A TCM Syndrome Analysis Of Acute Kidney Injury In Sepsis And A Retrospective Study Of Related Factors

Objective1 To analyze the correlation and difference of epidemiological trend,clinical test index and common score to assess the severity of acute kidney injury in sepsis.2 To analyze the distribution characteristics of TCM syndromes and syndrome elements in acute kidney injury in sepsis.3 To compare the correlation and difference between clinical syndromes and common scores among different TCM syndromes in acute kidney injury in sepsis.4 To compare correlations and differences between clinical syndromes and scores between different TCM syndromes in acute kidney injury in sepsis.MethodIn this study,a retrospective study was designed to explore the epidemiology,the distribution of TCM syndromes,and the correlation with various clinical test indexes and scores in acute kidney injury in sepsis in the intensive care unit of the Guanganmen Hospital of Chinese Academy of Chinese medicine from 2010 to 2017.Result1 Epidemiological characteristics:89 cases of acute kieney injury in sepsis were included in this study.The average hospitalization day was 15.98 ± 12.67 days,the incidence rate was 15.61%,the male accounted for 57.30%,and the female accounted for 42.70%.The age of the patients ranged from 43 to 95 years old,and mostly was 70-89 years old,accounting for 67%of the total age.The mortality rate of 89 patients in this study was 76%.Patients with pulmonary infection and acute cardio cerebrovascular disease were the primary diseases,which accounted for 84%of the proportion of the patients.Patients had many chronic diseases in the past.The top five were hypertension(22%),coronary heart disease(21%),diabetes(11%),arteriosclerosis(7%),and pulmonary interstitial fibrosis(7%).2 Clinical indicators and scores:the average APACHE ? score in this study was 24.67±8.16,and the average SOFA score was 9.76 ± 4.2,and the two scores were positively correlated.The two scores of death patients were all higher than those of survival patients,and the results were statistically different.The indexes of WBC,CRP,PCT,LC,Cr,BUN and NT-pro BNP in the blood were significantly higher than normal levels,and the increasing of blood Cr was more than 26.5umol/L,the average was 66.78 ±43.76umol/L,and the stage of acute kidney injury was mainly in stage 1 and 2.3 The distribution of syndromes of TCM syndrome:in this study,patients of acute kidney injury in sepsis were mainly with deficiency and solid inclusion.With the development of the disease,the proportion of simple deficiency syndrome and simple empirical patients gradually increased.When the patients entered ICU,the main syndromes were Yang Xu Shui Ting syndrome,Yang Xu Xue Yu syndrome,Yin Yang Liang Xu syndrome and Tan Re Hu Jie syndrome.In the diagnosis of acute kidney injury,the patients were mainly with Tan Yu Hu Jie syndrome,Qi Yin Liang Xu syndrome,Yang Xu Shui Ting syndrome,Yang Xu Xue Yu syndrome and Yin Yang Liang Xu syndrome.The syndrome was split into a single syndrome element.When entering ICU,top five of the patients' syndrome elements were Yang Xu,Xue Yu,Yin Xu,Shui Ting and Tan.When diagnosed,syndrome elements were Yang Xu,Xue Yu,Yin Xu,Qi Xu and Shui Ting.4 The correlation of syndrome elements and related indexes:in this study,the indexes of the patients with Xu Shi Jia Za syndrome are better than those of Xu syndrome or Shi syndrome.The APACHE II score and SOFA score are lower than those of Xu syndrome or Shi syndrome.At the time of diagnosis,Cr and the increasing of Cr are also lower than those of the other two syndromes.Patients with Xu Shi Jia Za syndrome when entered ICU had longer survival time,and patients with Xu Shi Jia Za syndrome when diagnosed had longer survival time,which indicates that the indexes of Xu Shi Jia Za syndrome were better than other two syndromes and the survival time were longer.And after analysis,there is no significant difference of indexes or scores among different syndrome elements.Conclusion1 Common syndromes:the patients with acute kidney injury in sepsis were mostly Xu Shi Jia Za syndrome.The proportion of Xu syndrome and Shi syndrome was rising in the later period of the disease.2 Common syndrome elements:the patients with acute kidney injury in sepsis were mostly Yang Xu,Xue Yu,Yin Xu,Qi Xu,Tan and Shui Ting.3 The correlation of scores,test indexes and prognosis among different syndromes:the index of Xu Shi Jia Za syndrome was better than Xu syndrome and Shi syndrome patients,APACHE II score and SOFA score were lower than two other syndromes.Cr and the increasing of Cr were lower.The patients of Xu Shi Jia Za syndrome when entered ICU had longer survival time.There was no difference among patients with different syndromes in electrolytes.4 The correlation of scores,indexes and prognosis of different syndrome elements:after analysis,there was no significant difference in score or index among different syndrome elements.