TCM Syndromes And Influencing Factors Of Urine Volume Of Patients With AECOPD During Mechanical Ventilation

Research purposes:This study summarizes the distribution of TCM syndrome in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)mechanical ventilation,discusses the relationship between polyuria and TCM syndrome characteristics,and provides ideas for the study of TCM syndrome characteristics of AECOPD mechanical ventilation.AECOPD mechanical ventilation patients in polyuretic and non-polyuretic groups showed significant differences in physical and chemical parameters,TCM symptoms,etc.Research methods:In this retrospective study,patients hospitalized with AECOPD mechanical ventilation were enrolled in the ICU for 24h,48h,72h,and 24h urine volume on day 7.Patients were divided into polyuretic and non-polyuretic groups based on the presence of polyuresis within 7 days of admission(≥2500ml of urine with a maximum of 24h).The TCM syndromes,pathology,tongue,pulse and syndromes of AECOPD mechanical ventilation patients were recorded,the TCM syndromes of AECOPD mechanical ventilation hospitalized patients were analyzed,and the relationship between polyuresis and TCM syndromes was compared.Patients were recorded for general information,inflammatory factor levels(WBC、NEUT%、LYM%、NLR),Arterial blood gas analysis and related information such as ion(PaO2、PaCO2、pH、NA+、K+)、kidney function index(BUN,SCr),mechanical ventilation pattern,statistical analysis of AECOPD mechanical ventilation patients with 24h urine volume variation clinical characteristics.At the same time,the symptoms,tongue,pulse and syndromes of the patients were collected,and the relationship between 24 h urine volume and syndromes was discussed.Research results:1 Distribution of TCM syndromes in patients with AECOPD mechanical ventilationA total of 163 patients with mechanical ventilation for AECOPD were included in the study,all of whom showed symptoms of wheezing,shortness of breath,chest diaphragm tightness and cough.Symptoms were most common(68.71%).Tongue was thicker(60.12%),yellow(58.9%),greasy(47.24%)and red(41.72%).Pulses led the way with smooth veins(72.39).Pathological factors were phlegm(60.74%),qi deficiency(57.67%),fever(48.47%),yin deficiency(48.47%)and stasis(40.49%).Pathogenic syndromes were mainly lung(77.30%),kidney(44.79%)and spleen(21.47%).2 Distribution of 24h urine in patients with AECOPD mechanical ventilationThe average daily urine volume(1073.41 ± 468.29 ml)in our department of AECOPD was 24h in 66 patients who were mechanically ventilated and not treated with diuretics.The overall average daily urine volume(2425.53± 681.63)per patient after conventional Western medicine treatment.Of these,the average maximum daily urine volume(2937.12 ± 416.79 ml)within 7 days of admission was in the polyuretic group.Average maximum daily urine volume(1913.94 ± 481.75)ml within 7 days of admission in the non-polyuretic group.3 Distribution of TCM syndromes in patients with AECOPD mechanical ventilationThe main clinical symptoms of AECOPD mechanical ventilation were cough,cough,wheeze and chest fullness.The pathogenicity is often mixed with falsity and truth.Tongue is often red or moss yellow or white;Pulse image is mainly synovial pulse,and the number of veins and so on is common.The TCM syndrome of AECOPD patients with mechanical ventilation is characterized by phlegm fever syndrome,lung kidney qi yin deficiency syndrome,lung kidney qi deficiency syndrome,phlegm opacity obstructive pulmonary syndrome and blood stasis syndrome.4 Relationship between urine volume and clinical indicators in patients with AECOPD mechanical ventilationAECOPD patients with mechanical ventilation early polyuria,often accompanied by improvement of clinical symptoms.Within 7 days of admission,WBC count,N%,NLR,PaCO2,and APACHE Ⅱ scores were lower in AECOPD mechanically ventilated patients in the polyuretic group than in non-polyuretic patients.Levels of LYM%,PaO2,and BUN were higher in non-polyuretic patients.There were no abnormal changes in pH,Na+,K+,SCr in polyuretic and non-polyuretic AECOPD mechanically ventilated patients.In this study,by establishing a logistic regression model,results showed that WBC,N%,BUN and PaCO2 were important factors affecting urine volume of 24h in AECOPD mechanically ventilated patients.4 Distribution of TCM syndromes in patients with AECOPD mechanical ventilationAfter admission,patients with AECOPD mechanical ventilation in the polyuretic group showed a more significant decrease in TCM syndrome score and TCM syndrome score(cough,sputum,wheezing,wheezing,chest tightness)than non-polyuretic patients.Tongue image,AECOPD mechanical ventilation patients in the polyuretic group Moss yellow,non-polyuretic patients Moss white.Pulse imaging,AECOPD mechanical ventilation patients in the polyuretic group more common synovial,several pulse,string pulse,non-polyuretic patients more common synovial,fine vein,sinus.Syndrome type aspect,polyuresis group sees phlegm heat syndrome,lung kidney qi yin deficiency syndrome;Phlegm opacity obstructive pulmonary syndrome and deficiency of lung and kidney qi are common in non-polyuretic group.Conclusions:The syndrome of phlegm fever,deficiency of lung kidney qi and yin,deficiency of lung kidney qi,obstructive pulmonary syndrome of phlegm opacity and blood stasis are the common syndrome types of AECOPD mechanical ventilation.There were significant differences in TCM syndromes and clinical indicators between patients with 7 days of AECOPD mechanical ventilation(i.e.,24 h urine per day≥2500ml)and patients without AECOPD mechanical ventilation.Within 7 days of admission to ICU,patients in the polyuretic group showed a more significant decrease in the total score of TCM syndrome and the score of main TCM syndrome(cough,sputum,asthma,wheezing,chest tightness)than those in the non-polyuretic group.The TCM syndrome of AECOPD patients with mechanical ventilation is characterized by phlegm fever syndrome,lung kidney qi yin deficiency syndrome,lung kidney qi deficiency syndrome,phlegm opacity obstructive pulmonary syndrome and blood stasis syndrome.In polyuresis group,there were backups of phlegm,fever and deficiency of lung,kidney,qi and yin.Phlegm opacity obstructive pulmonary syndrome and deficiency of lung and kidney qi are common in non-polyuretic group.WBC count,N%,NLR,PaCO2,APACHE Ⅱ scores were significantly reduced and LYM%,PaO2,BUN levels were significantly increased in AECOPD mechanically ventilated patients with normal pH,Na+,K+,SCr.Logistic regression models showed that WBC,N%,BUN,and PaCO were significant factors affecting urine volume of 24 h in patients with AECOPD mechanical ventilation.