The Distribution Of TCM Syndromes Of Inappropriate Antidiuretic Hormone Secretion Syndrome And The Diagnosis And Treatment Of Western Medicine

Objective:1.Through collecting,sorting out and statistical analysis of clinical data of SIADH patients,this study explored TCM syndrome types of SIADH and laid a foundation for further exploring the syndrome differentiation of SIADH;2.To observe the standard of blood sodium in patients with SIADH treated by internal medicine,and to provide basis for clinical treatment of SIADH by TCM.Methods:Seventy-three patients with SIADH admitted to Shandong University Affiliated Provincial Hospital from April 2010 to November 2018 were retrospectively analyzed.Data analysis was used to determine the correlation between TCM syndrome differentiation and other factors.T test was used to analyze the effectiveness of blood sodium before and after treatment.Results:1.In terms of age distribution,the average age of 73 patients was(64.49±10.53)years,the youngest was 19 years,the oldest was 84 years.The patients were mainly in the age group of 61-70 years.In gender distribution,male patients were significantly more than female patients.From the distribution of course,the shortest course of disease is 5 days,the longest is 4 years,and the patients whose course is less than 1 year are the most.2.The proportion of non-malignant tumors in chest and lung was the highest in 73 cases,followed by idiopathic SIADH,malignant tumor and central nervous system diseases.There were significant differences in etiological distribution between group A and group B.In group A(120 mmol /L≤ blood sodium < 135 mmol / L),patients with non-malignant tumors in chest and lung and idiopathic diseases were predominant.Group B(blood sodium < 120 mmol/L)was mainly malignant tumor patients,indicating that the blood sodium level of malignant tumor patients was low.3.73 patients were classified according to TCM syndrome differentiation.The spleen-stomach Qi deficiency syndrome is the most common,followed by Qi stagnation and phlegm blockage syndrome,Qi-blood deficiency syndrome,Yin deficiency and internal heat syndrome.Chi-square test showed that there was no significant difference in gender and age distribution among the four groups.In group A,the patients with spleen-stomach Qi deficiency syndrome were the most.In group B,the patients with Qi-blood deficiency syndrome were the most.4.After analysis,there were significant differences in the distribution of blood sodium and chlorine among the four groups of patients with TCM syndromes.The mean values of blood sodium and chlorine were the highest in the Spleen-stomach Qi deficiency syndrome group,followed by Yin deficiency and internal heat syndrome,Qi stagnation and phlegm blockage syndrome and Qi-blood deficiency syndrome.There was no significant difference in the distribution of serum potassium,serum calcium(Ca),serum creatinine(Cr),urea nitrogen(BUN),hematocrit(HCT),uric acid(URIC),blood osmotic pressure(Posm),urine osmotic pressure(Uosm)and 24-hour sodium in the four groups(P > 0.05).5.There was significant difference in the distribution of blood sodium before treatment in the four groups of TCM syndromes,but there was no significant difference in the distribution of blood sodium after treatment in the four groups(P > 0.05).Among 73 patients,45 were treated with tovaptan,13 with water restriction and 15 with sodium salt.The levels of serum sodium after tolvaptan treatment,sodium salt treatment and water restriction treatment were significantly higher than those before treatment.6.Among 73 patients,30 were markedly effective,36 were effective and 7 were ineffective.The total effective rate was 90.4%.Spleen-stomach Qi deficiency syndrome was the most common and Yin deficiency internal heat syndrome was the least among the patients with obvious therapeutic effect.There is no significant difference in the therapeutic effect among different TCM syndromes,and there is no statistical significance.Conclusion:The syndrome of inappropriate secretion of antidiuretic hormone is most common in the syndrome of deficiency of spleen and stomach qi,male patients are more than female patients;the proportion of non-malignant diseases in chest and lung is the highest in 73 patients;water restriction,sodium salt and tovaptan are all effective,water restriction is safe,but patients’ compliance is poor,and the curative effect is worse than that of sodium salt and tovaptan.In effect,the most effective group was Qi stagnation and phlegm blockade syndrome group,while the lowest effective group was spleen and stomach qi deficiency syndrome group.