| Objective:To analyze the distribution of syndrome type and the effect of syndrome elements on the weaning of respiratory failure patients with invasive mechanical ventilation,and summarize the experience of Professor Qi Wensheng in the treatment of respiratory failure patients with invasive mechanical ventilation,thus providing reliable evidence for clinical syndrome differentiation and treatment.Methods:1.This study retrospective collected general information,TCM syndrome types,and prescription names of 123 respiratory failure patients with invasive mechanical ventilation in the ICU of Guang'anmen Hospital of China Academy of Traditional Chinese Medicine.The patients were selected between January 1,2016 and December 31,2017.The data was entered into Excel in a unified manner,and statistical analysis was performed on the general conditions of the patients,the distribution characteristics of TCM syndromes,and the frequency of prescriptions.We used survival-analysis method to explore the prognosis of respiratory failure patients with different TCM syndromes.2.Based on the TCM inheritance assist platform(V2.5),the 266 prescriptions were included and entered by two adults.Using frequency statistics,improved mutual information methods,association rules,complex system entropy clustering,and unsupervised hierarchical clustering of entropy,analysis of drug frequency,four characters,five flavors,channel distribution,drug combination,drug association rules,evolution and extraction of core drug combinations,and new prescription in the above prescriptions.The medical effects were classified according to the ninth edition of Chinese Medicine.Results:1.General situation:Of the 123 respiratory failure patients with invasive mechanical ventilation,69 cases(56.1%)were male,and 54 cases(43.9%)were female.The incidence of males was higher than that of females.The age ranged from 48 to 96 among them.The highest incidence was 71-90,especially 81-90.The average age was 77.80±10.50 years old.Among the primary diseases causing respiratory failure,the top five were pulmonary infections(43 cases,35.0%),COPD(16 cases,13.0%),sepsis(12 cases,9.8%),and acute left heart failure(8 cases,6.5%),acute cerebrovascular disease(6 cases,4.9%);in the underlying disease,the top five were hypertension(91 cases,19.4%),coronary heart disease(74 cases,15.8%),diabetes(49 cases(10.5%),hyperlipidemia(48 cases,10.3%),renal insufficiency(42 cases,9.0%);55 patients with invasive ventilator were successfully weaned(44.7%);68 patients were failed(55.3%).2.TCM syndromes:of the 123 patients,30 patients with insufficiency syndromes(24.4%);39 patients with positive syndromes(31.7%);54 patients with insufficiency and excess syndrome(43.9%).Common syndromes include lung phlegm heat syndrome(17 cases),blood heat injury yin syndrome(16 cases),qi deficiency and blood stasis and water stopping syndrome(15 cases),yang deficiency and blood stasis syndrome(15 cases),and qi yin deficiency(12 cases);The top three of the demonstration elements were heat syndrome(47 cases),blood stasis syndrome(46 cases)and deafness syndrome(26 cases);The top three of deficiency elements were Qi deficiency(37 cases),yin deficiency syndrome(33 cases),Yang deficiency(28 cases).3.The effect of syndrome elements on weaning:The weaning failure rate of the phlegm syndrome was higher than that of the non-phlegm syndrome,and the difference was statistically significant.4.Prescription usage statistics:58 cases were applied with one decoction(47.2%);51 cases were applied with two decoction(41.5%);tripartite combination were 13 cases(10.6%);Quartet was one case(0.8%).The formula was used 201 times.The prescriptions used were Qinghua Decoction(11 cases),Sanzi Yangqin Decoction(10 cases),Simiao Yongan Decoction(10 cases),Shengmai Decoction(10 cases),and Xijiao Dihuang Decoction(9 cases)and New Sini decoction(9 cases).5.Based on TCM inheritance assist platform,prescriptions and medication law:The study included a total of 266 prescriptions for respiratory failure with invasive mechanical ventilation,including 166 herbs,2704 drug frequency;commonly used herbs contains licorice(115 times),tuckahoe(100 times),ramulus cassia twig(82 times),etc.;commonly used drug combinations were ramulus cinnamomi-tuckahoe,licorice-ephedra,atractylodes-tuckahoe,etc.;core drug combinations were licorice-almond-ephedra-gypsum,antelope horn-Radix Rehmanniae-Radix Paeoniae Rubra-cortex moutan,cassia twig-Atractylodes-tuckahoe-ardix stephaniae tetrandrae,Panax notoginseng-cornus officinalis sieb-aconite-Ginseng;In the context of a correlation of 5,a penalty of 2 under the premise of generating three new prescription,1 rhizoma imicifugae_Angelica sinensis_Asparagus fern_ligusticum wallichii_Radix Paeoniae Rubra,2 semen sinapis_tangerine peel_fructus perillae_Platycodon grandiflorum_Thunberg fritillary buib,3 rhizoma zingiberis_radix glycyrrhizae preparata_Asarum sieboldii_licorice_almond_Ephedra_gypsum.Conclusion:1.Respiratory failure Patients with invasive mechanical ventilation mainly consist of the elderly,and the condition is complex.Most of the causes are phlegm,fever,blood stasis,and deficiency;this study suggests that phlegm is the factor affecting the patient's weaning success;the initial syndrome of TCM syndrome is based on lung phlegm heat syndrome,blood heat injury yin syndrome,qi deficiency and blood stasis and water stopping syndrome,yang deficiency and blood stasis syndrome,and qi yin deficiency are the main symptoms;during treatment,lung phlegm heat syndromes were commonly used in Qinghua decoction;blood heat injury yin syndromes were commonly used in Simiao Yongan Decoction and Xijiao Dihuang decoction,qi deficiency and blood stasis and water stopping syndromes commonly used jiajian Mufangji Decoction,Yang Deficiency Blood Stasis Syndrome commonly used in the new Sini decoction,Qi and Yin Deficiency commonly used Shengmai Decoction.2.Pay attention to ventilate lung and strengthen spleen in the course of clinical treatment,use antipyretic,cough and phlegm-removing drugs,dampness-eliminating drugs,diaphoretic,qi-tonifying drugs,and blood circulation drugs. |
PDF Full Text Request