Distribution Of TCM Syndromes And Clinical Data Analysis Of Acute Exacerbation Of Chronic Obstructive Pulmonary Disease With Diabetes Mellitus

ObjectiveTo explore the distribution and clinical characteristics of TCM syndromes in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)and diabetes mellitus(DM).MethodsThe clinical data of 127 patients with AECOPD who met the diagnostic criteria and did not meet the exclusion criteria from December 2017 to May 2018 were collected.Among them,48 patients with AECOPD combined with DM and 79 patients with AECOPD alone were enrolled.The distribution pattern of TCM syndromes was analyzed.The main syndromes of AECOPD combined with DM(Qi-Yin deficiency combined with phlegm-heat accumulation of lung)were set as the research group,and the main syndromes(phlegm-heat stagnation of lung)of the simple AECOPD group were set as the control group.Two groups of clinical data such as sex,age,length of hospital stay,blood routine(white blood cells,percentage of neutrophils,ratio of neutrophils to lymphocytes),serum C-reactive protein(CRP),procalcitonin(PCT),lung function index VC(vital capacity),FVC(forced vital capacity),FEV1(percentage of forced vital capacity in the first second)and FEV1/FVC(forced expiration in the first second)were compared.The ratio of air volume to forced vital capacity,arterial blood gas analysis index Pa CO 2(partial pressure of carbon dioxide in arterial blood)and Pa O2(partial pressure of oxygen in arterial blood)were compared,and the correlation between white blood cells,C-reactive protein,pulmonary function and glycosylated serum protein level was determined.SPSS 22.0 statistical software was used to analyze the data,in which the counting data were expressed as% and the comparison between the two samples was carried out by chi-square test;for the quantitative data satisfying normal distribution,the data between groups were expressed as X + S,the data between groups were compared by independent sample t test,the data of non-normal distribution were tested by nonparametric test,and Pearson correlation analysis was used to analyze the risk factors associated with COPD and diabetes mellitus.Relevance,with P < 0.05 as the standard,the evaluation has statistical significance.Results(1)The main TCM syndromes of AECOPD combined with diabetes mellitus were deficiency and excess,and the distribution regularity was deficiency of both Qi and Yin and phlegm-heat stagnation of lung(62.5%),deficiency of Qi and blood stasis and phlegm-heat stagnation of lung(20.8%),deficiency of Qi and blood stasis and Phlegm-turbidity obstruction of lung(14.6%)and flooding of Yang and water with congestion ofinternal obstruction(2.1%).The main TCM syndromes in AECOPD group were syndrome of phlegm-heat stagnation of lung(37.9%),Phlegm-turbidity obstruction of lung(22.8%),phlegm-blood stasis obstruction of lung(15.2%),lung-kidney Qi deficiency(10.1%),external cold-inside drinking(7.6%),wind-cold attack of lung(5.1%)and Yang-deficiency of water flooding(1.3%).(2)There was no significant difference in sex and age composition between the study group and the control group(P >0.05).(3)The hospitalization days,white blood cells,GRA(absolute lymphocyte value),NLP(neutrophil/lymphocyte ratio),CRP and Pa CO2 in the study group were higher than those in the control group,with statistical significance(P < 0.05).(4)The procalcitonin level in the study group was higher than that in the control group,but there was no significant difference(P > 0.05).(5)The VC,FVC,FEV1,FEV1/FVC and Pa O2 in the study group were lower than those in the control group,with statistical significance(P < 0.05).There were significant differences in the composition of pulmonary function grading(P < 0.05).(6)Saccharified serum protein was positively correlated with leucocyte and CRP levels(P < 0.01,P < 0.01),negatively correlated with lung function indicators such as VC,FVC,FEV1,FEV1/FVC(P < 0.05,P < 0.01,P < 0.05,P < 0.01).Conclusions(1)The main TCM syndromes of AECOPD patients with diabetes mellitus are deficiency of both Qi and Yin and phlegm-heat stagnation of the lung.The main TCM syndromes of AECOPDpatients are phlegm-heat stagnation of the lung.(2)The length of hospitalization in the study group was longer than that in the control group,and inflammatory indexes such as white blood cells,CRP and NLP increased significantly,suggesting that hyperglycemia may lead to infection and aggravation of AECOPD patients.(3)Compared with the control group,the impairment of pulmonary function was more obvious in the study group,and the occurrence of hypoxemia and CO2 retention was more obvious.(4)In the study group,glycosylated serum protein was positively correlated with leucocyte and CRP levels and negatively correlated with pulmonary function indicators such as VC,FVC,FEV1,FEV1/FVC,indicating that inadequate glycemic control would aggravate AECOPD infection and lung function impairment.