Discussion on Differentiation Rules of Micro Inspection Diagnosis of Local Findings of Lung Tuberculosis under Bronchoscopy

ZHANG Yiyan; GAO Bing; LU Jiaquan; ZHANG Xiaona; YUAN Xiyan; XIAO Tiquan; ZHANG Jiang

Abstract：Objective:Through the bronchoscopic findings to explore the local morphological changes of tuber-culosis(TB) and to put forward a new local differentiation method of Traditional Chinese Medicine(TCM). Methods:Total of 93 patients diagnosed as pulmonary TB were differentiated into 4 types according to TCM four diagnostic methods:lung yin deficiency,yin deficiency and fire excess,consumption of qi and yin,im-pairment of both qi and yin. The experimenters observed the airway by electronic bronchoscope ,and com pared the findings(including the tonguecoating and pulse) in different syndrome types by holistic diagnosis. Results:The manifestation under bronchofiberscopy could be generalized as follows:yellow spot of mucosa,su-perficial ulceration,mucosal vascular varicose and other purulent lesions accounted for 74.19%;intra-luminal granuloma,widened carina,owl wink and other morphological changes accounted for 3.22%;pale mucosa,weak inter-cartilage ring muscle,cicatricial tissue and other malnutrition manifestation accounted for 22.58%. Syn drome differentiation,tongue coating and pulse were of statistical difference (P<0.05),but tongue quality was of no statistical difference ( P>0 . 05 ) . Conclusions:TCM clinical syndrome differentiation for TB focuses on"yin deficiency" and emphasizes "deficiency of healthy qi". TCM treatment for TB should be nourishing yin and strengthening healthy qi. Based on the electronic bronchoscopic findings ,in combination with the tongue coating and pulse,by local syndrome differentiation TB could be divided into types of accumulated toxic heat in the lungs with purulent blood rotten flesh,of qi stagnation,blood stasis,coagulation of phlegm and dampness block,of deficiency of qi, blood and yin,which could provide a new approach for diagnosis and treatment for TB.