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  • Title: [An expert analysis of diagnostic criteria for traditional Chinese medicine syndromes of chronic obstructive pulmonary disease at acute exacerbation stage].
    Author: Wang ZW, Li JS, Yu XQ, Li SY.
    Journal: Zhongguo Wei Zhong Bing Ji Jiu Yi Xue; 2011 Sep; 23(9):518-23. PubMed ID: 21944171.
    Abstract:
    OBJECTIVE: To investigate the common syndromes, clinical symptoms and characteristics of chronic obstructive pulmonary disease at acute exacerbation stage (AECOPD). METHODS: Delphi method was used to organize the AECOPD expert questionnaire. This questionnaire was distributed to 30 selected experts of respiratory diseases. The resulting data were statistically analyzed by Chi-square test and statistical description such as mean, coefficient of variation and ratio of full marks. Common syndrome: mean≥3.00, coefficient of variation <30% and ratio of full marks≥10% and common clinical symptoms: for major symptoms present, the index mean≥4.00 and coefficient of variation <30% and for minor symptom, index mean≥3.00 and coefficient of variation <30% were used as criteria. RESULTS: Twenty-nine valid expert questionnaires were received. The coefficient of positivity was 96.67%, of authority was 0.835 and of coordination equals 0.359 (χ(2)=463.15, P=0.001). The mean, coefficient of variation and ratio of full marks for AECOPD syndrome of wind and cold invasion of lung were 4.12, 21.50%, and 34.48%, respectively. Those for syndrome of exogenous cold-evil and fluid-retention were 4.39, 14.32%, 48.28%; those for syndrome of wind and heat invasion of lung were 3.54, 30.77%, 6.90%;those for syndrome of phlegm-heat obstruction of the lung were 4.85, 9.23%, 89.66%; those for syndrome of pulmonary stagnation of phlegm were 4.36, 15.57%, 48.28%; those for syndrome of external cold and internal heat were 4.59, 16.27%, 65.52%; those for syndrome of retention of phlegm and blood stasis in the lung were 4.54, 12.70%, 55.17%; those for syndrome of qi deficiency of the lung and spleen were 3.25, 27.30%, 13.79%; those for syndrome of qi deficiency of the lung and kidney were 3.32, 27.24%, 13.79%; those for syndrome of qi-yin deficiency of the lung and kidney were 3.29, 28.98%, 24.14%; those for syndrome of yin deficiency of the lung and kidney were 2.98, 32.71%, 3.45%; those for syndrome of blood stasis were 4.67, 10.29%, 62.07% and those for syndrome of fu shi were 3.07, 30.01%, 6.90%, all respectively. The blood stasis and fu shi were accompanying syndromes. CONCLUSION: Seven common syndromes of AECOPD are wind and cold invasion of lung, exogenous cold-evil and fluid-retention, phlegm-heat obstruction in the lung, pulmonary stagnation of phlegm qi deficiency of the lung and spleen, qi deficiency of the lung and kidney, as well as qi-yin deficiency of the lung and kidney. One additional syndrome that accompanies many of the afore-mentioned syndromes was blood stasis.
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