Objective

2

To determine the syndrome elements for effectiveness evaluation of acute exacerbation of chronic obstructive pulmonary disease （AECOPD）， and to provide the basis for the establishment of the theoretical framework and item pool of syndrome effectiveness evaluation scale.

Methods

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We searched CNKI， Wanfang， VIP and Sinomed from their inception dates to October 17th， 2019 for literature related to AECOPD syndromes， and the database was established based on the included literature. Data were standardized， and the frequency of basic syndromes and symptoms were calculated. Cluster analysis was performed on the symptoms with frequency ≥3%， to infer the common basic syndromes and extract the corresponding symptoms. Based on the results of literature research， expert consultation was conducted to analyze the mean value and coefficient of variation of importance score， and to select the basic syndromes with high importance score and corresponding symptoms with attribute of effectiveness evaluation. Based on the results of literature research and expert questionnaire， the syndrome elements for effectiveness evaluation of AECOPD were determined finally.

Results

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A total of 211 papers with 979 items （syndromes and symptoms） were included， involving 30 basic syndromes and 174 symptoms. Systematic cluster analysis was performed on symptoms with frequency ≥3%， and seven common basic syndromes were inferred based on professional knowledge of traditional Chinese medicine， including wind cold syndrome， cold fluid syndrome， phlegm heat syndrome， phlegm dampness syndrome， blood stasis syndrome， spleen

qi

deficiency syndrome， and kidney

qi

deficiency syndrome； the corresponding symptoms with factor loading coefficient ≥ 0.3 were extracted. According to the expert questionnaire， the basic syndromes with frequency ≥ 50%， mean importance score ≥ 3.0， and coefficient of variation ≤ 0.3 were wind cold syndrome， cold fluid syndrome， phlegm heat syndrome， phlegm dampness syndrome and blood stasis syndrome； the corresponding symptoms with mean importance score ≥ 7.0 and coefficient of variation ≤ 0.3 were extracted.

Conclusion

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Five common basic syndromes of AECOPD are finally determined， including wind cold syndrome， cold fluid syndrome， phlegm heat syndrome， phlegm dampness syndrome and blood stasis syndrome， and simultaneously the corresponding symptoms with attribute of effectiveness evaluation in each common basic syndrome are also defined， thereby providing a basis for the establishment of theoretical framework and item pool of syndrome effectiveness evaluation scale of AECOPD.