Distribution of Traditional Chinese Medicine Patterns and Analysis of Factors Related to Acute Exacerbation in Group E of Chronic Obstructive Pulmonary Disease
10.13288/j.11-2166/r.2023.17.011
- VernacularTitle:慢性阻塞性肺疾病E组患者中医证型分布及急性加重相关因素的回顾性分析
- Author:
Xiaoning LI
1
;
Mingzhe CHEN
1
;
Xurui HUANG
1
;
Ping'an ZHANG
1
;
Deyu KONG
1
;
Xudong ZHENG
1
;
Liangduo JIANG
2
;
Jianjun WU
1
Author Information
1. Beijing University of Chinese Medicine Third Affiliated Hospital, Beijing, 100029
2. Dongzhimen Hospital, Beijing University of Chinese Medicine
- Publication Type:Journal Article
- Keywords:
chronic obstructive pulmonary disease;
acute exacerbation;
lung-spleen qi deficiency;
lung-kidney deficiency
- From:
Journal of Traditional Chinese Medicine
2023;64(17):1786-1791
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo analyze the distribution of traditional Chinese medicine (TCM) patterns as well as factors related to acute exacerbation in group E of chronic obstructive pulmonary disease (COPD). MethodsThe general data of 161 COPD patients, including gender, age, body mass index (BMI), disease course, smoking history, and past history, were collected. In terms of the four examinations of TCM, the differentiated patterns included phlegm-heat obstructing the lung, turbid phlegm obstructing the lung, phlegm stasis obstructing the lung, lung-spleen qi deficiency, and lung-kidney deficiency. The modified British Medical Research Council (mMRC) scale and COPD assessment test (CAT), the pulmonary function indicators including forced expiratory volume in the first second (FEV1) and ratio of forced expiratory volume to forced vital capacity at second 1 (FEV1/FVC), GOLD grade, and the patient's acute exacerbations in the previous year were recorded. Multivariate regression analysis was performed using logistic regression model to determine the relevant factors of patients in COPD group E. The distribution of acute exacerbations in different TCM symptom patients in group E was analyzed. ResultsThere were 80 patients (49.69%) in group E and 81 patients (50.31%) in non-group E. In group E, 23 (28.75%) patients had a history of two acute exacerbations, while 35 (43.75%) had three acute exacerbations, and 22 (27.5%) had more than three acute exacerbations. There were 13 (16.25%) cases of phlegm-heat obstructing the lung pattern, 6 (7.5%) cases of turbid phlegm obstructing the lung pattern, 8 (10%) cases of phlegm stasis obstructing the lung pattern, 22 cases (27.5%) of lung-spleen qi deficiency pattern, and 31 (38.75%) cases of lung-kidney deficiency pattern. There were significant differences in smoking history, disease course, TCM pattern, TCM syndrome score, mMRC score, and CAT score between groups (P<0.05). A total of 107 of the 161 patients completed pulmonary function tests, and the differences in FEV1, FEV1/FVC and GOLD grades between groups were statistically significant (P<0.05). Multivariate regression analysis showed that TCM pattern, TCM syndrome score and CAT score were statistically significant factors for COPD patients in group E (P<0.05). There were statistically significant differences in the number of acute exacerbations in different TCM patterns in group E (P<0.05). The patients with two acute exacerbations in the past year were mainly phlegm-heat obstructing the lung and lung-spleen qi deficiency patterns, while the three acute exacerbations were mainly seen in lung-spleen qi deficiency and lung-kidney deficiency patterns, and more than three exacerbations were more common with lung -kidney deficiency pattern. ConclusionsPatients in COPD group E were mainly the lung-spleen qi deficiency and lung-kidney deficiency patterns. Deficiency of healthy qi is the main reason for the increase in the number of acute exacerbations, and TCM patterns and CAT score were the main related factors.