Correlation Between TCM Syndrome And Exhaled Nitric Oxide In Elderly Patients With Asthmatic Attack

Objective:In this study,we observed and analyzed the correlation between the characteristics of common TCM syndromes and exhaled nitric oxide(FENO)in elderly patients with acute attack of bronchial asthma.Meanwhile,the relationship between TCM syndromes and FENO.EOS%in peripheral blood and pulmonary function were analyzed.Combine TCM syndromes with examination data to better guide clinical treatment based on syndrome differentiation.Method:We collected elderly patients with acute attack of bronchial asthma from February 2018 to December 2018 in the Department of Respiration,Wangjing Hospital,China Academy of Chinese Medical Sciences.The attending physician assesses the severity of the condition based on the severity of the asthma attack assessment form.Then according to the clinical symptoms,signs,tongue,pulse and other symptoms of traditional Chinese medicine syndrome differentiation.All elderly patients with asthma attacks included in this study were followed by FENO,peripheral blood EOS%,and pulmonary function tests,and recorded FeNO,EOS%,FEV1,and FEV1/FVC%test data.Establishing the database of elderly patients with asthma attack,which was processed by SPSS 23.0 statistical software.Results:1.Basic information on inclusion in the study A total of 159 elderly patients with asthma attack were included in this study,including 71 male patients(44.65%)and 88 female patients(55.35%).Female patients were more than male patients.20 cases of cold asthma(12.58%),32 cases of heat asthina(20.13%).16 cases of cold pack heat asthma(10.06%).45 cases of wind-phlegm asthma(28.30%).46 cases of deficiency asthma(28.93%).cold asthma,heat asthma,cold pack heat asthma,wind-phlegm asthma,deficiency asthma.Patients with acute asthma in the deficiency asthma have the oldest age and the longest course of disease.By variance analysis,there was no significant difference in age,course of disease and body mass index(BMI)among different TCM syndromes in elderly patients with asthma attack(P>0.05).2.The correlation between different TCM syndromes and FENO levelThe distribution of FENO in different TCM syndromes was different,by Kruskal-Wallis Rank sum test,and the difference of FENO levels between the groups was statistically significant(P=0.002,P<0.01).The DSCF method was used to compare the FENO levels between groups,there was a significant statistical difference in the level of FENO between the patients with wind-phlegm asthma and heat asthma,deficiency asthma in the elderly(P<0.01).The FENO level of patients with wind-phlegm asthma in the elderly with asthma is significantly higher than that of heat and deficiency.Patients with mild inflammation,deficiency asthma>heat asthma>wind-phlegm asthma>cold asthma>cold pack heat asthma;Severe inflammation,wind-phlegm asthma>deficiency asthma>heat asthma>cold pack heat asthma>cold asthma.Taking TCM syndromes as dependent variables and different degrees of airway inflammation as independent variables,the disordered multi-classification logistic regression analysis was carried out.With severe inflammation as a reference,mild inflammation in patients with asthma of cold-packed heat had statistical significance(P=0.028,P<0.05),regression coefficient was-1.622,OR value was 0.198;mild inflammation in patients with asthma of wind-phlegm had statistical significance(P=0.003,P<0.05),regression coefficient was-1.359,OR value was 0.257.With mild inflammation as a reference,the distribution of asthma patients with cold-packed heat syndrome was statistically significant(P=0.011,P<0.05),the regression coefficient was 2.485,and the OR value was 12.000.3.Relationship between different TCM syndrome EOS%levels The EOS%distribution of different TCM syndromes was different,by Kruskal-Wallis Rank sum test,and the difference of EOS%levels between the groups was statistically significant(P=0.007,P<0.01),The DSCF method was used to compare the EOS%levels between groups.There was a statistically significant difference in the EOS%level between deficiency asthma and wind-phlegm asthma in the elderly patients with asthma(P=0.005,P<0.05).Patients with wind-phlegm asthma had the highest EOS%level,and patients with deficiency asthma had the lowest EOS%.4.Comparison of FEV1,FEV1/FVC%of different TCM syndromes By variance analysis,there was no significant difference in the FEV1 between the TCM syndrome patients with different TCM syndromes(P>0.05).FEV1 of elderly asthmatic patients with heat asthma in attack stage was compared with FEV1 of elderly asthmatic patients with wind-phlegm asthma and deficiency asthma.By variance analysis,the difference was statistically significant(P<0.05);The FEV1 level of elderly asthmatic patients with wind-phlegm asthma and deficiency asthma is lower.By variance analysis.there was no significant difference in the FEV1/FVC%of patients with different TCM syndromes in the elderly with asthma(P>0.05).5.FENO level and EOS%correlation Spearman correlation analysis was used to determine the correlation between FENO levels and EOS%in elderly patients with asthma attacks.There was a significant correlation between FENO levels and EOS%in elderly patients with asthma attacks(correlation coefficient r=0.626,P<0.001).the two are positively correlated.6.The correlation between FENO level and pulmonary function index Spearman correlation analysis showed that there was no correlation between FENO level and FEV 1 in elderly patients with asthma attack(correlation coefficient r=0.060,P>0.05).There was no correlation between FENO levels and FEV1/FVC%in elderly patients with asthma(correlation coefficient r=0.048,P>0.05).Conclusions:1.This study shows that in the elderly patients with bronchial asthma,there are more deficiency asthma and wind-phlegm asthma,the patients of deficiency asthma have the largest age and the longest course.2.The distribution of FENO levels in different TCM syndromes is different the FENO level of patients with bronchial asthma in the elderly of wind-phlegm asthma is significantly higher than other TCM syndromes;The FENO level of patients with deficiency asthma is mostly distributed in mild inflammation,and the FENO level of patients with wind-phlegm asthma is mostly distributed in severe inflammation.In the distribution of mild inflammation,patients with asthma of cold-packed heat syndrome were 0.198 times as many as those with asthma of deficiency,patients with asthma of wind-phlegm syndrome were 0.257 times as many as those with asthma of deficiency;in the normal distribution,patients with asthma of cold-packed heat syndrome were 12 times as many as those with asthma of deficiency.3.The EOS%distribution of different TCM syndromes is different.The EOS%level of patients with wind-phlegm asthma is the highest,and the EOS%level of patients with deficiency asthma is the lowest;The FEV1 level of patients with wind-phlegm asthma and deficiency asthma is low.The level of FENO in elderly patients with bronchial asthma was positively correlated with EOS%and not correlated with FEV1,FEV1/FVC%.