| The first partChapter 1 Correlation between bronchial asthma and anxiety and depressionObjective :Through the statistical analysis of the distribution of ACT and anxiety and depression in patients with bronchial asthma(bronchial asthma BA),the correlation between bronchial asthma and anxiety and depression was explored to provide ideas and methods for the diagnosis and treatment of bronchial asthma.Methods :A total of 185 asthma patients with bronchial asthma were selected from the Department of Respiratory and Critical Care in the Second Affiliated Hospital of Tianjin University of Chinese Medicine(January 2019-December 2020)using the General Data Sheet,Asthma Control Test Self-Test(ACT),Hamilton Anxiety Scale and Hamilton Depression Scale.Their age,gender,smoking history,asthma course,ACT score,Hamilton Anxiety Scale score and Hamilton Depression Scale score were analyzed.Through statistical analysis,the correlation between bronchial asthma and anxiety and depression was explored.Results :1.Among the 185 BA patients in this study,103 were female,accounting for 54.3% of the total number,and 82 were male,accounting for 45.7%;Among them,the oldest was 86 years old and the youngest was 16 years old,with an average age of 57.03±12.98 years old.There were 119 non-smokers,accounting for 64.3% of the total,and 66 smoking patients,accounting for 37.5% of the total.Asthma control level(ACT): 97 patients with poor asthma symptom control accounted for 52.4% of the total;Secondly,77 patients(41.6%)had well controlled asthma symptoms.The number of patients with asthma under complete control was the least,with only 4 cases(2.2%).Uncontrolled asthma symptoms were found in seven cases,or 3.8% of the total.Course of disease: The number of patients with course of disease less than 5 years was the largest,accounting for 85 cases,about 45.7%;Secondly,38 cases(20.3%)were infected for 5 to 10 years.The shortest course of disease is 1 month,the longest course of disease is 60 years.22.The anxiety state of 185 BA patients in this study : 23.8 % may have anxiety,30.3 %must have anxiety,22.7 % must have obvious anxiety,and 13 % must have serious anxiety.There were 66 men with possible anxiety,certain anxiety,certain obvious anxiety and possible serious anxiety,accounting for 80.4 % of the total number of men;There were 100 women with anxiety,certain anxiety,certain obvious anxiety and possible serious anxiety,accounting for 97.08 % of the total number of women;Female patients had more anxiety than male patients,and the difference between anxiety and gender was statistically significant(P < 0.05).Depression : 33.5 % may have depression,50.3 % must have depression,7.0 %have severe depression;There were 66 males with depression,accounting for 80.48 % of the total number of males;A total of 102 women suffered from depression,accounting for99.02 % of the total number of women;Statistical calculations,P < 0.05,depression and gender differences were statistically significant.The difference of depression scores between male and female was statistically significant,and the degree of depression in female was higher than that in male.Correlation between anxiety and depression and age,course of disease and ACT of asthma patients :3.(1)185 patients with BA may have anxiety age concentrated in 46-55 years old and56-65 years old;Those who are definitely anxious,those who are definitely obviously anxious,and those who may be seriously anxious are all concentrated in 56 – 65 years old and over 66 years old,with statistical significance(P = 0.001)(P < 0.05).The difference in anxiety score and age is statistically significant,indicating that the older the age is,the greater the possibility of anxiety is.The age of possible depression and certain depression in 185 BA patients were concentrated in 45-55 years old,56-65 years old and over 66 years old.The age of patients with severe depression is concentrated in 56 ～ 65 years old.There was a statistically significant difference in depression score between ages(P = 0.008(P <0.05)).(2)The distribution of anxiety in ACT of 185 BA patients : asthma symptoms were not controlled(85.71 %)> asthma symptoms were poorly controlled(80.41 %)> asthma symptoms were well controlled(48.05 %)> asthma symptoms were completely controlled(0 %).The largest number of anxiety was distributed in the two groups of poor asthma symptoms and asthma symptoms were not controlled.By Kruskal-Wallis test analysis,(P =0.000)P < 0.05,the difference was statistically significant;The distribution of depression in185 BA patients in ACT was as follows : uncontrolled asthma symptoms(85.71 %)> poorly controlled asthma symptoms(69.07 %)> well controlled asthma symptoms(41.55 %)>completely controlled asthma symptoms(25 %).By Kruskal-Wallis test analysis,P < 0.001.The difference was statistically significant.(3)Through this study,it was found that only 175 cases were counted due to the failure of 10 patients to provide correct asthma pathogenesis;The prevalence of anxiety : the duration of less than 5 years with anxiety was 88.37 %;anxiety was 83.78 % in the course of 5–10 years;anxiety was 100 % in the course of 10 – 20years;the anxiety rate of 20 – 30 years was 88.23 %;Course of disease over 30 years 96 %.Prevalence of anxiety : duration of 10 – 20 years > duration of more than 30 years > duration of less than 5 years > duration of 20 – 30 years > duration of 5 – 10 years.Kruskal-Wallis test,P = 0.206(P > 0.05)Chapter Two Literature Research on Treating Bronchial Asthma from LiverObjective :Through the collation,analysis and summary of the literature on the treatment of bronchial asthma from the liver,a new treatment scheme is provided for the treatment of bronchial asthma.Results :According to the statistics of 72 literatures,the common syndromes of treating bronchial asthma from the liver are : stagnation of liver qi,liver fire invading lung,liver wind moving inside,liver qi multiplying lung,liver qi multiplying spleen,liver and lung yin deficiency.Common pathological factors are : phlegm,qi stagnation,wind,fire or heat,deficiency;The commonly used treatment methods are soothing liver,clearing liver,softening liver and calming liver.Commonly used drugs for liver meridian : Bupleurum,Bombyx batryticatus,Citrus aurantium,Dilong,Chuanxiong,Danshen,Xiangfu,Baishao.Part Ⅱ Clinical researchObjective :In view of the acute attack or clinical remission of bronchial asthma(liver qi insulting lung,lung qi stagnation syndrome),Xuanfei Jieyu traditional Chinese medicine compound in our hospital was used for treatment,providing new treatment ideas for bronchial asthma comorbid anxiety and depression.Methods :Sixty patients with asthma complicated with anxiety and depression were selected from the Department of Respiratory and Critical Care of the Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine(January 2019 to December 2020)as the research subjects,who met all clinical criteria and were included in the study.Patients were numbered from 1 to 60 in order before and after admission,and then random numbers were generated with the help of statistical software,which were divided into two groups according to the singly and douly attributes of the generated numbers.The singular number was the control group,and the even number was the observation group.The control group was given conventional treatment of western medicine.Observation group: on the basis of treatment in the control group,they were given "Xuanfei Jieyu" Chinese medicine compound.The total treatment course was 2 weeks.SPSS22.0 statistical software was used to compare the serum indexes,lung function indexes,asthma scores,anxiety and depression scores before and after treatment to evaluate the clinical efficacy of Xuanfei Jieyu Decoction.Results :1.Serum indicators: EOS count and serum total Ig E in the observation group and the control group were significantly decreased compared with those before treatment,P<0.05 was calculated,and the difference was statistically significant.However,the serum indexes in the observation group were better than those in the control group(P<0.05),and the difference was statistically significant.2.Pulmonary function test: Compared with before treatment,all pulmonary function indexes were significantly improved after treatment,and the calculated difference of P<0.05 was statistically significant.The improvement of FEV1,FVC,FEV1/FVC and other indexes in the observation group was better than that in the control group(P<0.05),and the difference was statistically significant.3.ACT score: After treatment,the asthma scores of both groups were improved,and the ACT score of the observation group was higher than that of the control group(P<0.05).The difference was statistically significant.4.Anxiety score and depression score: After treatment,anxiety score and depression score in the two groups were significantly reduced,and the improvement of anxiety score and depression score in the observation group was better than that in the control group(P<0.05).The difference was statistically significant.Conclusion:1.Anxiety and depression exist in asthmatic patients,and female patients are more than male patients,mainly in the middle-aged and elderly.The lower the ACT score,the more serious the anxiety and depression will be.2.Xuanfei jieyu prescription can significantly reduce HAMA and HDMD,improve serum indexes,lung function indexes and ACT scores in patients with asthma complicated with anxiety and depression. |
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