The relationship between the distribution of traditional Chinese medicine syndrome types of post-infection cough and the airway immune characteristics and small airway function

QIN Hong; ZHU Yong; LI Xia; HAN Jing

doi:10.13431/j.cnki.immunol.j.20250049

Abstract：Objective To explore the distribution of traditional Chinese medicine(TCM)syndrome types of post-infection cough and their relationship with the level of airway immune characteristics and small airway function.Methods A retrospective study was conducted on 216 patients with post infection cough admitted to our hospital from January 2023 to June 2024.Syndrome information was collected and cluster analysis was performed to analyze the correlation between TCM syndrome types and airway immune characteristic indicators.According to the degree of small airway dysfunction,the patients were divided into mild group(n=74),moderate group(n=84)and severe group(n=53).The correlation between airway immune characteristic indicators and small airway function indicators was analyzed,and the relationship between small airway dysfunction degree and TCM syndrome was also correspondingly analyzed.Results In terms of TCM,cough after infection could be divided into five types:wind-heat stagnation of the lung syndrome,wind-cold invasion of the lung syndrome,phlegm-dampness accumulation in lung syndrome,liver fire invading the lung syndrome,and qi-yin deficiency syndrome.Patients with qi-yin deficiency syndrome had specific airway immune characteristics,with an increase in the proportion of neutrophils,eosinophils and lymphocytes,a decrease in the proportion of macrophages(P＜0.05),an increase in the levels of inflammatory factors IL-17 and TNF-α,and a decrease in the levels of IL-10 and TGF-β.The wind-cold attacking lung syndrome and qi-yin deficiency syndrome were positively correlated with the proportion of neutrophils,eosinophils and lymphocytes,while negatively correlated with the proportion of macrophages(P＜0.05).Qi-yin deficiency syndrome was positively correlated with IL-17 and TNF-α levels,while negatively correlated with IL-10 and TGF-β levels(P＜0.05).As the degree of small airway dysfunction worsened,the proportion of neutrophils,eosinophils and lymphocytes increased(P＜0.05),the proportion of macrophages decreased(P＜0.05),the levels of inflammatory factors IL-17 and TNF-αincreased,and the levels of IL-10 and TGF-β decreased(P＜0.05).The indicators of small airway function(FVC％pred,FEV1％pred,FEV1/FVC,PEF％pred,FEF25％pred,FEF50％pred,FEF75％pred,FEF25-75％pred)were negatively correlated with the proportion of neutrophils,eosinophils and lymphocytes,the levels of inflammatory factors IL-17 and TNF-α(P＜0.05),while positively correlated with the proportion of macrophages,the levels of IL-10 and TGF-β(P＜0.05).Conclusion This study not only reveals the correlation of different TCM syndromes of cough after infection with airway immune characteristics and small airway function,but also clarifies the immunological characteristics of qi-yin deficiency syndrome as a key syndrome type,and confirms that the immune imbalance pattern of high neutrophil proportion and low macrophage level in this syndrome type is specifically associated with severe small airway dysfunction.