运用德尔菲法制定COPD发展"快""慢"的判定标准及其体质特征、T细胞亚群平衡及ADAM33基因多态性差异研究

临床发现，慢性阻塞性肺病（简称COPD）虽是进行性发展的疾病，但是由于个体差异而病情呈现出不同的发展速度，有"快""慢"之分。因此虽都为COPD患者，但其发展速度有天壤之别，表现出其特异性。而明确两类患者病情发展差异的原因，则有利于对疾病的发展方向及速度有一个预判。但是到目前为止，尚没有一个判定"快""慢"的标准。本研究将采用德尔菲法对COPD发展"快""慢"的判定依据进行全国专家咨询，制定出COPD发展"快""慢"的判定标准。并根据此标准，对两类患者进行中医体质的调查；同时通过免疫学及分子生物学的方法研究不同发展速度患者体内免疫细胞Th17/Treg的变化规律及遗传基因ADAM33的基因多态性。探讨两类患者中医体质类型特征，机体Th17/Treg免疫调节状况，遗传基因之间的差异。为COPD患者发展方向、发展速度的预测，以及提前防治提供依据，为今后的进一步研究打下基础。

The clinical findings, chronic obstructive pulmonary disease (COPD) is a progressive development of the disease, but due to individual differences in the condition showing the different pace of development, "fast" and "slow" parts. Are for patients with COPD, but its growth rate have very difference, showing its specificity. To clear the differences of two types of disease progression in patients, it will help a pre-sentence direction and speed of development of the disease. But so far, still no one to determine the "fast" and "slow" standard. In this study, using the Delphi method in COPD development of "fast" and "slow" to determine the basis for a national expert consultation and formulate the criteria of COPD development "fast" and "slow". in accordance with this standard we will investigate the TCM constitution and Using the immunology and molecular biology to study the variation of the different pace of development of immune cells in vivo in patients with Th17/Treg and genetic ADAM33 gene polymorphisms. Explore the two types of constitutions in Chinese medicine in patients with features, the Th17/Treg immunomodulatory situation and the difference between the genes. Provide the basis for the development direction of the COPD patients, the prediction of the speed of development, and advance prevention and treatment and to lay the foundation for further research.