Relevance Study Between TCM Syndromes And Nutritional Status In Elderly Patients With Acute Exacerbation Of Chronic Obstructive Pulmonary Disease

Objective:To explore the distribution characteristics of TCM syndromes and nutritional status in elderly patients with AECOPD,analyze the internal correlation between them,and study the related factors affecting nutritional status,so as to play an important role in improving the nutritional status of elderly patients with AECOPD.Methods:The elderly patients with AECOPD who met the inclusion criteria in Sichuan Hospital of Traditional Chinese Medicine from January 2020 to February2021 were investigated by cross-sectional survey.The general data,clinical indicators and symptom observation were collected.The patients were divided into normal nutritional status group,malnutrition risk group and camp group according to the MNA-SF score Malnutrition group.The database was established and analyzed by Spss25.0.Results:1.A total of 215 elderly patients with AECOPD were included in this study.There were 125 males（58.14%）and 90 females（41.86%）with an average age of 72.85±7.31 years and average BMI of 21.77±2.96kg/m².According to MNA-SF score,there were 53 cases（24.6%）with normal nutritional status,101 cases（46.9%）with malnutrition risk and 61 cases（28.3%）with malnutrition.2.In 185 cases of this deficiency syndrome,there were 55 cases of lung qi deficiency syndrome,60 cases of lung spleen qi deficiency syndrome,64 cases of lung kidney qi deficiency syndrome,and 6 cases of lung Kidney Qi Yin deficiency syndrome,accounting for 29.73%,32.43%,34.59%and 3.24%respectively.Among them,21 cases of lung qi deficiency syndrome（53.84%）were in the normal nutritional status group;34 cases of lung kidney qi deficiency syndrome（37.36%）were in the malnutrition risk group;24 cases of lung spleen qi deficiency syndrome（43.63%）and 24 cases of lung kidney qi deficiency syndrome（43.63%）were in the malnutrition group;the difference in the distribution of this deficiency syndrome among the three groups was statistically significant（P<0.05）.3.There were 20 cases（10.53%）of external cold and internal drink syndrome,61cases（32.10%）of phlegm turbid obstructing lung syndrome,65 cases（34.21%）of phlegm heat obstructing lung syndrome and 44 cases（23.16%）of blood stasis syndrome in 190 cases of standard syndrome.Among them,21 cases（42.86%）of normal nutritional status group were phlegm turbid obstructing lung syndrome;16cases（40%）of malnutrition risk group were phlegm heat obstructing lung;22 cases（43.13%）of malnutrition group were blood stasis syndrome.There was significant difference in the distribution of symptoms among the three groups（P<0.05）.4.There were no significant differences in FEV₁%pred,FEV₁/FVC and Hb between different nutritional status groups（P>0.05）;The BMI,TP,ALB and LC of the normal nutritional status group were better than those of the other two groups.（P<0.05）.5.There was no significant difference in TP,Hb and LC among different deficiency syndromes（P>0.05）.There was significant difference in BMI between lung qi deficiency syndrome and other deficiency syndromes（P<0.05）,but there was no significant difference between the other two groups（P>0.05）.There was significant difference between ALB of deficiency of both qi and Yin of lung and kidney and other deficiency syndromes（P<0.05）,but there was no significant difference between the other two groups（P>0.05）.6.There was no significant difference in BMI,TP,ALB and LC between different standard syndromes（P>0.05）;there was significant difference in Hb between phlegm turbid obstructing lung syndrome and blood stasis syndrome（P<0.05）,and there was no significant difference between the other two groups（P>0.05）.7.Age,marriage,disease course and gold grade had statistical significance on the nutritional status of elderly AECOPD patients（P<0.05）;gender,residential area,living condition,smoking and drinking had no statistical significance on the nutritional status of elderly AECOPD patients（P>0.05）Conclusion:In elderly patients with AECOPD,the deficiency of lung and kidney qi is the most common,and the syndrome of phlegm heat obstructing lung is the most common.Most of the elderly patients with AECOPD have malnutrition risk or malnutrition,and their nutritional status may be related to age,marital status,disease course and airflow limitation.The TCM Syndromes of normal nutritional status elderly AECOPD patients are lung qi deficiency syndrome and phlegm turbidity obstructing lung syndrome.The TCM Syndromes of malnutrition elderly AECOPD patients are lung spleen qi deficiency syndrome,lung kidney qi deficiency syndrome and blood stasis syndrome.