Discussion on Asthma Comorbid Anxiety/Depression Immune Imbalance and Intestinal Homeostasis Disorder Based on Theory of Ascending and Descending of Qi Movement

MENG Zixia; LI Jie; HUANG Mingming; YU Ziyang

doi:10.16295/j.cnki.0257-358x.2023.12.007

Abstract：Objective:To investigate the differences of CD4+T lymphocytes,gastrointestinal symptoms(GSRS score),asthma control(ACT score)between asthmatic patients with comorbid anxiety/depression and those without anxiety/depression based on the theory of ascending and descending of qi movement,and the distribution of three yin and three yang constitution,so as to provide a new direction for improving asthma control.Methods:A total of 101 patients with asthma from September 2020 to December 2021 were included.Clinical data were collected,and quantity and proportion of perimeter blood immune cell helper T cell-1(Th1),helper T cell-2(Th2),helper T cells 17(Th 17),regulatory T cells(Tregs)were record,and ACT score,GSRS score,self-evaluation of anxiety scale(SAS),self-evaluation of depression scale(SDS)and three yin and three yang constitution scale score were measured for the study.According to SAS and SDS scores,patients were divided into anxiety/depression group(observation group,49 patients)and non-anxiety/depression group(control group,52 patients),to analyze the differences of each index and constitution between the two groups.Results:The scores of Th1,Th17,Th17/Treg and GSRS in the observation group were higher than those in the control group(P＜0.05),ACT score was lower in the observation group than that of the control group(P＜0.05).GSRS score was positively correlated with Th1,Th1/Th2,Th17 and Th 17/Treg(P＜0.05),while GSRS score was negatively correlated with ACT score(P＜0.05).On body constitution distribution,there were 57 patients with jueyin constitution(30 patients in observation group),23 patients with shaoyang constitution(14 patients in observation group),19 patients with yangming constitution(5 patients in observation group),1 patients with taiyang constitution(0 patient in observation group)and 1 patients with shaoyin constitution(0 patients in observation group).There was no significant difference in the ratio of anxiety/depression among 3 groups of jueyin shaoyang and yangming(P＞0.05),while the female patients with asthma usually showed shaoyang constitution(P＜0.05).Conclusions:Disorder of qi's ascending and descending was closely related to the incidence of asthma,anxiety/depression,intestinal homeostasis and immune imbalance.Patients with asthma had a high incidence of anxiety/depression,with high incidence in constitutions of jueyin,shaoyang and yangming.The immune imbalance was more serious and the treatment effect for asthma was worse in patients with anxiety/depression and severe gastrointestinal symptoms.Regulating qi movement should be an important part of relieving asthma symptoms and anxiety/depression to maintain intestinal homeostasis.