Study of the Correlation between the Acute Exacerbation of Chronic Obstructive Pulmonary Disease (Syndrome of Phlegm-heat Obstructing Lung) and the Clinically Relevant Indicators_Chinese Journal of Evidence-Based Medicine

Authors：

 TANG Bin ¹ ^# ,  CHEN Min ^1,2 ^# , LIAN Xiang-zhong ³ , ZHU Qiao-ling ⁴ , FU Min ² , ZHANG Tong-tong ⁵ ,  WANG Fei ²

1. Department of Traditional Chinese Medicine, the Third People's Hospital of Chengdu, Chengdu 610031, China;
2. School of Clinical Medicine, Chengdu University of TCM, Chengdu 610072, China;
3. Department of Respiratory, the Third People's Hospital of Chengdu, Chengdu 610031, China;
4. Department of Laboratory Medicine, the Third People's Hospital of Chengdu, Chengdu 610031, China;
5. Office of Laboratory Medicine, the Third People's Hospital of Chengdu, Chengdu 610031, China;

Corresponding?author：

WANG Fei, Email: wangfei896@163.com

Keywords：

Acute exacerbation of chronic obstructive pulmonary disease; Syndrome of phlegm-heat obstructing lung; Association

DOI：

10.7507/1672-2531.20160135

Video：

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Objective To analyze the association between the acute exacerbation of chronic obstructive pulmonary disease (AECOPD) (syndrome of phlegm-heat obstructing lung) and clinical indicators related to COPD. Method AECOPD in-patients and out-patients were enrolled from the Third People's Hospital of Chengdu from January 2013 to January 2014. The patients were grouped to Tanre Syndrome and non-Tanre Syndrome according to their clinical symptoms, signs and tongue, pulse. All patients underwent the following tests including routine blood test, erythrocyte sedimentation rate, lung function, blood gas analysis, C-reaction protein (CRP), procalcitonin (PCT) and other clinically relevant indicators. The association between AECOPD and clinically relevant indicators were analyzed by using SPSS 19.0 software. Results A total of 194 AECOPD patients were included, of which 88 patients were syndrome of phlegm-heat obstructing lung and 106 were non syndrome of phlegm-heat obstructing lung according to the traditional Chinese medicine (TCM) classifications. The results of single factor analysis showed that age (Z=-4.848, P=0.000) and course of disease (Z=-2.455, P=0.014) were associated with syndrome of phlegm-heat obstructing lung. While further logistic regression analysis showed that age (r=0.090, P=0.000) and the level of CRP (r=-0.008, P=0.000) were associated with syndrome of phlegm-heat obstructing lung. Conclusion Syndrome of phlegm-heat obstructing lung is the major clinical TCM syndrome of AECOPD. Syndrome of phlegm-heat obstructing lung is associated with age and level of CRP.

Citation： TANG Bin, CHEN Min, LIAN Xiang-zhong, ZHU Qiao-ling, FU Min, ZHANG Tong-tong, WANG Fei. Study of the Correlation between the Acute Exacerbation of Chronic Obstructive Pulmonary Disease (Syndrome of Phlegm-heat Obstructing Lung) and the Clinically Relevant Indicators. Chinese Journal of Evidence-Based Medicine, 2016, 16(8): 876-881. doi: 10.7507/1672-2531.20160135 Copy

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2.	中華中醫藥學會內科分會肺系病專業委員會.慢性阻塞性肺疾病中醫證候診斷標準(2011版).中醫雜志, 2012, 53(2):177-178.
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5.	中華醫學會呼吸病學分會慢性阻塞性肺疾病學組.慢性阻塞性肺疾病診治指南(2013年修訂版).中華結核和呼吸雜志, 2013, 36(4):255-260.
6.	歐陽忠興, 柯新橋.中醫呼吸病學:中國醫藥科技出版社, 1997.
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10.	徐雯潔, 王天芳, 王智瑜, 等.基于現代文獻的慢性阻塞性肺疾病中醫證候及證候要素的研究.中華中醫藥雜志, 2008, 23(1):19-22.
11.	Celli BR, Cote CG, Marin JM, et al. The body-mass index, airflow obstruction, dyspnea, and exercise capacity index in chronic obstructive pulmonary disease. N Engl J Med, 2004, 350(10):1005-1012.
12.	周宓, 潘柏申. C反應蛋白在臨床應用中的進展.國外醫學臨床生物化學與檢驗學分冊, 2005, 26(1):65-66.
13.	董玉華.痰熱清治療慢性阻塞性肺疾病急性加重期的臨床觀察蛇志, 2009, 21(4):283-284.
14.	盧家勝, 李喬, 趙衛星, 等.痰熱清注射液對AECOPD痰熱郁肺證患者血氣分析、血常規、C反應蛋白的臨床觀察.中醫藥臨床雜志, 2013, 25(1):29-30.
15.	Saigo M, Waters DD, Abe S, et al. Soluble fibrin, C-reactive protein, fibrinogen, factor VII, antithrombin, proteins C and S, tissue factor, D-dimer, and prothrombin fragment 1+2 in men with acute myocardial infarction < /=45 years of age. Am J Cardiol, 2004, 94(11):1410-1413.
16.	孫學東, 鄭世良, 徐偉華, 等.血清高敏C反應蛋白和血清降鈣素原在慢性阻塞性肺疾病急性發作期中的表達及意義.臨床合理用藥, 2010, 3(2):21-22.
17.	常春, 姚婉貞, 陳亞紅, 等.慢性阻塞性肺疾病患者急性加重期血清降鈣素原水平的變化及臨床意義.中華結核和呼吸雜志, 2006, 29(7):444-447.
18.	Wilson R, Dowling R, Jackson A. The effects of bacterial products on airway cells and their function. Am J Respir Crit Care Med, 1996, 154(2):197-201.
19.	Martinez FJ, Curtis JL. Procalcitonin-guided antibiotic therapy in COPD exacerbations:closer but not quite there. Chest, 2007, 131(1):1-2.
20.	鄭曉文, 陳一強, 張劍鋒, 等.不同炎癥指標聯合檢測在AECOPD中的診斷與應用.廣西一顆大學學報, 2013, 30(3):376-378.
21.	葉濤, 楊杰. C反應蛋白在老年AECOPD患者中的臨床價值.醫藥前沿, 2013, (22):205.

1. ?周仲瑛, 主編.中醫內科學:中國中醫藥出版社, 2003.
2. 中華中醫藥學會內科分會肺系病專業委員會.慢性阻塞性肺疾病中醫證候診斷標準(2011版).中醫雜志, 2012, 53(2):177-178.
3. 鄭筱萸.中藥新藥臨床研究指導原則(試行):中國醫藥科技出版社, 2002.
4. Vestbo J, Hurd SS, Agusti AG, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease:GOLD executive summary. American journal of respiratory and critical care medicine, 2013, 187(4):347-365.
5. 中華醫學會呼吸病學分會慢性阻塞性肺疾病學組.慢性阻塞性肺疾病診治指南(2013年修訂版).中華結核和呼吸雜志, 2013, 36(4):255-260.
6. 歐陽忠興, 柯新橋.中醫呼吸病學:中國醫藥科技出版社, 1997.
7. 王至婉, 李建生, 余學慶, 等.慢性阻塞性肺疾病急性加重期證候及特征的臨床調查研究.中華中醫藥雜志, 2010, 25(4):504-509.
8. 呂佳蒼, 王智瑜, 王天芳, 等. 774例慢性阻塞性肺疾病患者常見的中醫證候類型及其舌象分布特點.云南中醫學院學報, 2009, 32(1):19-25.
9. 王至婉, 李建生, 王明航, 等.慢性阻塞性肺疾病急性加重期中醫證候分布規律的文獻研究.中醫雜志, 2008, 49(8):727-730.
10. 徐雯潔, 王天芳, 王智瑜, 等.基于現代文獻的慢性阻塞性肺疾病中醫證候及證候要素的研究.中華中醫藥雜志, 2008, 23(1):19-22.
11. Celli BR, Cote CG, Marin JM, et al. The body-mass index, airflow obstruction, dyspnea, and exercise capacity index in chronic obstructive pulmonary disease. N Engl J Med, 2004, 350(10):1005-1012.
12. 周宓, 潘柏申. C反應蛋白在臨床應用中的進展.國外醫學臨床生物化學與檢驗學分冊, 2005, 26(1):65-66.
13. 董玉華.痰熱清治療慢性阻塞性肺疾病急性加重期的臨床觀察蛇志, 2009, 21(4):283-284.
14. 盧家勝, 李喬, 趙衛星, 等.痰熱清注射液對AECOPD痰熱郁肺證患者血氣分析、血常規、C反應蛋白的臨床觀察.中醫藥臨床雜志, 2013, 25(1):29-30.
15. Saigo M, Waters DD, Abe S, et al. Soluble fibrin, C-reactive protein, fibrinogen, factor VII, antithrombin, proteins C and S, tissue factor, D-dimer, and prothrombin fragment 1+2 in men with acute myocardial infarction < /=45 years of age. Am J Cardiol, 2004, 94(11):1410-1413.
16. 孫學東, 鄭世良, 徐偉華, 等.血清高敏C反應蛋白和血清降鈣素原在慢性阻塞性肺疾病急性發作期中的表達及意義.臨床合理用藥, 2010, 3(2):21-22.
17. 常春, 姚婉貞, 陳亞紅, 等.慢性阻塞性肺疾病患者急性加重期血清降鈣素原水平的變化及臨床意義.中華結核和呼吸雜志, 2006, 29(7):444-447.
18. Wilson R, Dowling R, Jackson A. The effects of bacterial products on airway cells and their function. Am J Respir Crit Care Med, 1996, 154(2):197-201.
19. Martinez FJ, Curtis JL. Procalcitonin-guided antibiotic therapy in COPD exacerbations:closer but not quite there. Chest, 2007, 131(1):1-2.
20. 鄭曉文, 陳一強, 張劍鋒, 等.不同炎癥指標聯合檢測在AECOPD中的診斷與應用.廣西一顆大學學報, 2013, 30(3):376-378.
21. 葉濤, 楊杰. C反應蛋白在老年AECOPD患者中的臨床價值.醫藥前沿, 2013, (22):205.

Chinese Journal of Evidence-Based Medicine

Study of the Correlation between the Acute Exacerbation of Chronic Obstructive Pulmonary Disease (Syndrome of Phlegm-heat Obstructing Lung) and the Clinically Relevant Indicators

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