Research Of The Relativity Between TCM Syndrome Types Of Acute Exacerbation Of Chronic Obstructive Pulmonary Disease And Some Laboratory Targets

Objective:In this research,we explored the intrinsic connection between TCM syndrome types and some laboratory targets by contrasting and analyzing the differences of laboratory indicators of different syndromes of AECOPD,such as White Blood Cell(WBC),Neutrophil(N),Neutrophil Percentage(N%),lymphocyte(L),Lymphocyte Percentage(L%),Red Blood Cell(RBC),Hemoglobin(Hb),Platelet(PLT),Albumin(ALB),Prealbumin(PA),High Sensitive C-reactive protein(hs-CRP),The Ratio of Neutrophil to Lymphocyte(NLR),The Ratio of Platelets to Lymphocytes(PLR),The Ratio of Hypersensitive C-reactive Protein to Albumin(hs-CRP/ALB),etc.Objective to explore the internal relationship between TCM syndrome differentiation and laboratory targets,and to find simple targets,so as to provide objective basis for TCM syndrome differentiation and treatment of AECOPD.Methods:We collected the general information and TCM diagnosis data of patients with comply with AECOPD and disease staging standard,determined the type of TCM syndrome,sorted out laboratory indicators,and wielded the statistical methods of variance analysis and rank sum test to analyse the differences of laboratory index in different TCM syndrome types,thus analysed the relationship between TCM syndrome type and each inspection index of AECOPD patients.Results:1.The final effective samples were 305 cases,257 male cases and 48 female cases.The average age was 72.49 ± 8.597 years,190 cases were 71～85 years old,105 cases were 56～70years old and 10 cases were 41～55 years old.In these 305 samples,76 cases were Phlegm Dampness Obstructing Lung Syndrome,52 cases were Phlegm Heat Obstructing Lung Syndrome,41 cases were Exterior Cold and Interior Heat Syndrome,39 cases were Lung Kidney Qi Deficiency Syndrome,36 cases were Wind Cold Attacking Lung Syndrome,34 cases were Exterior Cold and Interior Drink Syndrome,28 cases were Yang Deficiency and Water Flooding Syndrome.2.There were significant differences in WBC(P=0),N(P=0),N%(P=0),L%(P=0),PLT(P=0),ALB(P=0),hs-CRP(P=0),NLR,hs-CRP/ALB(P=0),PA(P=0.009),PLR(P=0.037)among different TCM Syndromes of AECOPD(P<0.05).After further multiple comparison,the difference was significant in statistic(P<0.05): WBC,N,N% of Phlegm Heat Obstructing Lung Syndrome was higher than the other six syndrome types.L% of Phlegm Heat Obstructing Lung Syndrome was lower than the other six syndrome types.PLT level of Phlegm Heat Obstructing Lung Syndrome was higher than the other five syndrome types except Syndrome Wind Cold Attacking Lung.ALB level of Yang Deficiency and Water Flooding Syndrome was lower than the other five syndrome types except Phlegm Heat Obstructing Lung Syndrome,and the ALB level of Phlegm Heat Obstructing Lung Syndrome was lower than that of the four syndrome types except Lung Kidney Qi Deficiency,the level of ALB in the Wind Cold Attacking Lung Syndrome was higher than Yang Deficiency and Water Flooding Syndrome,Phlegm Heat Obstructing Lung Syndrome and the Deficiency of Lung and Kidney Qi,the level of PA in the Phlegm Dampness Obstructing Lung Syndrome was higher than that of the four syndromes except Wind Cold Attacking Lung Syndrome and External Cold and Internal Drink Syndrome.The average of hs-CRP level of AECOPD patients was above the normal level,the hs-CRP level of Phlegm Heat Obstruction Lung Syndrome was higher than that of the other six syndromes,the level of hs-CRP in the External Cold and Internal Heat Syndrome was lower than the former but higher than that of Wind Cold Attacking Lung Syndrome and External Cold and Internal Drinking Syndrome.The NLR level of Phlegm Heat Obstructing Lung Syndrome was higher than that of the other six syndromes,and the NLR level of Wind Cold Obstructing Lung Syndrome was lower than the former,Exterior Cold and Interior Heat Syndrome and Yang Deficiency and Water Flooding Syndrome.The PLR level of Phlegm Heat Obstructing Lung Syndrome was higher than that of Wind Cold Obstructing Lung Syndrome,Exterior Cold and Interior Drink Syndrome and Phlegm Dampness Obstructing Lung Syndrome.The level of hs-CRP/ALB in the Phlegm Heat Obstructing Lung Syndrome was higher than that in the other six syndromes,the level of hs-CRP/ALB in the External Cold and Internal Heat Syndrome was higher than that in the Wind Cold Attacking Lung Syndrome and External Cold and Internal Drinking,the level of hs-CRP/ALB in the latter two syndromes was lower than that in the other three syndromes except Phlegm Dampness Obstructing Lung Syndrome and Lung Kidney Qi Deficiency Syndrome.3.There was no difference in the level of L(P = 0.054)in different syndromes of AECOPD(P > 0.05),but it was lower than the lower limit of normal value.Here was no statistical difference in RBC(P = 0.851)and Hb(P = 0.746)(P > 0.05).Conclusion:1.TCM syndrome types of AECOPD are correlated with WBC,N,N%,L%,PLT,ALB,PA,hs-CRP and NLR,PLR,hs-CRP/ALB.The specific manifestations are as follows: the higher level of WBC,N,N%,PLT,NLR,PLR and the lower level of L% are correlated with the Phlegm Heat Obstructing the Lung Syndrome.The decrease of L% is not obviously and the low level of NLR related to the Wind Cold Attacking Lung Syndrome.The low level of ALB is related to the Yang Deficiency and Water Flooding Syndrome and the Phlegm Heat Obstructing the Lung Syndrome,and the decrease of it was not significantly correlated with the Wind Cold Attacking Lung Syndrome.The decrease of PA was not significantly correlated with the Phlegm Dampness Obstructing the Lung.The higher level of hs-CRP and hs-CRP/ALB is correlated with Phlegm Heat Obstructing The Lung Syndrome.The increase of hs-CRP was not significantly correlated with the Wind Cold Attacking Lung Syndrome and the External Cold and Internal Drink Syndrome.2.The levels of L and PA in AECOPD patients were lower than the normal level,the levels of L% and ALB were close to the lower limit of normal level,and the average level of hs-CRP was higher than the normal level.