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.	中华中医药学会内科分会肺系病专业委员会.慢性阻塞性肺疾病中医证候诊断标准(2011版).中医杂志, 2012, 53(2):177-178.
3.	郑筱萸.中药新药临床研究指导原则(试行):中国医药科技出版社, 2002.
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5.	中华医学会呼吸病学分会慢性阻塞性肺疾病学组.慢性阻塞性肺疾病诊治指南(2013年修订版).中华结核和呼吸杂志, 2013, 36(4):255-260.
6.	欧阳忠兴, 柯新桥.中医呼吸病学:中国医药科技出版社, 1997.
7.	王至婉, 李建生, 余学庆, 等.慢性阻塞性肺疾病急性加重期证候及特征的临床调查研究.中华中医药杂志, 2010, 25(4):504-509.
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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医证候分布规律的文献研究.中医杂志, 2008, 49(8):727-730.
10.	徐雯洁, 王天芳, 王智瑜, 等.基于现代文献的慢性阻塞性肺疾病中医证候及证候要素的研究.中华中医药杂志, 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反应蛋白在临床应用中的进展.国外医学临床生物化学与检验学分册, 2005, 26(1):65-66.
13.	董玉华.痰热清治疗慢性阻塞性肺疾病急性加重期的临床观察蛇志, 2009, 21(4):283-284.
14.	卢家胜, 李乔, 赵卫星, 等.痰热清注射液对AECOPD痰热郁肺证患者血气分析、血常规、C反应蛋白的临床观察.中医药临床杂志, 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.	孙学东, 郑世良, 徐伟华, 等.血清高敏C反应蛋白和血清降钙素原在慢性阻塞性肺疾病急性发作期中的表达及意义.临床合理用药, 2010, 3(2):21-22.
17.	常春, 姚婉贞, 陈亚红, 等.慢性阻塞性肺疾病患者急性加重期血清降钙素原水平的变化及临床意义.中华结核和呼吸杂志, 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.	郑晓文, 陈一强, 张剑锋, 等.不同炎症指标联合检测在AECOPD中的诊断与应用.广西一颗大学学报, 2013, 30(3):376-378.
21.	叶涛, 杨杰. C反应蛋白在老年AECOPD患者中的临床价值.医药前沿, 2013, (22):205.

1. 周仲瑛, 主编.中医内科学:中国中医药出版社, 2003.
2. 中华中医药学会内科分会肺系病专业委员会.慢性阻塞性肺疾病中医证候诊断标准(2011版).中医杂志, 2012, 53(2):177-178.
3. 郑筱萸.中药新药临床研究指导原则(试行):中国医药科技出版社, 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. 中华医学会呼吸病学分会慢性阻塞性肺疾病学组.慢性阻塞性肺疾病诊治指南(2013年修订版).中华结核和呼吸杂志, 2013, 36(4):255-260.
6. 欧阳忠兴, 柯新桥.中医呼吸病学:中国医药科技出版社, 1997.
7. 王至婉, 李建生, 余学庆, 等.慢性阻塞性肺疾病急性加重期证候及特征的临床调查研究.中华中医药杂志, 2010, 25(4):504-509.
8. 吕佳苍, 王智瑜, 王天芳, 等. 774例慢性阻塞性肺疾病患者常见的中医证候类型及其舌象分布特点.云南中医学院学报, 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医证候分布规律的文献研究.中医杂志, 2008, 49(8):727-730.
10. 徐雯洁, 王天芳, 王智瑜, 等.基于现代文献的慢性阻塞性肺疾病中医证候及证候要素的研究.中华中医药杂志, 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反应蛋白在临床应用中的进展.国外医学临床生物化学与检验学分册, 2005, 26(1):65-66.
13. 董玉华.痰热清治疗慢性阻塞性肺疾病急性加重期的临床观察蛇志, 2009, 21(4):283-284.
14. 卢家胜, 李乔, 赵卫星, 等.痰热清注射液对AECOPD痰热郁肺证患者血气分析、血常规、C反应蛋白的临床观察.中医药临床杂志, 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. 孙学东, 郑世良, 徐伟华, 等.血清高敏C反应蛋白和血清降钙素原在慢性阻塞性肺疾病急性发作期中的表达及意义.临床合理用药, 2010, 3(2):21-22.
17. 常春, 姚婉贞, 陈亚红, 等.慢性阻塞性肺疾病患者急性加重期血清降钙素原水平的变化及临床意义.中华结核和呼吸杂志, 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. 郑晓文, 陈一强, 张剑锋, 等.不同炎症指标联合检测在AECOPD中的诊断与应用.广西一颗大学学报, 2013, 30(3):376-378.
21. 叶涛, 杨杰. C反应蛋白在老年AECOPD患者中的临床价值.医药前沿, 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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