Risk Factors Of Acute Ischemic Stroke Associated Pneumonia And Clinical Efficacy Of Traditional Chinese Medicine Of Tongfu-retrospective Analysis

Objective1.To analyze the risk factors of acute ischemic stroke-associated pneumonia,and to provide evidence for the prevention and treatment of acute ischemic stroke-related pneumonia.2.To investigate the relationship between dysphagia and acute ischemic stroke-associated pneumonia.3.To explore the distribution of TCM syndromes in acute ischemic stroke-related pneumonia,and to provide theoretical basis for clinical syndrome differentiation and treatment of TCM.4.To observe the clinical effect of "Tongyu Xingshen Capsule" on acute ischemic stroke-related pneumonia and provide reference for clinical treatment.Methods1.A total of 930 patients diagnosed with "cerebral infarction" at the Department of Encephalopathy,Guangdong Provincial Hospital of Traditional Chinese Medicine from January 2005 to December 2009 were retrospectively collected.According to the standard of sputum,273 patients with acute ischemic stroke were selected,and subgroups were divided according to the presence or absence of pneumonia and dysphagia.2.The general demographic data of hospitalized cases,clinical characterization,TCM syndrome types,water swallow score and lung infection score after admission,brain MRI DWI lesions,neurological function score,and the use of antibiotics and defecation drugs after admission were collected3.Chi-square test,single factor analysis and binary logistic regression analysis were used to analyze the risk factors of acute stroke-related pneumonia,to explore the distribution of TCM syndromes in acute episodes of stroke,to investigate the relationship between dysphagia and acute dilated stroke-associated pneumonia,and to observe the clinical effect of "Tongfu Xingshen Capsule" on acute dilated stroke-associated pneumonia.Results1.A total of 273 patients with eligible patients were enrolled in study,there are 78 patients(33.2%)with stroke-associated pneumonia,and 84 patients(30.8%)were Dysphagia.2.Univariate analysis revealed age,smoking and drinking history,hypertension,diabetes,heart disease,stroke-related history,dysphagia,indwelling gastric tube,constipation,high NIHSS score,water swallow grading,imaging infarction,TCM syndrome types are closely related to the occurrence of stroke-associated pneumonia(P<0.05).3.Indwelling gastric tube,difficulty swallowing,high NHISS score,constipation is an independent risk factor for prognosis of acute ischemic stroke(P<0.05).Patients with significant dysphagia(the grade of water swallow is V)have a greater risk of developing stroke-associated pneumonia(P<0.05).4.The types of TCM syndromes are mainly composed of five types:wind-fire disturbance,phlegm heat and viscera excess,wind phlegm blocking collaterals,qi deficiency and blood stasis,yin deficiency and wind movement,of which the proportion of phlegm heat and viscera is the highest(112 cases,41.0%).and is closely related to the occurrence of stroke-associated pneumonia(P<0.05).Linear regression analysis suggests that the proportion of phlegm heat and viscera is significantly different than other Syndrome type(P<0.05).5.The use of Tongyu Xingshen Capsule during hospitalization is a protective factor for the prognosis of pulmonary infection(P<0.05).And the the clincal effect is much more precise.Conclusion1.Indwelling gastric’ tube,History of smoking,constipation is an independent risk factor of Stroke-associated pneumonia(P<0.05).2.Indwelling gastric tube,high NHISS score,constipation is an independent risk factor for prognosis of Stroke-associated pneumonia(P<0.05).3.deglutition disorders,is an independent risk factor for Stroke-associated pneumonia(P<0.05).4.Therapeutic effect of Tongyu Xingshen Capsule is better than laxative in Stroke-associated pneumonia.