The Study Of The TCM Syndrome Types Of AECOPD Hospitalized Patients With T2DM And Related Factors

Objectives:To investigate the general hospitalization,epidemiological trends,physical and chemical indicators,and related treatment plans of AECOPD hospitalized patients with T2DM,and to summarize the TCM syndrome types of AECOPD hospitalized patients with T2DM,and compare the different T2DM course and TCM syndrome types.Differences in patient-related indicator to assess the severity of such patients and provide a reliable basis for clinical prospective studies.Method:1.This study collected the clinical data of all patients who met the T2DM and AECOPD inclusion criteria in the Department of Respiratory Medicine of Guangdong Provincial Hospital of Traditional Chinese Medicine from January 1,2014 to December 31,2018,and analyzed the patients according to the course of T2DM.Divided into three subgroups:AECOPD+T2DM(0-10 years),AECOPD+T2DM(11-20 years)and AECOPD+T2DM(>20 years).According to the different analysis of common TCM syndromes of patients,it is summarized as Qi deficiency and yin deficiency,phlegm and heat stasis,qi and yin deficiency,phlegm obstruction of lung,qi and yin deficiency,phlegm and heat,lung qi,qi deficiency,phlegm and heat resistance.In the group,the differences of related indicators between the three subgroups and the four syndrome types were compared.2.The following items were compared according to AECOPD hospitalized patients with different disease course T2DM and different syndromes combined with T2DM:average hospitalization days,average hospitalization costs,inflammation indicators(WBC,NEUT96,CRP,PCT),coagulation function(PT,AT,INR,Fib,APTT,PLT,DDi),glycated hemoglobin,random blood glucose,pulmonary artery pressure,antibiotic use,and ventilator use.3.The collected data were recorded into SPSS19.0 statistical software to establish the original clinical database.The continuous variables were descriptively analyzed and expressed as mean±standard deviation.The data were consistent with the normal distribution.The data were compared by one-way ANOVA or independent sample t test.Non-parametric rank sum test when non-normal distribution and variance are different;The two categorical variables were expressed by composition ratio and frequency.The comparison between groups was performed by chi-square test or non-parametric rank sum test.P<0.05 was considered statistically significant.Result:1.General hospitalization:This study collected 231 AECOPD patients with T2DM who met the inclusion criteria.The average hospital stay was 11.96 days and the average hospitalization cost was 21,260 yuan.The course of COPD patients is mainly concentrated between 11-20 years(62.3%),while the course of T2DM is mainly concentrated between 0-10 years(71.4%).The average length of hospital stay and the average hospitalization cost of AECOPD patients with different T2DM durations were statistieally Signifieant(P<0.05).For further comparison between groups,T2DM(>20 years)+AECOPD group had a higher average hospital stay.The average hospitalization cost of T2DM(10-20 years)+AECOPD group,T2DM(0-10 years)+AECOPD group,T2DM(>20 years)+AECOPD,T2DM(10-20 years)+AECOPD group was higher than T2DM(0-10 years)+AECOPD group,the difference was statistically significant(P<0.05).2.Epidemiological trend:The total incidence rate of AECOPD patients combined with T2DM was 9.96%,and the incidence rates in each year from 2014 to 2018 are 7.560h,10.41%,11.980h,13.08%,8.350h,and 9.96%,respectively?Among the 231 patients,189 were male patients,accounting for 81.8%,42 female patients,accounting for 18.2%,and the high-incidence age group was 61-90 years old,accounting for 95.15%,and the highest incidence rate was 71-80 years old,accounting for 39.39%.There was no significant difference in the incidence of gender and age between the years(P>0.05).In the past,the top five were hypertension(16%),benign prostatic hyperplasia(11%),cerebrovascular disease(7%),coronary heart disease(7%),hyperlipidemia(7%);Other previous medical history included arrhythmia,cardiac insufficiency,renal insufficiency,hyperuricemia,anemia,etc.3.Relevant physical and chemical indicators:The inflammatory indexes(WBC,NEUT%,CRP,PCT)of AECOPD patients with T2DM were higher than the normal range.The WBC,NEUT%and CRP levels of AECOPD patients with different T2DM durations were statistically significant(P<0.05);Further comparison between groups,T2DM(>20 years)+AECOPD group WBC,NEUT%,CRP levels were higher than T2DM(0-10 years)+AECOPD group,the difference was statistically significant(P<0.05).In terms of coagulation function,the AT,INR,APTT,and PLT levels of these patients were in the normal range,and the PT,FIB,and DDi levels were higher than the normal range.The differences in DDI levels between the three groups and the AECOPD patients with different T2DM durations were statistically significant.Significance(P<0.05);Further comparison between groups,T2DM(>20 years)+AECOPD group DDi level higher than T2DM(10-20 years)+AECOPD group,T2DM(0-10 years)+AECOPD group,T2DM(10-20 years)+AECOPD group The DDi level was higher than that of T2DM(0-10 years)+AECOPD group,and the difference was statistically significant(P<0.05).In other aspects,patients with random blood glucose were in the normal range,and glycosylated hemoglobin and pulmonary ar'terial pressure were significantly higher than the normal range.There were significant differences in PA levels between the three groups and AECOPD patients with different T2DM duration(P<0.05);further group In comparison,T2DM(>20 years)+AECOPD,T2DM(10-20 years)+AECOPD group PA level was higher than T2DM(0-10 years)+AECOPD group,the difference was statistically significant(P<0.05).4.Related treatment options:The average duration of antibiotic use for AECOPD patients with T2DM was 10.16 days,and the average duration of ventilator treatment was 8 days.There were significant differences in the course of antibiotics between the three groups of patients with different T2DM and AECOPD(P<0.05).For further comparison between groups,T2DM(>20 years)+AECOPD group was higher than T2DM(0-10 years).In the AECOPD group,the difference was statistically significant(P<0.05).5.TCM syndrome type:A 222 patients with AECOPD combined with T2DM have a total of 222 cases of syndrome differentiation and treatment,and TCM syndromes are mainly composed of three syndromes,four syndromes and five syndromes,of which 66 cases(29.73%)are composed of three syndromes.With Qi deficiency+yin deficiency+phlegm syndrome,93 patients(42.34%)with four syndromes were mainly qi deficiency+yin deficiency + phlegm syndrome+heat syndrome,and 39 syndrome patients(17.57%),only Qi deficiency + yin deficiency + phlegm syndrome+heat syndrome+blood stasis,and summed up the qi and yin deficiency,phlegm and heat stasis(17.56%),qi and yin deficiency,phlegm obstruction lung(16.22%),qi and yin deficiency,phlegm and heat sputum(13.06%),qi deficiency,phlegm and heat resistance(11.71%)fur common types of syndromes.Among the four syndrome types,there were no statistical differences in inflammation index,most coagulation function,blood glucose level,and ventilator use duration between the two groups,while D-Di,pulmonary artery pressure,and the qi and yin deficiency,phlegm and blood stasis type,D-Di,pulmonary artery pressure,The course of antibiotic use was significantly higher than that of the other three groups of syndromes,and qi and yin deficiency,phlegm obstruction lung,pulmonary artery pressure,The course of antibiotic use was significantly higher than that of the other three groups of syndromes and the difference was statistically significant(P<0.05).Gonclusion:The severity of AECOPD inpatients with T2DM may be related to the course of T2DM in patients.The longer the course,the more severe the condition,mainly in the average hospital stay,average hospitalization cost,antibiotic use course,and degree of inflammatory response(WBC,NEUT%,CRP),D-dimer and pulmonary artery pressure are higher;And such patients are mainly concentrated in the two qi and yin deficiency,phlegm and heat stasis,qi and yin deficiency,phlegm obstruction of the lungs,qi and yin deficiency,phlegm and heat,lung qi,qi deficiency,heat and phlegm resistance,four types of syndrome The two imaginary,qi and yin defieiencyphlegm,heat resistance and,qi and yin deficiency,phlegm obstruction of the lungs are more serious than the disease,mainly in the D-Di,pulmonary artery pressure and antibiotic use.