Distribution Of TCM Syndromes And Clinical Features In 135 Patients With Pulmonary Interstitial Fibrosis And Emphysema

Objective: Combined pulmonary fibrosis and emphysema(CPFE)patients have more severe symptoms and worse prognosis than patients with pulmonary fibrosis,and there are relatively few data on current Chinese medicine research.This study analyzes the clinical symptoms,general conditions and related examinations of CPFE patients to explore their clinical characteristics and the distribution of TCM syndromes in order to provide theoretical reference for the prevention of this disease and TCM treatment.Methods: 135 patients with pulmonary interstitial fibrosis and emphysema who met the inclusion criteria were all from Second Affiliated Hospital of Tianjin University of TCM.According to the "Pulmonary Interstitial Fibrosis Patient Information Questionnaire",the patient's general information,examination data,clinical symptoms and other information were collected,Excel2010 was used to summarize and establish an electronic database,and the data was processed through SPSS 24.0 software.Descriptive statistics of the patient's basic data to summarize its clinical characteristics,cluster analysis of high-frequency symptoms to summarize the TCM syndromes of the disease,using chi-square test to explore the correlation between different influencing factors and the patient's basic syndrome.Results:1.Analysis of clinical data of CPFE patientsAmong the patients with pulmonary interstitial fibrosis and emphysema,89 were male patients(65.93%),46 were female patients(34.07%),and the male to female ratio was 1.93: 1.It can be seen that male patients are significantly more than females,most of which are 60-80 years old.Seniors.The analysis found a total of 94 patients with a clear smoking history,accounting for 69.63% of the total number of patients,including 66 males and 28 females.The disease course of patients is mostly less than 3 years,and the underlying diseases are mainly cardiovascular diseases.The basic statistical results of patients with pulmonary interstitial fibrosis and emphysema are: cardiovascular system 74.81%,other respiratory diseases 40.74%,immune system diseases 32.59%,digestive system diseases 29.63%,and endocrine system 22.96%.Common diseases for the elderly.The HRCT of the patients included in the study was analyzed and statistically.Of the 135 cases,the lobular-centered emphysema was the most common in emphysema in 75 cases(55%),followed by 36 cases(27%)next to the interval type 24 cases(18%)of bullous type.It was found that the imaging findings of pulmonary fibrosis were mostly grid-like shadows.A survey of past and family history shows that 22.96% of patients have a history of allergies and 37.04% of patients havea history of familial respiratory diseases.In terms of treatment,29.63% of patients were treated with antibiotics,which is considered to be associated with acute exacerbation of pulmonary fibrosis and often associated with respiratory infections.62.22% of patients had a history of hormone use,which is considered to be associated with CPFE patients who often have airway diseases and allergic diseases.In this study,22.22% of those who could clearly describe the history of exposure were dust and dust,followed by chemicals and asbestos.2.Study on TCM Syndromes of CPFE PatientsDescribe and analyze the symptoms of 135 patients with pulmonary interstitial fibrosis and emphysema syndrome.The top 15 frequencies are cough,sputum,chest tightness,palpitations,dull complexion,shortness of breath,dry mouth,dry throat,cyanosis of lips,and spots.Rash,fatigue,mental exhaustion,sticky sputum,muscle pain,pale complexion,and fear of wind.The frequencies of the syndromes in descending order are: lung,qi deficiency,heart,kidney,spleen,blood stasis,drinking,phlegm dampness,yang deficiency,liver,cold coagulation,blood deficiency,yin deficiency,phlegm fever,Qi reverse,yang hyperactivity Qi stagnation.The disease sites are mainly in the lung,heart,and kidney.Compared with previous studies of pulmonary interstitial fibrosis,the disease sites are mostly different in the lung,spleen,and kidney.Based on the four diagnosis information of CPFE patients,the five types of syndromes obtained by this cluster analysis are: Qi deficiency and blood stasis,phlegm and turbid obstruction of lung;Qi deficiency and qi yin deficiency,lung dysfunction;lung deficiency and kidney deficiency,yang deficiency and flooding;liver qi Stagnation,phlegm and fire disturbing the heart;lack of heart qi,phlegm and stasis.3.Correlation researchThis study analyzed the correlation between whether the patients smoked and the type of emphysema.The results of the chi-square test were c 2= 18.171,p = 0.01,(p <0.05),indicating that there was a difference between the types of emphysema between smoking and non-smokers.Moreover,emphysema caused by smoking is mostly lobular center type,and non-smoker patients are mainly paraseptal type.Chi-square test showed that there was a difference in the distribution of two types of TCM syndromes of lung deficiency and heart blood deficiency in patients with lobular central emphysema and paraseptal CPFE,c2= 7.778,p = 0.005,(p <0.05),the former is easier Lung qi deficiency syndrome appears,which is more prone to heart and blood deficiency syndrome.Conclusion:1.The population of patients with pulmonary interstitial fibrosis and emphysema is mainly elderly,more men than women,and mainly male smoking patients.2.Patients with comorbidities were mainly cardiovascular diseases,respiratory system and digestive system diseases,mainly hypertension,coronary heart disease,pulmonary hypertension,COPD and gastroesophageal reflux.3.According to Chi-square test,there is a difference between emphysema types in smoking and non-smokers.The emphysema types in smoking patients are mainly lobular center type,and non-smoker patients are mainly paraseptal emphysema.4.Comprehensive analysis of high-frequency symptoms,syndromes and basic syndromes of patients shows that the CPFE pathology is mainly lung,heart,and kidney.Deficiency,stasis,and sputum are the main pathological factors of CPFE.The basic pathogenesis is heart and lung qi deficiency and blood line failure.Chang,blood stagnation and blockage,lung loss caused by cough and asthma,chronic cough and injury,eventually resulting in weak lung lobe.5.Five types of syndromes were obtained based on cluster analysis: deficiency of heart qi,phlegm and blood stasis;qi deficiency and blood stasis,phlegm and turbid stasis;lung and qi stagnation,phlegm and fire disturbing heart;Deficiency in both lungs and lungs.6.According to the chi-square test,the distribution of lobular central emphysema and paraseptal emphysema between the two types of deficiency of lung qi and heart and blood deficiency are different.certificate.