Study On Clinical Features And TCM Syndromes Of Patients With Pulmonary Fibrosis Combined With Lung Cancer

Objective: To analyze and summarize the clinical data of patients with pulmonary fibrosis combined with lung cancer,analyze the distribution characteristics of TCM syndromes and related influencing factors of them,and explore the different types of syndromes and related influencing factors based on clinical reality relationship.Accumulate experience in early prevention and diagnosis and provide theoretical references of pulmonary fibrosis combined with lung cancer.Methods: From January 2013 to December 2019,105 eligible patients with pulmonary fibrosis combined with lung cancer who were admitted to the Department of Respiratory Medicine of the Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine were selected as the research subjects.Based on the previous research on pulmonary fibrosis,a "Pulmonary fibrosis combined with lung cancer Patients Questionnaire" was formulated to collect and summarize the general information of patients,clinical symptoms,physical and chemical examinations,and summarize the clinical characteristics of pulmonary fibrosis combined with lung cancer.According to the types of symptoms of TCM syndromes,group them based on the types of TCM syndromes,statistically analyze the influencing factors of the distribution of syndromes,and explore the factors that influence the distribution of TCM syndromes in lung fibrosis.Result: 1 Of the 105 patients with pulmonary fibrosis combined with lung cancer studied,74 were male and 31 were female.The incidence of sex was significantly higher in men than women.The majority of the patients were elderly,with an average age of(76.25 ± 9.03)years.Survey of risk factors: 74 males,accounting for 70.5% of the total,98 elderly patients,accounting for 93.33%;87 smoking history,accounting for 82.9%;23 patients with history of harmful substance exposure,accounting for 21.90% of the total.Investigation of lung cancer: There were 27 lung cancer patients with clear pathological type,accounting for 25.71% of the total.Among them,adenocarcinoma was the most: 17 cases of adenocarcinoma> 6 cases of squamous cell carcinoma> 4 cases of small cell carcinoma;33 cases of lung cancer metastasis,accounting for 31.43% of the total.Comorbidity survey: combined with other chronic diseases: 66 cases ofcoronary heart disease(62.86%)>42 cases of hypertension(40.00%)>29 cases of cerebrovascular disease(27.62%)>17 cases of diabetes(16.19%)>10 cases Patients with immune system disease(9.52%);most other diseases of the respiratory system are pneumonia and old tuberculosis.2 Inducted 105 cases of pulmonary fibrosis combined with lung cancer patients disease,disease level evidence and frequency statistics: order of pathological order: 100 cases of qi deficiency(95.24%)> 82 cases of blood stasis(78.10%)> 40 cases of yin deficiency(38.10%)> 21 cases of phlegm dampness(20.00%)> 18 cases of yang deficiency(17.14%)> 5 cases of heat(fire)(4.76%).The order of the disease was 105 lungs(100%)> 73 spleens(69.52%)> 60 kidneys(57.14%)> 44 livers(41.90%)> 41 heart(39.05%).Five types of TCM syndromes were obtained: 44 cases of the syndrome of Qi deficiency and blood stasis(41.91%)>38 cases of the syndrome of Qi-Yin deficiency and blood stasis(36.19%)>18 cases of the syndrome of Yang deficiency and phlegm dampness(17.14%)>3 cases of the syndrome of phlegm-heat accumulating lung(2.86%)>2 cases of the syndrome of Yin deficiency and heat-toxicity(1.90%).3 According to result 2,the number of cases of the syndrome of phlegm-heat accumulating lung and the syndrome of Yin deficiency and heat-toxicity cannot meet the requirements of statistical analysis.Therefore,only 100 patients with the syndrome of Qi deficiency and blood stasis,the syndrome of Qi-Yin deficiency and blood stasis,the syndrome of Yang deficiency and phlegm dampness,were studied.At the same time,the relevant data were divided into three groups for comparative analysis.3.1 General Information:(1)Among the 100 patients with pulmonary fibrosis combined with lung cancer,71 were male and 29 were female,the difference was statistically significant(P<0.05);however,there was no statistically significant difference in gender between the three syndrome types(P> 0.05).(2)The average age of 100 patients with pulmonary fibrosis combined with lung cancer was(75.90 ± 9.06)years.There was no significant difference in age between the three syndrome types(P>0.05).(3)The smokers and non-smokers of 100 patients with pulmonary fibrosis combined with lung cancer were 83 and 17,respectively,the difference was statistically significant(P<0.05).The relationship between smoking and the three syndrome types was statistically significant(P<0.05).Pairwise comparisons between the two groups: The smoking rates in the syndrome of Qi-Yin deficiency and blood stasis group and the syndrome of Yang deficiency and phlegm dampness group were significantly higher than those in the syndrome of Qi deficiency and blood stasis group(P<0.05).(4)The 100 patients with pulmonary fibrosis combined with lung cancer who were exposed to harmful substances and not exposed to harmful substances were 22 and 78,respectively,and the difference was statistically significant(P<0.05).There was no significant difference between the history of harmful substance exposure and the three syndrome types(P>0.05).3.2 Complications: The number of patients with old pulmonary tuberculosis and the number of patients with diabetes had statistically significant differences between the three syndrome types(P<0.05).Specifically,the prevalence of old pulmonary tuberculosis disease with the syndrome of Qi-Yin deficiency and blood stasis was higher than that of patients with the syndrome of Qi deficiency and blood stasis(P<0.05).Patients with the syndrome of Qi-Yin deficiency and blood stasis group had higher rates of diabetes mellitus than the syndrome of Qi deficiency and blood stasis group and the syndrome of Yang deficiency and phlegm dampness group(P<0.05).Patients with pneumonia,coronary heart disease,hypertension,and cerebrovascular disease had no significant differences in the distribution of the three syndrome types(P>0.05).3.3 Research on TCM Syndromes and Physical and Chemical Examinations The distribution of TCM syndromes of pulmonary fibrosis with lung cancer was significantly different in the plasma D-dimer count(P<0.05).The comparison of the two groups showed that the plasma D-dimer count was between the syndrome of Yang deficiency and phlegm dampness group and the syndrome of Qi deficiency and blood stasis group,and the plasma D-dimer count was between the syndrome of Yang deficiency and phlegm dampness group and the syndrome of Qi-Yin deficiency and blood stasis group.There are statistical differences between them.(P<0.05).There was a statistically significant difference in blood glucose counts in the distribution of TCM syndromes of lung fibrosis in lung cancer(P<0.05).There was a statistically significant difference in blood glucose levels between the syndrome of Qi-Yin deficiency and blood stasis group and the syndrome of Qi deficiency and blood stasis(P<0.05).CEA and CA19-9 counts were statistically different in the distribution of TCM syndromes of pulmonary fibrosis with lung cancer(P<0.05).Compared with the syndrome of Yang deficiency and phlegm dampness group,the CEA counts in the syndrome of Qi-Yin deficiency and blood stasis group and the syndrome of Qi deficiency and blood stasis group were statistically significant(P<0.05).While the CA19-9 counts in the syndrome of Qi-Yin deficiency and blood stasis syndrome group and the syndrome of Qi deficiency and blood stasis group were statistically significant in the distribution of syndrome types(P<0.05).WBC,RBC,HGB,CRP,PH,PO2,PCO2,ESR,NSE,CYFRA21-1,and SCC counts had no significant difference in the distribution of TCM syndromes in pulmonary fibrosis with lung cancer(P>0.05).In conclusion: 1 Pulmonary fibrosis with lung cancer is predominantly male.Risk factors for the disease include: advanced age,smoking,and exposure to harmful substances.2 The syndrome of Qi deficiency and blood stasis,the syndrome of Qi-Yin deficiency and blood stasis,the syndrome of Yang deficiency and phlegm dampness are the main syndrome types of patients with pulmonary fibrosis combined with lung cancer.Among them,the syndrome of Qi deficiency and blood stasis is the most common.3 Smoking has an impact on the distribution of TCM syndromes in patients with pulmonary fibrosis combined with lung cancer: the number of smokers in the group of Qi-Yin deficiency and blood stasis and the group of Yang Deficiency and Phlegm-Dampness are larger than in the group of Qi deficiency and blood stasis.4 Combining old tuberculosis or diabetes will affect the distribution of TCM syndromes in patients with pulmonary fibrosis combined with lung cancer: the ratio of PF-LC patients with old pulmonary tuberculosis and diabetes is the syndrome of qi-yin deficiency and blood stasis Bigger.5 D-dimer,blood glucose,CEA,CA19-9 counts have an effect on the distribution of TCM syndromes in patients with pulmonary fibrosis combined with lung cancer.