| ObjectiveSenile cerebral infarction in acute stage of pulmonary infection of TCM syndrome type distribution and combination of different complex, there is no unified standard. So that is not conducive to clinical application and improve the level of clinical diagnosis and treatment. Explore TCM syndrome classification and evolution rules, standardization and standardized research, to better guide clinical application. Choose the card type distribution is the most typical syndromes of phlegm heat phlegm in the lung, to carry out syndrome differentiation and treatment of traditional Chinese medicine, and observe the clinical curative effect, verify the effect of syndrome differentiation and treatment, and to explore its mechanism of action and clinical application to provide law basis.Methods1.Study on TCM syndrome type distribution:By using the method of prospective study, from March 2014-2015 year in April in the center of the First Affiliated Hospital of Guangzhou University of Chinese Medicine encephalopathy diagnosed senile cerebral infarct in acute stage of pulmonary infection in hospitalized patients in 120 cases, including the general situation, the content of syndrome elements, syndrome type of outcome, (to recognized by 3 doctors experienced at the same time to each patient. The syndrome and syndrome type determination, determine the results of the 2 physicians also need to set up.) were collected on the first day syndrome, respectively statistics the first 1～5 days,6～10 days,11～14 days of distribution of TCM syndromes and the most common syndrome type transformation, and results in the designed questionnaire, the establishment of the original the clinical database, import data into SPSS 19, the overall distribution of syndrome elements, frequency statistical distribution of syndromes, to summarize the most common syndrome type distribution, with the course of disease transformation.2. Study on the treatment of phlegm heat obstructing the lung: From May 2015～2016 year in January in the center of the First Affiliated Hospital of Guangzhou University of Chinese Medicine encephalopathy were diagnosed as cerebral lung phlegm heat syndrome of senile cerebral infarction in acute stage of pulmonary infection in 60 cases of patients were randomly divided into control group and treatment group (on the basis of modern medicine conventional therapy, oral or nasal feeding phlegm Tong fu mixture, syndrome differentiation the mixture, supplementing qi and nourishing Yin mixture), each group 30. Observed before and after treatment of TCM syndrome score, NIHSS score, pulmonary infection score of symptoms and signs, biochemical indicators of white blood cells and procalcitonin changes, and pulmonary infection control time. Verify the expectorant agent, syndrome differentiation and Tongfu mixture, supplementing qi and nourishing Yin decoction, clinical effect of treatment of senile cerebral infarction in acute stage of pulmonary infection of phlegm heat obstructing the lung, and to explore its mechanism of action.Results1. Study of syndrome type distribution:(1) The elderly cerebral infarction in acute stage of pulmonary infection of main syndrome type distribution:phlegm and heat obstruct lung syndrome (48.3%), Qi deficiency and phlegm obstructing the lung syndrome (16.7%), Yin and Yang deficiency with accumulated phlegm syndrome (13.3%), Qi deficiency with blood and phlegm state syndrome(6.7%), blood and heat state with accumulated toxin syndrome (3.3%), Qi and Yin deficiency syndrome (3.3%). phlegm and heat obstructing the lung for senile cerebral infarction in acute stage of pulmonary infection the most common syndromes.(2) Syndrome of phlegm heat obstructing the lung in 58 cases of patients in 6～10 days with 30 cases of Fu shi syndrome,10 cases of Qi and Yin deficiency syndrome. A further increase in 11 to 14 days, Fu shi syndrome, respectively, 32 cases, Qi and Yin deficiency syndrome also respectively,30 cases.2. Study on the treatment of phlegm heat obstructing the lung:(1) The treatment group at the time of admission NIHSS score before treatment NIHSS scores were compared with a significant statistical difference (P<0.05), the control group at the time of admission NIHSS score and infection before treatment NIHSS score were more significant statistical difference (P<0.05). The treatment group and the control group after treatment NIHSS score, before and after the treatment, the difference between the two groups no significant statistical difference (P>0.05).(2) The treatment group and the control group in the lungs infection control time compared to a statistically significant difference (P<0.05). Two groups of patients in treatment of white cells and calcitonin hormone abnormal no significant statistical difference (P>0.05). Two groups of patients during treatment with death toll had no significant difference (P>0.05).(3) The treatment group and the control group before and after the treatment of TCM symptom score, before and after the treatment of TCM syndrome score difference comparison, the score of symptoms and signs of pulmonary infection after treatment compared both statistically significant difference (P<0.05).Conclusion1. Study on TCM syndrome type distribution:(1)There are six major syndromes distribution of senile cerebral infarction in acute stage of pulmonary infection, is as follows:phlegm and heat obstruct lung syndrome, Syndrome of qi deficiency and phlegm obstructing lung, Yin and Yang deficiency with accumulated phlegm syndrome, Qi deficiency with blood and phlegm state syndrome, blood and heat state with accumulated toxin syndrome, Qi and Yin deficiency syndrome.(2)Phlegm heat obstructing lung syndrome is most common syndromes of senile cerebral infarction in acute stage of pulmonary infection, as the course goes on a lot of patients with both Fu shi syndrome, Qi and yin deficiency syndrome.2. Study on the treatment of phlegm heat obstructing the lung:(1)acute pulmonary infection in elderly patients with acute cerebral infarction affects the short-term prognosis and increases the mortality rate. It is an independent risk factor for the patients with acute cerebral infarction.(2)Clearing heat and resolving phlegm mixture based on syndrome differentiation combined with Tong fu, supplementing qi and nourishing Yin mixture than simple modern medicine conventional therapy can effectively control lung infection, reduce the pulmonary infection treatment time. But the acute phase to improve the symptoms of nerve function defect of patients with simple modern medicine conventional therapy compared no significant difference.(3) on the basis of clearing away heat and resolving phlegm mixture combined with purgation, supplementing qi and nourishing Yin mixture can improve clinical symptoms, improve the therapeutic effect of traditional Chinese medicine. |
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