TCM Syndrome Type And Pathogen Analysis Of Severe Pneumonia Patients In ICU

OBJECTIVE:By retrospective analysis,the distribution of TCM syndromes and pathogens in ICU patients with severe pneumonia in our hospital was counted,and Its Clinical Regularity and distribution characteristics were summarized,which could provide reference for standardizing TCM syndromes differentiation of ICU patients with severe pneumonia and summarizing the distribution characteristics of pathogens,and provide clinical basis for further guiding the treatment of severe pneumonia by TCM and Western medicine,METHODS:118 patients admitted to ICU from September 1,2016 to February 28,2019,who met the diagnosis of severe pneumonia by western medicine and were examined for sputum culture,were collected.The patients`names,gender,age,ICU days,prognosis,body temperature,heart rate,respiration,blood pressure,pulse oxygen,basic signs,tongue coating and pulse signs,sputum culture results after ICU entry were collected.SPSS22.0 was used to collect the relevant data.Accounting analysis.The counting data are expressed by frequency and frequency.The comparison of the counting data between the two samples is carried out by chi-square test,and the results are statistically analyzed.Result:1.In this study,71 males(60.2%)and 47 females(39.8%)suffered from severe pneumonia.Nine patients(7.6%)were under 60 years old,39 patients(33.1%)were between 60 and 79 years old,and 70 patients(59.3%)were over 80 years old.The overall mortality rate of 118 patients was 39.8%.The mortality rate was not related to age and sex,but was related to the use of mechanical ventilation.2.TCM syndromes can be divided into four types:phlegm-heat accumulation syndrome(43.9%),Phlegm-turbidity obstruction syndrome(28.0%),heat trapping pericardium syndrome(15.3%),pathogenic trapping syndrome(13.5%)and phlegm-heat accumulation syndrome(the largest proportion).The distribution of syndrome types is not related to age and sex,but the mortality rate is related to syndrome types.The mortality rate of phlegm-heat obstructing lung syndrome and Phlegm-turbidity obstructing lung syndrome is lower,and the mortality rate of pathogenic depression and positive decoupling syndrome is the highest.3.Gram-negative bacteria accounted for 55.0%,fungi 25.6%,Gram-positive bacteria 16.1%,Mycoplasma 3.3%.Acinetobacter baumannii and Klebsiella pneumoniae were the most common gram-negative bacteria;Staphylococcus aureus was the most common gram-positive bacteria;Candida albicans was the most common fungus.The main pathogenic bacterial infections are phlegm-heat accumulation of lung syndrome.Among them,30 cases were not detected pathogens,42 cases were detected one pathogen and 46 cases were detected multiple pathogens.The mortality rate of patients without pathogen infection was 23.3%,that of patients with single pathogen infection was 33.3%,and that of patients with multiple pathogen infection was 56.5%.Chi-square test showed that the mortality rate of severe pneumonia was correlated with the number of pathogenic bacteria.Conclusion:Age is one of the main risk factors for severe pneumonia in ICU.TCM syndromes are mainly phlegm-heat accumulation of lung,and the mortality rate of pathogenic depression and Zhengtuo syndrome is the highest.Gram-negative bacteria are the main pathogens.Fungal infection is an important pathogen that can not be ignored in ICU of our hospital.Acinetobacter baumannii,Klebsiella pneumoniae,Staphylococcus aureus and Candida albicans were the most common pathogens.The main pathogenic bacterial infections are phlegm-heat accumulation of lung syndrome.The mortality rate of multi-pathogen infection was higher than that of non-pathogen infection and single pathogen infection.