A retrospective study on clinical manifestations,syndromes and location characteristics of cryptogenic organizing pneumonia in TCM
Objective To analyze the clinical manifestations,syndromes and location characteristics of cryptogenic organizing pneumonia(COP)in TCM.Methods Four TCM diagnostic information and syndrome differentiation data of the patients diagnosed with COP were collected from April 2015 to March 2022 and a retrospective study was made on them.Results Among 56 patients,2 cases were found during routine physical examination,and the rest had 7 first symptoms,with cough and suffocation as the most common symptoms;then the sputum,shortness of breath and fever.There were 21 symptoms in 56 patients,including wheezing,cough,sweating,expectoration,chest tightness and shortness of breath with the frequency of occurrence more than 50%.The percentage of chest tightness was significantly lower in patients with fibrosis than in patients without fibrosis(P＜0.05);The percentage of sweating,thirst and polydipsia,weakness of lower back and knees was significantly higher in patients who took glucocorticoids than in patients who didn't take glucocorticoids(P＜0.05,P＜0.01).Among 56 patients,pale tongue is the most common,white coating is the most important,and string-taut pulse and rolling pulse are the most important,with the frequency exceeding 50%.Compared with the patients without fibrosis,the proportion of middle chords in patients with fibrosis was lower(P＜0.05).Compared with patients who did not take glucocorticoid,the proportion of pulse string,pulse slip and pulse number in patients who took glucocorticoid was higher(P＜0.05,P＜0.01).Among 56 cases,48 belong to mixed deficiency and excess syndrome,5 deficiency syndrome,3 excess syndrome.Deficiency syndrome is mainly qi deficiency,followed by yin deficiency and yang deficiency.Combined with syndrome differentiation of zang-fu,the highest frequency of syndrome types is lung qi deficiency,followed by kidney yin deficiency and spleen qi deficiency,with the frequency exceeding 30%.Deficiency syndrome occurred in two or three syndromes at the same time,mainly for lung and spleen deficiency with kidney yin deficiency and spleen qi deficiency.The excess syndrome were mainly retention of cold fluid in the lung,phlegm dampness blocking lung,damage of lung by qi stagnation and obstruction of stagnation in lung collaterals with the frequency exceeding 25%.The combination of syndrome types was mainly phlegm-dampness blocking lung and qi stagnation damaging lung,and cold fluid obstructing lung and blood stasis blocking lung collaterals.The percentage of kidney yang deficiency and blood stasis obstructing pulmonary collaterals in patients with fibrosis was significantly higher than in patients without fibrosis(P＜0.05,P＜0.01),and the percentage of qi stagnation hurting the lung was significantly lower than in patients without fibrosis(P＜0.01);the percentage of kidney yin deficiency was significantly higher in patients who took glucocorticoids than in patients who didn't take glucocorticoids(P＜0.01),and the percentage of lung Yang deficiency and blood stasis obstructing pulmonary collaterals was significantly lower than in patients who didn't take glucocorticoids(P＜0.05).In 56 patients,most of the lesions were located in lung,followed by kidney,spleen and stomach.Among them,compared with patients who did not take glucocorticoids,the proportion of patients who took glucocorticoids was higher in kidney and spleen(P＜0.05,P＜0.01).Conclusion The clinical TCM symptoms of COP are mainly pulmonary symptoms,combination of deficiency and excess is the main syndrome type and location of disease is lung.Patients taking glucocorticoids are prone to symptoms of deficiency of kidney yin such as sweating,thirst and polydipsia,soreness and weakness of lumber and knees,and the proportion of diseases is high in kidney and spleen.Chest tightness and string-taut pulse are more common in patients without fibrosis,and more common syndrome type is excess syndrome.
Cryptogenic organizing pneumoniasymptomsyndromelocation of diseaseglucocorticoidpulmonary fibrosis
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万方数据
