Study On Chinese Medicine Syndrome Types And Relationship Between Syndrome Types And Correlative Indicators In Elderly With Community-acquired Pneumonia

Objective:To investigate the Traditional Chinese Medicine (TCM) Syndrome Types and clinical characteristics of the elderly suffered from community-acquired pneumonia(CAP), and analysis the distribution regularity of white blood cell count (WBC), percentage of granulocyte (GR%) and plasma concentrations of D-dimer(D-D) in each TCM syndrome differentiation-type, for guiding clinical syndrome differentiation and treatment.Methods:120 cases of elderly pneumonia were selected. The information acquired through the four diagnostic methods was recorded and the database was established by spss13.0 software, by classify analysis the TCM Syndrome Type was identified. White blood cell count, percentage of granulocyte and plasma concentrations of D-dimer were detected, which performed using SPSS 13.0 software.Results:1.74.2% of objects merging various chronic disease. The main physical sign was low-intermediate fever (41.7%), with tachycardia(27.5%).67.5% of patients had Lung moist rales. And WBC (41.7%) and GR%(56.7%) increased. The main pulmonary pathological changes were bronchial pneumonia, majority locating on both sides of lungs. Hypoxia(32.5%) and disorder of electrolyte(45.8%)were the common complication.2. According to the information acquired from the four diagnostic methods, the elderly suffered from CAP were classfied into 5 TCM Syndrome Types:Syndrome of wind -heat invading the lung 47 cases, Syndrome of phlegm-heat obstructing the lung 47 cases, Syndrome of phlegm-blood stasis obstructing in lung 22 cases, Syndrome of qi-dificiency and phlegm turbidity in lung 14 cases, Syndrome of qi-yin deficiency 21cases.3. Comparison of WBC of all TCM subgroups:The count of WBC:Syndrome of phlegm-heat obstructing the lung> Syndrome of phlegm-blood stasis obstructing in lung> Syndrome of qi-dificiency and phlegm turbidity in lung> Syndrome of wind and heat invading the lung> Syndrome of qi and yin deficiency. The difference within Syndrome of wind -heat invading the lung and Syndrome of qi, yin deficiency, Syndrome of qi-dificiency and phlegm turbidity in lung was not statistically significant (P>0.05). Syndrome of phlegm-blood stasis obstructing, Syndrome of qi-yin deficiency and Syndrome of qi-dificiency and phlegm turbidity in lung were not significantly different(P>0.05).The other subgroups were significantly different(P<0.05).4. Comparison of GR% of all TCM subgroups:Syndrome of phlegm-heat obstructing the lung> Syndrome of phlegm-blood stasis obstructing in lung> Syndrome of wind- heat invading the lung> Syndrome of qi-yin deficiency> Syndrome of qi-dificiency and phlegm turbidity in lung. The difference within Syndrome of wind-heat invading the lung, Syndrome of qi-yin deficiency and Syndrome of qi-dificiency and phlegm turbidity in lung was not of significance in statistics science (P>0.05). Syndrome of phlegm-blood stasis obstructing in lung and Syndrome of phlegm-heat obstructing the lung were not significantly different(P>0.05). The other subgroups were significantly different(P<0.05).5. Comparison of D-D of all TCM subgroups:Syndrome of phlegm-blood stasis obstructing in lung > Syndrome of phlegm-heat obstructing the lung > Syndrome of qi-yin deficiency > Syndrome of wind-heat invading the lung > Syndrome of qi-dificiency and phlegm turbidity in lung. The difference within Syndrome of wind-heat invading the lung and Syndrome of qi-dificiency and phlegm turbidity in lung was not of significance in statistics science (P>0.05). Syndrome of phlegm-heat obstructing the lung and Syndrome of qi-yin deficiency were not significantly different(P>0.05). The other groups were significantly different(P<0.05).Conclusion:1. The elderly with CAP whose clinical manifestation were not typical had various of basic diseases. The elderly patients with suspected CAP should do chest X-ray or CT examination to diagnose as soon as possible, avoiding misdiagnosis and misdiagnosis. And the treatment should be given to the elderly who had all kinds of complications.2. The elderly with CAP were presented 5 TCM Syndrome Types:Syndrome of wind and heat invading the lung, Syndrome of phlegm-heat obstructing the lung, Syndrome of phlegm and blood stasis obstructing in lung, Syndrome of qi-dificiency and phlegm turbidity in lung, Syndrome of qi and yin deficiency.3. Different kinds of TCM Syndrome Types were related to the levels of WBC and GR%. It might be helpful to clinical syndrome differentiation.4. D-D was related to healthy energy-evil struggle and the changes of both vital energy and blood during different kinds of TCM Syndrome Types,which were contributed to the diagnosis and treatment by syndrome differentiation.