| 1Objec t i veTo explore the different etiology, pathogenesis and their mutual relationship based on the results of statistics and analysis of TCM syndrome feature in H1N1influenza cases which were classified into three groups, no internal injury group, five different internal injury group and special group, and then to gain enlightenment from it for cures of H1N1influenza.2Method770cases of H1N1influenza were classified into no internal injury group, five different internal injury group and special group. We selected different point in Course according to different severity of patients’condition, and then calculated frequency distribution of symptoms and signs in different point in time in different groups, summarize their evolvement characteristics, and compare them among groups. The internal injury group was classified into lung system internal injury group, cardiac system internal injury group, kidney and bladder internal injury group, Xiaoke internal injury group, hepatobiliary system internal injury group. The special group, divided into pregnant women group and obesity group, was contained in no internal injury group. Each group above was classified into mild group, severe group and critically ill group. Frequency analysis was used to describe the frequency of39symptoms and9signs in each group. The symptoms of which frequencies were equal or greater than50%were regarded as primary symptoms and subsidiary symptoms for reference.3Resul t3.1no-internal injury groupThe course of mild group was about10days. Beside pulmonary and body surface symptoms, the performances of mouth, nose, pharyngeal were obvious in primary symptoms. The course of severe group was about11days. Expectoration and rapid pulse became two primary symptoms. Blood-stained sputum and even pink bubble sputum can be seen in severe cases. The course of critically ill group was about18days. Moist rales and tachypnea appeared in primary symptoms, frequencies of blood-stained sputum and pink bubble sputum were increased, and the performances of dysthesia, coma and delirium, purpura and hemorrhagic spot can be seen in some cases.3.2internal injury group3.2. Hung system internal injury groupThere was no mild case in this group. The course of severe group was about17days. Moist rales, languid, poor appetite, pharyngeal hyperemia and rhonchus became primary symptoms. The course of critically ill group was about16days. Frequencies of expectoration, moist rales and rhonchus and rapid pulse were significantly increased, and chest congestion, labored breathing, shortness of breath, languid, abdominal distension were newly appeared.3.2.2cardiac system internal injury groupThe course of mild group was about9days. Frequency of fever decreased, nasal congestion and running nose, headache, sweating, pharyngalgia, dry throat and tongue disappeared, and pharyngeal hyperemia became a primary symptom. The course of severe group was about10days. Moist rales, pharyngalgia and pharyngeal hyperemia became primary symptoms except rapid pulse. The course of critically ill group was about12days. Chest congestion, labored breathing, languid appeared in primary symptoms, and frequency of chest congestion, labored breathing was higher than tachypnea.3.2.3kidney and bladder internal injury groupThere was no mild case in this group too. The course of severe group was about8days. Pharyngeal hyperemia and moist rales became primary symptoms, and frequency of rapid pulse significantly increased. The course of critically ill group was about7days. Languid, poor appetite, palpitation, shortness of breath, edema became primary symptoms, and frequencies of chest congestion, labored breathing, moist rales, blood-stained sputum significantly increased.3.2.4Xiaoke internal injury groupThe course of mild group was about5days and only a few symptoms appeared. The longer course of severe group was about15days. Moist rales appeared and frequency of rapid pulse decreased. The course of critically ill group was about18days. There were obvious cough and tachypnea. fever was not prominent, and chest congestion, labored breathing, pharyngeal hyperemia, shortness of breath appeared. Frequency of rapid pulse decreased.3.2.5hepatobiliary system internal injury group The course of mild group was about14days. Expectoration, muscular soreness, diarrhea became primary symptoms. The course of severe group was about18days. The primary symptoms were the same as that in no internal injury group except rapid pulse. The course of critically ill group was about16days. Tachypnea and rapid pulse disappeared and yellow urine languid became primary symptoms comparing with that in no internal injury group.3.3special groups3.3.1pregnant women groupThe course of mild group was about5days. Aversion to wind and cold appeared and frequencies of nasal congestion and running nose, sweating significantly increased. Headache, pharyngalgia, dry throat and tongue disappeared. The course of severe group was about7days. Headache, pharyngalgia became main symptoms and frequency of rapid pulse increased. The course of severe group was about13days. Frequencies of tachypnea and rapid pulse increased, while expectoration and moist rales decreased.3.3.2obes i ty groupThere was no mild case in this group. The course of severe group was about16days. Expectoration, moist, pharyngeal hyperemia, tachypnea were obvious. The course of severe group was about19days. Poor appetite, pharyngalgia, blood-stained sputum, tachypneawere prominent in primary symptoms while fever and rapid pulse not.4conelusion4. lno internal injury groupThis group obey the law of defensive, energy, nutrients and blood transmission in general and lung is the focus location. It transmitted fast and the steps were clear.The main syndrome characteristic of mild group was lung-defensive hit by wind-heat toxin evil. Turning point of the condition was in the third day and evil was relieved from defensive exterior.The main syndrome characteristic of severe group was dominant heat in Qi system, producing phlegm and blood disturbance. Turning point of the condition was in the fifth day. The main change was the transmission from invisible Qi to visible phlegm. The evil was mainly relieved from Qi system, only a few from exterior, and no trend to blood system. The syndrome characteristic of severe group was dominant heat in Qi system, body fluid impairment and blood disturbance, heat, dampness, toxin, body fluid and blood mixing, and even obstruction of the lung and Qi exhaustion. Turning point of the condition was in the seventh day. The main pathogenesis change lay in suddenly increased visible phlegm, heat, dampness toxin and consumption of invisible Qi. The evil was mainly relieved from Qi system too, and in some cases with obvious exosmosis of body fluid and blood it was relieved from blood system, but no trend to exterior.The key factor of blood trouble lay in not only blood-heat, but also dampness toxin, consumption of body fluid and qi deficiency.4.2internal injury groupThe cases in lung system internal injury group had serious condition and longer course, the prognosis is poor. The basic pathogenesis was being infected bywind-heat toxin evil on the basis of lung qi deficiency, latent phlegm and blood stasis. Turning point of severe group was in fifth day. The syndrome characteristic of this group lay in phlegm-heat obstructing lung, lung qi deficiency, lung-spleen qi deficiency and incoordination between the spleen and the stomach could be seen in some cases. Turning point of critically ill group was after the seventh day. Fever was not obvious and the main performance was exuberance of interior phlegm-dampness, lung-kidney qi deficiency, kidney dysfunction in qi holding and fu-qi impassable. They were in danger of stopping breathing due to tachypnea.The course of cardiac system internal injury group was shorter and it had favourable prognosis in spite of intense condition. The main pathogenesis was pectoral qi obstruction due to infected based on heart-qi deficiency. Performance of pharyngeal hyperemia was obvious in mild groups and turning point was in the third day, evil was relieved from exterior. There were significant pharyngalgia and pharyngeal hyperemia in severe group. The turning point was in the fifth day and evil was relieved from qi system. The feeling of weakness, such as chest congestion, labored breathing, languid, obviously appeared in critically group. Turning point of the course was in the seventh day and the evil was relieved from qi system too, a few with trend to blood. The kidney and bladder internal injury group had a shorter course and serious condition. The basic pathogenesis was lung and heart invaded by water-qi due to infected by exogenous evil on basis of kidney qi deficiency. The significant performance was moist rales, chest congestion, labored breathing, blood-stained sputum, languid, palpitation and rapid pulse.The condition of Xiaoke internal injury group was more serious and it had a poor prognosis. The progress was slow and longer. Body fluid impairment and consumption of qi was the basic pathogenesis due to being infected on the basis of deficiency of both qi and yin. The main syndrome of severe group was dampness-heat in qi system and fever was non-significant. The turning point was in the fifth day. Deficiency of both qi and yin was as obvious as exuberance of interior phlegm-dampness in critically ill group and the turning point was in the seventh day. It was in danger of stopping breathing due to tachypnea.The course of hepatobiliary system internal injury group was longer, the condition was serious and it had a poor prognosis too. The significant characteristic was stagnation of shaoyang-qi activity. The performance of non-circulating exterior qi and stoppage of fu-qi could be seen not only in mild group but also in severe group. Cough and expectoration were not obvious in critically ill group and the significant performance was the stoppage of sanjiao and deficiency of spleen and kidney.4.3special groups4.3.1pregnant women groupThe performance of disharmony between ying and wei, deficiency of qi and blood could be seen commonly in this group. Firstly, it performed evil in lung-defensive in mild group, and deficiency of weiqi was significant. The turning point was in the third day, and evil was relieved from lung-defensive along with sweating. The primary syndrome of severe group was phlegm-heat obstructing lung with some performance of non-circulating ying-qi, and the main location was in qisystem, only some in ying and blood system. The turning point was in the third day and evil was relieved from qi system. The significant performance of critically ill group was endogenetic water-dampness and particularly damaged qi and yin, especially in the first three days. Cases with blood syndrome performed dominant heat in blood system in the first seven days. The turning point was in the seventh day, and patients still need to be care to prevent recurrence during the second week. The chance of critically ill cases increased with the increasing of gestational weeks.4.3.2obesity groupThe significant performance of this group was phlegm-dampness obstructing lung and closing of lung-defensive qi at first. The condition was serious but the prognosis was well. The severe group performed mainly excess of evil and the turning point of it was in the third day. Turning point of critically ill group was in the fifth day. Deficiency of lung-spleen qi was as obvious as the performance of phlegm-dampness obstructing lung and closing of lung-defensive qi in this group at first. Change of pathogenesis lay in that the closed lung-defensive qi extended with reduction of phlegm-dampness. |
PDF Full Text Request