| ObjectiveThis study will analyze the correlation between chest CT signs,PFT and different TCM syndromes in patients with chronic obstructive pulmonary disease,verify the accuracy of TCM syndromes,and provide scientific theoretical basis for them.It is helpful to standardize the diagnosis and treatment of integrated traditional Chinese and western medicine.Scientific diagnosis and treatment will provide new ideas and methods for clinical diagnosis and treatment of COPD.MethodsThis topic adopts a retrospective research method,selecting382COPD inpatients diagnosed by the deputy chief physician or above in the respiratory department of Dongzhimen Hospital from 2013 to 2017 as the research object,including patients in acute exacerbation and stable phase.The imaging interpretation is interpreted by senior imaging experts,collecting high-resolution CT imaging features of patients' lungs,and collecting TCM syndrome types and lung function examination results.To investigate the distribution of TCM syndromes of COPD scientifically,and to explore the relationship between TCM syndromes of COPD and PFT and chest HRCT signs.Results1.General data:382 COPD patients diagnosed by deputy chief physician or above in respiratory department of Dongzhimen hospital from 2013 to 2017 were selected as the research object,including 230 male patients and 152 female patients in acute exacerbation and stabilization periods.The proportion of male patients was 60.2%,the proportion of female patients was 39.8%,the average age was(76.007±7.522)years old,and the course of disease was(12.365±7.532).The proportion of smokers was 71.2%,and the proportion of non-smokers was 28.6%.2.Distribution:(1)Distribution of CT phenotypes:382 COPD patients were divided into 3 groups:type A,type E and type M by imaging classification,of which 74 cases(19.4%)were type A;There were 210 cases of type E,accounting for 54.9%of the total.There were 98 cases of M type,accounting for 35.7%of the total.Among the CT phenotypes of COPD patients,type E is the most common,followed by type A and type M.(2)Distribution of TCM syndrome types:382 COPD patients are divided into 3 groups according to TCM syndrome types,namely,pure excess syndrome,pure deficiency syndrome and deficiency-excess mixed type,of which 84 cases are pure excess syndrome,accounting for 22.0%,83 cases are pure deficiency syndrome,accounting for 21.8%,215 cases are deficiency-excess mixed type,accounting for 56.3%,mostly concentrated in deficiency-excess mixed type;There are 2 cases of external cold and internal drinking,the ratio is about 0.5%,50 cases of phlegm-heat obstructing the lung,the ratio is about 13.1%.9 cases of phlegm-dampness obstructing the lung,the ratio is about 2.4%,23 cases of phlegm-stasis obstructing the lung,the ratio is about 6.0%,11 cases of lung qi deficiency,the ratio is about 2.9%,27 cases of lung-spleen qi deficiency,the ratio is about 7.1%,and 30 cases of lung-kidney qi deficiency,the ratio is about 7.9%.There were 15 cases of deficiency of both lung and kidney qi and yin,with a ratio of about 3.9%,69 cases of deficiency and phlegm-heat with a ratio of about 18.1%,44 cases of deficiency and phlegm-dampness with a ratio of about 11.5%,50 cases of deficiency and phlegm-stasis with a ratio of about 13.1%,52 cases of deficiency and blood stasis with a ratio of about 13.6%;Most of them are concentrated in deficiency syndrome combined with phlegm heat,followed by deficiency syndrome combined with blood stasis,deficiency syndrome combined with blood stasis,etc.,with deficiency-excess mixed mainly(3)Distribution of pulmonary function classification:382 COPD patients are divided into 3 groups according to TCM syndrome types:pure excess syndrome,pure deficiency syndrome and deficiency-excess mixed syndrome,of which 84 cases are pure excess syndrome,accounting for 22.0%,83 cases are pure deficiency syndrome,accounting for 21.8%,215 cases are deficiency-excess mixed syndrome,accounting for 56.3%,mostly concentrated in deficiency-excess mixed syndrome.Conclusion?3.Correlation between different CT phenotypes,TCM syndromes and pulmonary function classification(1)CT phenotype is type A,which is mainly mixed with deficiency and excess,followed by simple deficiency syndrome.COPD phenotype is type E and type M,which is mainly mixed with deficiency and excess,followed by simple excess.Type A,type E and type M are mostly mixed with deficiency and excess syndrome.In syndrome composition,COPD is mainly mixed with deficiency and excess syndrome.(2)CT phenotype is type A,which is mostly concentrated in deficiency syndrome and phlegm heat,followed by lung qi deficiency,etc.The CT phenotype is type E,which is mostly concentrated in deficiency syndrome with phlegm and heat,followed by deficiency syndrome with phlegm and blood stasis.The CT phenotype is M-type,mostly concentrated in phlegm-heat obstructing lung,followed by deficiency syndrome and blood stasis.Pathological factors of different TCM syndromes exist in different CT phenotypes.(3)PFT with CT phenotype of type A is mainly classified into grade I,while type E and type M are mainly classified into grade III.It can be seen that the lung function severity grade of type A patients in COPD CT phenotype is lower than that of the other two types.Therefore,the more obvious emphysema is,the more sever lung ventilation is.(4)Patients with Grade ? is more than those with simple deficiency syndrome,while patients with Grade ? is more than those with deficiency-excess syndrome.The severity of grade ? is more than that of pure demonstration.From light to heavy disease evolution.It is suggested that the evolution of TCM syndromes of COPD is related to the changes of lung functionconclusionCT phenotype and PFT of COPD patients have certain correlation with TCM syndromes.COPD evolves from mild to severe.It is suggested that the TCM syndrome type of COPD changes from deficiency to excess,the lung function decreases gradually,and pulmonary HRCT is often accompanied by emphysema changes. |
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