 years old were the most and had the longer course of disease.(2)In patterns of TCM syndromes,Wind-Dryness Injuring Lung Syndrome,Wind-Phlegm Obstructing Lung Syndrome and Deficiency Of Lung-Spleen Syndrome were the most common.The proportion of Wind-Dryness Injuring Lung Syndrome in patterns of TCM syndromes had the obvious rising tendency with the increase of FeNO value.(3)Tongue appearance in chronic cough gave priority to pale red and red texture,while tongue coating appearance were thin white,thin yellow,and greasy.Pulse was thin,string and sliding.The proportion of pulse string was increased with the increase of FeNO.The clinical performance included nocturnal cough,dry cough,less sputum quantity,middle sputum quantity,white phlegm,sticky phlegm,peculiar smell irritative cough,cough after catching a cold,itchy throat,foreign body sensation in throat,gurgling with sputum in throat,clear snot,sneezing and dry mouth.Nocturnal cough,peculiar smell irritative cough,gurgling with sputum in throat,clear snot,sneezing and dry cough had correlation with FeNO value.Nocturnal cough,peculiar smell irritative cough,gurgling with sputum in throat,clear snot,and sneezing had the obvious rising tendency with the increase of FeNO value,while dry cough had the reducing tendency.(4)In this research,patients were involved in 193 kinds of chinese herbs.12 kinds of chinese herbs,including Radix Ophiopogonis,platycodon grandiflorum,white mulberry root-bark,stiff silkwonn,ephedra,rhizome pinellinae praeparata,radix glehniae,lumbricus,ginger processed pinellia,peach kernel,radix bupleuri and scutellaria baicalensis had the correlation with FeNO value.The proportion radix glehniae was lower in the Medium FeNO Group.The proportion of radix ophiopogonis,platycodon grandiflorum,white mulberry root-bark and still silkworm was reduced with the increase of FeNO value.The proportion of ephedra,rhizome pinellinae praeparata,lumbricus,ginger processed pinellia,peach kernel,radix bupleuri and scutellaria baicalensis was increased with FeNO.(5)There was no statistical significance in bronchial dilation test,pulmonary ventilation function,small airway function and airway resistance of patients with chronic cough in three groups with different FeNO level.Eosinophilic granulocyte percentage and absolute value had the obviously rising tendency with the increase of FeNO value.Moreover,it had the positive correlation with FeNO value.Conclusions:(1)With the main complaint of chronic cough,patients have the longer course of disease.High FeNO Group may have certain correlation with the long course of disease.Patients with chronic cough give priority to middle-aged people,especially for females.(2)Wind-Dryness Injuring Lung Syndrome,Wind-Phlegm Obstructing Lung Syndrome and Deficiency Of Lung-Spleen Syndrome are the most common in patterns of TCM syndromes in patients with chronic cough,while Wind-Dryness Injuring Lung Syndrome is closely linked with high FeNO value.The proportion has the obviously rising tendency with the increase of FeNO value.In clinical syndromes,nocturnal cough,peculiar smell irritative cough,gurgling with sputum in throat,clear snot,and sneezing has correlation with FeNO value.With the increase of FeNO,the frequency distribution is obviously increased.These symptoms conform to clinical symptoms of Wind-Dryness Injuring Lung Syndrome.With the increase of FeNO,prescription pays more attention to dispel pathogenic wind and eliminate phlegm,valuing syndrome differentiation of disease with long course.(3)Pulmonary function indexes of patients with chronic cough in different FeNO level have no obvious difference.Clinically,FeNO is more sensitive than pulmonary function detection,showing early-stage airway inflammation of patients with chronic cough.(4)Eosinophilic granulocyte percentage and absolute value have the correlation with FeNO value,showing that airway inflammation of chronic cough is mutually supplemented with FeNO.