Distribution of Traditional Chinese Medicine Syndromes and Prediction Perform-ance of Serum Biomarkers in AECOPD
Objective To explore the distribution pattern of traditional Chinese medicine(TCM)syndromes in the patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)and analyze the serum levels and pre-diction performance of total bilirubin(TBIL)and C-reactive protein(CRP).Methods A total of 101 AECOPD patients treated in the Department of Respiratory Medicine of Suqian First Hospital from June 2020 to June 2023 were selected and included in the AECOPD group.At the same time,55 patients with stable chronic obstructive pulmonary disease(SCOPD)treated in the same department during the same time period were selected and included in the SCOPD group.In addition,55 healthy individuals undergoing physical examination were included in the control group.The serum levels of bilirubin and CRP were measured in all the groups,and the distribution pattern of TCM syndromes in the AECOPD group was statis-tically analyzed.Spearman's correlation analysis was carried out to analyze the correlation between serum bilirubin and CRP levels.The AECOPD patients were classified according to pulmonary function into a mild to moderate group(n=72)and a severe to critical group(n=29).Logistic regression was employed to analyze the influencing factors of AECOPD patients.The receiver operating characteristic(ROC)curves were drawn for prediction.Results Compared with the control group,both the SCOPD and AECOPD groups showed lowered levels of TBIL and indirect bilirubin(IBIL)(P＜0.05).The AE-COPD group showed lower levels of TBIL,IBIL,and CRP than the SCOPD group(P＜0.05).However,there was no signif-icant difference in the level of direct bilirubin(DBIL)among the three groups(P＞0.05).The top three TCM syndromes in AECOPD patients were phlegm-turbidity obstructing the lung(23.76％,24/101),phlegm-stasis obstructing the lung(21.78％,22/101),and phlegm-heat congesting the lung(19.80％,20/101).There was a positive correlation between TBIL and CRP levels in AECOPD patients(r=0.549,P＜0.05).The multivariate Logistic regression analysis revealed that CRP was an independent risk factor,while TBIL was an independent protective factor for AECOPD.The area under the ROC curve for TBIL alone,CRP alone,and the combination of both was 0.821,0.687,and 0.892,respectively.TBIL a-lone,CRP alone,and the combination of both showed the sensitivity of 0.908,0.607,and 0.942 and the specificity of 0.812,0.715,and 0.877,respectively.The combination of TBIL and CRP was superior to those alone in prediction.Con-clusion Phlegm-turbidity obstructing the lung is the most common TCM syndrome in the patients with AECOPD.The AECOPD group has lower level of TBIL and higher level of CRP than the control group and the SCOPD group.The com-bined use of TBIL and CRP levels can effectively predict the condition of AECOPD.
Acute Exacerbation of Chronic Obstructive Pulmonary Disease(AECOPD)Traditional Chinese Medi-cine SyndromeSerum BilirubinC-Reactive Protein(CRP)Pulmonary Function IndicatorsPrediction
万方数据
维普
