| According to the current world literature reported that sepsis is critical areas of high incidence, high mortality, and one of the economic burden of disease. Sepsis in its main ages old, mainly concentrated in the pulmonary infection of infectious diseases. Through literature analysis, senile pneumonia correlation sepsis is critically ill people suffering from one of the major diseases. Sepsis patients mainly is the elderly(60 years old or more), the main part is lung infection.Mentor group proposed the pneumonia correlation sepsis of disease in 2011. But it is lack of senile pneumonia correlation condition analysis of sepsis. In Traditional Chinese medicine, Studied 99 cases of severe pneumonia at symptoms, syndrome, syndrome types, and evolution law. It is a great progress. But still not perfect. We believe that the Qixuxueyutanzu is the core of the elderly critical patients common pathogenesis,senile pneumonia correlation sepsis is one of the pathogenesis of typical symptoms. Compared to usual research and related documents of TCM diagnosis and treatment of sepsis senile pneumonia correlation sepsis and sepsis in pathogenesis, syndrome factor and syndrome type has it’s particularity, need to study and improve the clinical curative effect.A The study of Chinese and western medicine clinical characteristics of senile pneumonia correlation of sepsisObjectiveExplore the senile pneumonia correlation sepsis medicine clinical characteristics and the TCM symptom and syndrome factor, card type characteristics and summarize the pharmaceutical drug laws for them.MethodsAll cases came from guangdong hospital of treated patients, in accordance with sepsis criteria for the diagnosis of senile pneumonia correlation. Medicine, statistics for age, sex, course, basic diseases, Modified early warning score (MEWS), Acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ).Systemic inflammatory response syndrome (SIRS), Clinical pulmonary infection score (CPIS), viscera function disorder, disease severity, the 5th day efficacy and outcome during hospitalization. Traditional Chinese medicine, TCM symptoms, the original certificate type, prescriptions of traditional Chinese medicine, proprietary Chinese medicine use. By using PASW Statistics 18.0 statistical analysis software package.Results1. The general situationThis study included 303 cases, male to female ratio is about 1.4:170-89 years old is the main patient age, accounting for 75.25%. The age stratification course more men and women, there were no statistically significant difference (P>0.05). Consolidated basis of chronic diseases, heart, lung and brain disorders.2. The medicine aspectAge, MEWS score and APACHEⅡ score, SIRS score, CPIS score, number of organ dysfunction and disease severity was positively linear correlation(P< 0.05), indicating the older, the higher the score, the more advanced disease.3. The traditional Chinese medicine aspect(1) TCM four diagnostic information Collection of TCM symptoms 106, a total of 4 836 times, cough, sputum, asthma, god exhausted lazy speech, ropy sputum, fever, shortness of breath, weakness and dark tongue, poor appetite, much sputum volume, moss oily is the most common symptoms.(3) syndrome factor dialectical In disease syndrome elements, disease in lung> kidney> spleen> heart break (god) in the top four, accounted for 94.72%,79.21%,51.16% and 94.72% respectively. Disease syndrome factor statistics, Tanzhuo syndrome, Xueyu syndrome, Qixu syndrome, Yinxu syndrome, hot in the top five, respectively,92.08%,79.21%,77.23%,69.79% and 77.23%.(4) the syndrome type analysis Qixutanreyuzu (31.35%), Tanreyuzu and Qiyinliangshang(31.35%), Qixuxueyu and Tanrebiqiao(17.82%), Tanreyuzu and Qisunshangyang (19.14%). The new dialectical system can cover the original 93.73% cases.(5) medicinal broth of traditional Chinese medicine A total of 265 cases of patients using traditional Chinese medicine medicinal broth, a total of 157 taste traditional Chinese medicine, liquorice, poria cocos, pinellia, radix platycodi, dried tangerine or orange peel, bitter almond, peach kernel, radix scutellariae, reed stems, atractylodes, zhejiang fritillary, barley, winter melon kernel is the most commonly used ingredients. According the commonly used mainly from the Qingrehuatan, Quyupainong, Jianpiyiqiyangyinshengjin, Huoxuehuayu, and Yiqiwenyang six aspects.(6) 182 cases used Chinese herbal, Huoxuetongluo(47.25%), Yiqifuzhe--ng(41.21%), Qingrejiedu (38.46%), Huatan(18.68%)in the top four.Conelusion1. The speculation from the merger basic diseases, senile pneumonia corr--elation sepsis possible pathogenesis is Quxueyutanzu.2. Elderly pneumonia correlation sepsis patients age, organ failure, the gr--eater the number, the more the more serious the illness.3. MEWS, APACHE II, SIRS score, CPIS score can reflect from different angles senile pneumonia correlation degree of severe sepsis, the higher the score, the more advanced disease.4. Traditional Chinese medicine, cough, sputum, asthma,god exhausted lazy spe--ech, ropy sputum, fever, shortness of breath, weakness and dark tongue, poor appetite, much sputum volume, moss oily is the most common symptoms. Another blood stasis physical abnormalities are also common.5. Sepsis senile pneumonia correlation disease in the lungs, spleen and kidney heart break(god) are closely related. Qi deficiency, blood stasis, phlegm heat, Yin deficiency is a common factor.6. The core of senile pneumonia correlation sepsis pathogenesis is Qixuxueyu--tanzu. Qixutanreyuzu, Tanreyuzu and Qiyinliangshang, Qixuxueyu and Tanrebiqi--ao, Tanreyuzu and Qisunshangyang syndrome are the mainly traditional Chinese medicine syndrome types.7. Senile pneumonia correlation sepsis is the most commonly used method of Chinese medicine ingredients of radix glycyrrhizae, poria cocos, pinellia, radix platycodi, dried tangerine or orange peel, bitter almond, peach kernel, radix scutellariae, reed stems, atractylodes, zhejiang fritillary, barley, winter melon kernel.8. Senile pneumonia correlation of sepsis are commonly used for Huoxuetong luo, Quyupainong, Yiqijianpi, Yangyinshengjin, Huoxuehuayu and Yiqiwenyang. B The study of Chinese herbal medicine treatment of senile pneumonia correlation sepsis.ObjectiveIn view of the core mechanism to heat phlegm, promoting blood circulation to remove blood stasis, qi spleen class qi deficiency of the traditional Chinese medicine medicinal broth in treatment of senile pneumonia correlation sepsis phlegm hot blood stasis resistance the clinical curative effect observation.MethodsCases from Guangdong hospital in January 2012-December 2014 treated 62 cases of patients. All patients comply with senile pneumonia correlation sepsis and all Qixutanreyuzu. According to the principle of randomized, controlled, and randomly divided into control group and treatment group,31 cases each. The control reference in 2012 severe sepsis and septic shock treatment guidelines given conventional treatment, the treatment group on the basis of the former to give professor Zhou Zhongying experience medication, treatment for 7 days.Two groups in the first day of the hospital, the fourth day,7 days to collect data, main indexes, including traditional Chinese medicine qi deficiency syndrome, blood stasis syndrome score, phlegm heat syndrome integral, medicine APACHE Ⅱ score, SIRS score, CPIS score, SOFA score; Secondary indexes, the WBC count, HCT, PCT, CRP, FIB, oxygenation index, propagated, immune 6 and T lymphocyte count. Statistical analysis using PASW Statistics 18.0 statistical software for processing.ResultsTwo groups of patients in the gender, age, course of the disease, the disease severity, the score and biochemical indicators are comparable, there was no statistically significant difference(P<0.05). 1. TCM syndrome integral aspectAfter treatment, two groups of patients with qi deficiency syndrome, phlegm heat syndrome, blood stasis syndrome integral are improved, the treatment group is more significant, differences have statistics to learn meaning(P< 0.05). Clinical curative effect of traditional Chinese medicine, the treatment group total effective rate was 83.87%, control group total effective rate was 66.67%, the difference between groups was statistically significant (P< 0.05).2. Medicine scoring systemAfter treatment, in APACHE Ⅱ score, SIRS score, CPIS score, SOFA score, the treatment group decreased more significantly, the difference was statistically significant (P<0.05).Clinical curative effect of western medicine, treatment group total effective rate was 80.65%, control group total effective rate was 74.19%, there was no statistically significant difference between the groups (P>0.05), but the treatment group efficiency 74.19%, control group efficiency 48.38%, differences between groups was statistically significant(P<0.05).3. The laboratory biochemical indicators(1) inflammationAfter treatment, the treatment group of PCT down more obvious compared with control group, the difference was statistically significant (P<0.05). On CRP and WBC count also decreased, there was no statistically significant difference between the two way (P>0.05).(2) nutrition indicatorsHCT and ALB in both groups were decreased, there was no statistically significant difference between groups (P>0.05), but the propagated within the treatment way to compare difference was statistically significant (P<0.05).(3) high condensation indexBefore treatment two group were higher than normal, after the treatment group decreased more obvious, difference between groups was statistically significant (P<0.05).(4) oxygenation indexThe oxygenation index in two groups of has rebounded, there was no statistically significant difference between the groups(P>0.05), but within the treatment way to compare difference was statistically significant(P< 0.05).(5) the immune indexesThe Cellular immunity and Humoral immunity indexes before and after treatment in comparison between group and group were not significant(P> 0.05).Conelusion1. The Dialectical classification of senile pneumonia correlation dialecti- -cal classification is feasibility.2. The core of senile pneumonia correlation sepsis pathogenesis is Qixueyu--tanzu.3. On the basis of the medicine comprehensive treatment, Chinese medicine can improve curative effect according to core and pathogenesis... |
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