The Effect Estimation And The Optimization Of Clinical Pathway For CPHD Of Traditional Chinese Medicine Of Guangdong Province

ObjectiveThe method of case-control study was adopted to evaluate and optimization the treatment strategies of combining traditional Chinese and western medicine clinical pathway for CPHD, in order to find out the combination traditional Chinese and western medicine treatment of clinical path optimization recommendations.MethodsWe collected 168 cases of hospitalized patients with Chronic Pulmonary Heart Disease(CPHD) between September 2014 and August 2015. Through the descriptive analysis, it was concluded that TCM syndrome type distribution of CPHD and formated the optimization scheme. Then, we used case control analysis. According to the Chinese medicine dialectical classification area group was established. Each group is divided into clinical pathway and non clinical pathway group. Afterwards, A descriptive analysis of the distribution regularity of Chinese traditional medicine prescription, clinical curative effect of different Chinese traditional medicine prescription treatment were compared. Respectively to compare the clinical symptoms of period, average hospitalization days, the average hospitalization expenses, blood gas analysis and safety indicators, it is concluded that the clinical curative effect of different treatments.Result1. In TCM syndrome type distribution, there were a total of six main Chinese medicine syndrome types:phlegm turbidity obstructing lung pattern (51.79%), heat phlegm obstructing lung syndrome (17.26%), phlegm and blood stasis obstructing lung (26.19%).pattern of edema due to Yang deficiency (2.98%), dragon’s Yin Yang to take off (1.19%) and cold fluid shooting lung (0.60%),respectively. It was suggested to increase the phlegm turbidity obstructing lung pattern.2. In phlegm turbidity obstructing lung pattern clinical efficacy, there were mainly adopted three prescriptions, called Erchen and Sanziyangqin decoction (67.82%), Dingchuan decoction (8.05%) and Suzi Jiangqi decoction (5.75%). Clinical curative effect analysis results showed that Erchen and Sanziyangqin decoction treated phlegm turbidity obstructing lung pattern. The results showed that the symptom improvement rate and the related indicators are good. Although compared with other prescription curative effect had no statistical significance (P＞ 0.05), but the mean result showed that the hospitalization days were the shortest and treatment costs were the least.3. In heat phlegm obstructing lung syndrome clinical efficacy, there were mainly adopted four prescriptions, called Dingchuan and Qianjinweijing decoction (44.83%), Dingchuan decoction (20.69%) Qingjin Huatan decoction (13.79%) and Qianjin Weijing decoction (10.34%). Clinical curative effect analysis results showed that Dingchuan and Qianjinweijing decoction treatedheat phlegm obstructing lung syndrome. The results showed that the symptom improvement rate and the related indicators are good. Although compared with other prescription curative effect had no statistical significance (P＞ 0.05), but the mean result showed that the hospitalization days were the shortest and treatment costs were the least.4. In phlegm and blood stasis obstructing lung clinical efficacy, there are adopted forteen prescriptions, there was no statistical significance in clinical pathway group or non clinical pathway group＞ 0.05). It was suggested to continue to use the clinical pathway as it was more suitable for clinical.5. In other syndrome types, because of the number of cases less or dispersed treatment, clinical curative effect could not be compared and analyzed. It was advised to the follow-up study.Conclusion1. It was suggested to increase the phlegm turbidity obstructing lung pattern and the phlegm heat stasis obstructing lung.2. It was suggested Erchen and Sanziyangqin decoction as the main treatment prescriptions of the phlegm turbidity obstructing lung pattern.3. It was suggested Dingchuan and Qianjinweijing decoction as the main treatment prescriptions of the heat phlegm obstructing lung syndrome.4. Other syndrome types, clinical path did not be recommended to modify the original treatment plan.