Analysis Of TCM Syndromes Of Sepsis And Its Correlation

Objectives① This research aids to find out the traditional Chinese medicine syndrome characteristics and evolution law of sepsis based on patients of Guanganmen Chinese medicine hospital② To figure out the relationships between the sepsis syndrome and age, gender, past medical history, APACHE Ⅱ score, the correlation of the WBC count, CRP and PCT and so on.MethodsUsing the retrospective research method to choose 113 cases from emergency department, ICU of Guanganmen hospital from January 2014 to January 2015, who met the diagnosis of sepsis. Collect their general clinical information, TCM syndrome, physical and chemical indicators and prognoses and fill in the questionnaire. Use the SPSS 17.0 to analyze the original database.Results1.The general clinical information analysis results show that 113 patients 66 cases of the men and women in 47 cases. The age distribute from 44 to 99, with the highest incidence between 66 to 75 years old. Mean age is about 74.6 years old. The primary diseases are mainly distributed in the respiratory system and nervous system disease. The most common disease is pulmonary infection, which has the largest proportion of about 41.5%, followed by acute cerebrovascular disease, about 23.0%. These two account for 64.5%. the past medical history included hypertension, coronary heart disease, cerebral stroke, COPD and other chronic pulmonary diseases.2.Common TCM syndrome of sepsis:the syndrome includes the excess TCM syndrome, the deficiency syndrome, and the intermingled deficiency and excess syndrome. In the first day, there are 65 excess TCM syndrome patients, accounted for 57.5%; 36 in the intermingled deficiency and excess syndrome, accounted for 31.9%; in the 3rd day, there are 44 excess TCM syndrome patients, accounted for 38.9%; 56 in the intermingled deficiency and excess syndrome, accounted for 49.6%; in the 7st day,there are 17 excess TCM syndrome patients, accounted for 15.0%; 87 in the intermingled deficiency and excess syndrome, accounted for 77.0%.3.The TCM syndrome distribution results:there are 5 excess syndrome, the most common syndromes are heat syndrome (64.6%), toxicity syndrome (57.5%), phlegm syndrome (54.0%). There are 7 deficiency syndromes, including the Yin deficiency syndrome which is accounted for 31.9%, Yang deficiency syndrome for 23.0%, Qi deficiency syndrome for 17.7%. The combination forms of syndrome factors are 2-factor-combined form and 3-factor-combined form. The 2-factor-combined form incorporates phlegm syndrome+heat syndrome, accounted for 34.3%, followed by heat syndrome+toxicity syndrome, accounted for 24.3%. and the Yang deficiency+ phlegm syndrome takes 15.7%. The 3-factor-combined form include the Yin deficiency+Yang deficiency+toxicity syndrome (36.6%), phlegm+heat+Fu-organ syndrome (24.4%), phlegm+heat+blood stasis syndrome (14.6%). The most common combination results in 5 syndromes:24 cases of phlegm+heat syndrome, its constituent ratio is 21.2%,,17 cases of heat+toxicity syndrome (15.0%),,15 cases of Yin deficiency+Yang deficiency+toxicity syndrome (13.3%),11 cases of Yang deficiency+phlegm syndrome accounted for 9.7%,10 cases of phlegm+heat+ Fu-organ syndrome accounting for 8.8%.4.the correlation analysis of the most common syndrome with various clinical indicators results:in APACHE II score, the ICU stays and the death rate, Yin deficiency and Yang deficiency and toxicity syndrome is higher than the others, P<0.05. The implication of phlegm and heat syndrome’s white blood cell count, and CRP value is highest, each data in excess group are higher than the deficiency and excess syndrome group, and P values were less than 0.05. PCT is characterized by at the highest of Yin and Yang are two virtual accumulate poison, but each group’s PCT has no significant differences (P>0.05).Conclusion1.The general clinical data correlation analysis:elderly patients have a higher probability than young patients with sepsis, showing that the incidence of sepsis is proportional to the age. Sepsis history disease includes high blood pressure, coronary heart disease, stroke; the primary diseases are mainly distributed in the respiratory system disease. Cardiovascular diseases and lung diseases may are high risk factors for sepsis.2. Probability analysis of common syndrome:the early stage of sepsis is given priority to the excess syndrome. And it declines in the medium-term, while the deficiency and excess syndrome increases. And the late is given priority to the deficiency and excess syndrome. The most common syndrome mark as phlegm heat syndrome, toxic heat syndrome, phlegm heat Fu-organ syndrome and phlegm heat blood stasis syndrome, Yang and Yin deficiency toxicity syndrome and Yang deficiency-phlegm obstruction syndrome.3. Common syndrome and the physical and chemical index correlation analysis: The implication of phlegm and heat syndrome’s white blood cell count, and CRP value is highest. It reflects the fight between the Zheng and evil is fierce in the excess groups. And it is the best period of clinical treatment. If the treatment is correct, the human body can uprights and helps to shorten the hospitalization days, reducing the case fatality rate. The PCT data is higher than other groups of data, but not statistically significant.4. Correlation of syndrome and prognosis:Yin and Yang toxic syndrome is higher than the other groups in APACHE II score, hospitalization days, and case fatality rate. It means patients with this syndrome are more deficient in Zheng qi, which can rid out illnesses. And its prognosis is poorer.