Clinical correlation of distribution characteristics of traditional Chinese medicine syndromes in tracheobronchial tuber-culosis
Objective To explore the distribution characteristics of traditional Chinese medicine(TCM)syndromes in tracheobronchial tuberculosis(TBTB)and its clinical correlation.Methods A total of 272 TBTB patients were recruited.Their general condition and distribution of TCM syndromes were observed.The distribution of TCM syndromes in TBTB patients with different classification of TBTB were compared.The distribution of TCM syndromes in TBTB patients with different foci were com-pared.The bronchoalveolar lavage fluid(BALF)staining bacterial smears with fluorescent antibody of TBTB patients with differ-ent TCM syndromes were compared.Pathogenic test results of BALF in TBTB patients with different TCM syndromes were com-pared.Results There were 272 TBTB patients involving 4 types of TCM syndromes.No significant differences in the distribu-tion of 4 types of TCM syndromes,body mass index(BMI)and age were detected among the four groups(P>0.05).The pro-portion of female TBTB patients was significantly higher than that of males(χ2 =3.859,P<0.001),with the male-to-female ratio of 1∶2.4.There was a significant difference in the classification of TBTB among the 4 types of TCM syndromes(P<0.05).TBTB patients with the TCM syndrome type of lung Yin deficiency were mainly categorized into the inflammatory infiltration type(32.8%);those with the TCM syndrome type of Yin deficiency and fire hyperactivity were mainly categorized into the granulation proliferation type(41.7%);those with the TCM syndrome type of deficiency of both Qi and Yin were mainly categorized into the ul-cer necrotic type;those with the TCM syndrome type of deficiency of both Yin and Yang were mainly categorized into the scar stenosis type.The proportions of wall softening type and lymph node fistula type were relatively low,which were mainly discovered in TBTB patients with the TCM syndrome type of deficiency of both Qi and Yin.A significant difference was detected in the TBTB classification among patients with 4 types of TCM syndromes(P<0.05).The foci of TBTB patients with the TCM syndrome type of lung Yin deficiency were mainly located in the right lower lobe bronchus(31.3%);those of TBTB patients with the TCM syn-drome type of Yin deficiency and fire hyperactivity were mainly located in the left main bronchus(30.6%);those of TBTB pa-tients with the TCM syndrome type of deficiency of both Qi and Yin were mainly located in the left upper lobe bronchus(28.8%);those of TBTB patients with the TCM syndrome type of deficiency of both Yin and Yang were mainly located in right main bronchus(30.0%).The highest number of acid-fast staining bacteria was detected in TBTB patients with the TCM syn-drome type of deficiency of both Yin and Yang,followed by the TCM syndrome type of deficiency of both Qi and Yin,Yin defi-ciency and fire hyperactivity,and lung Yin deficiency.No significant difference was detected in the acid-fast staining bacteria between TBTB patients with the TCM syndrome types of lung Yin deficiency and Yin deficiency and fire hyperactivity(P>0.05).It was significant different between the TCM syndrome type of deficiency of both Qi and Yin versus lung Yin deficiency(P<0.05),the TCM syndrome type of Yin deficiency and fire hyperactivity versus deficiency of both Yin and Yang(P<0.01),and the TCM syndrome type of deficiency of both Qi and Yin versus deficiency of both Yin and Yang(P<0.05).The amount of phlegm bacteria in TBTB patients with the TCM syndrome type of deficiency of both Yin and Yang was significantly higher than those with the TCM syndrome type of deficiency of both Qi and Yin.Pairwise comparison showed that there was no significant difference in the positive rate of Mycobacterium tuberculosis detected by GeneXpert,TB genotyping(TB-DNA),loop-mediated isothermal amplification(TB-LAMP)and in vitro culture(P>0.05).Conclusion There are significant differences in the manifestations of TBTB with different TCM syndromes under electronic bronchoscopy,including the classifica-tion,location and bacterial count of TBTB.Our findings provide references for clinical syndrome differentiation and medication of TBTB.
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