| ObjectiveThe epidemiological characteristics of senile viral pneumonia were identified by comparison with simple bacterial infection of elderly pneumonia.At the same time,it discusses the characteristics of TCM syndromes of senile viral pneumonia,and provides reference and basis for TCM syndrome differentiation and treatment.MethodsThe case-control trial was used to study elderly pneumonia patients diagnosed in the emergency department,inspected and inpatient department of Guangdong Provincial Hospital of Traditional Chinese Medicine from January 2016 to June 2018.The patients with respiratory tract infection diagnosed by pathogens were selected as the case group,and 1:1 pairing was performed by age and sex.The elderly pneumonia patients with simple bacterial infection diagnosed at the same time were selected as the control group.Collect basic clinical information of the two groups,including gender,age,ethnicity,admission date,length of hospital stay,place of residence,past medical history,clinical symptoms and signs;blood routine,blood gas analysis,emergency biochemistry,CK,CK-MB and hypersensitive muscle Calcium protein T(Hs-cTnT),procalcitonin(PCT),hypersensitive C-reactive protein(Hs-CRP),D-Dimer,coagulation function,liver function,renal function and other laboratory tests;electrocardiogram and chest X-ray Or chest CT and other imaging findings;at the same time record the four diagnostic information of Chinese medicine,tongue and pulse diagnosis,TCM syndrome differentiation and other information.The differences in past medical history,clinical features,laboratory indicators,and TCM syndromes between the two groups were compared,and the epidemiological characteristics and TCM syndrome characteri sti cs of elderly pati ents wi th viral pneumonia were identified.The database was built using the Excel table.After the data verification was locked,the SPSS 17.0 statistical software was imported for statistical analysis.The test level ?=0.05,F<0.05 indicates that the difference between the groups was statistically significant.Result:1.Seventy patients were included in the case group and the control group.There were 39 males and 31 females in each group.The average age of the virus combined with bacterial pneumonia group was 79.21±7.89 years old,and the average age of the simple bacterial pneumonia group was 79.40±9.49 years old.The pathogenicity of the virus combined with bacterial pneumonia group showed that the parainfluenza virus infection was the most,accounting for 46%,followed by influenza B,influenza A,herpes simplex virus,respiratory syncytial virus,adenovirus,cytomegalovirus,rubella virus are relatively few.2.In terms of combined basic diseases,the combination of virus and bacterial pneumonia and the underlying diseases from high to low are hypertension,diabetes,cerebrovascular disease,malignant tumor,and coronary heart disease;the high-to-low of bacterial bacterial pneumonia group is hypertension,diabetes,coronary heart disease,cerebrovascular disease,malignant tumor.There were significant differences in the distribution of cerebrovascular disease,diabetes mellitus and malignant tumor between the two groups(P<0.05).In terms of clinical signs and symptoms,the main symptoms and signs of the two groups were:fever,cough,expectoration,and shortness of breath,but the proportion of fever with viral pneumonia was the highest,and the mean temperature was also higher(P<0.05).The proportion of cough in the simple bacterial pneumonia group was the highest,and the average body temperature was relatively low(P<0.05),suggesting that fever has a certain significance for judging whether the elderly pneumonia is infected with the virus.In terms of laboratory indicators,NEUT,RBC,Hb,PaCO2,K+,and Cr values were compared between the two groups,and the differences were statistically significant(P<0.05).In addition,the average length of hospital stay in the virus-associated bacterial pneumonia group was 9.40±3.98,and the average hospital stay in the bacterial-only pneumonia group was 9.94±4.36.There was no significant difference between the two groups(P>0.05).3.Logistic regression analysis was performed on the statistically significant differences between the groups.The results suggest that diabetes(OR=4.410,P=0.027),abnormal blood carbon dioxide partial pressure(OR=3.248,P=0.042),abnormal lactic acid(OR=4.165),P=0.015),total bilirubin abnormalities(OR=34.637,P=0.006),hemoglobin abnormalities(OR=0.159,P=0.033),respiratory abnormalities(OR=0.203,P=0.010)may be associated with the virus combined with bacterial pneumonia or simple bacterial pneumonia was associated(P<0.05).4.In terms of TCM syndromes,the TCM syndromes of the elderly virus with bacterial pneumonia group and the simple bacterial pneumonia group mainly involved lung,spleen and kidney,and all of them were based on lung qi deficiency,spleen qi deficiency and phlegm heat syndrome.The difference was not statistically significant(P>0.05).Conclusion:1.The clinical features of senile virus combined with bacterial pneumonia:There are many underlying diseases,and the proportion of cerebrovascular diseases,diabetes,and malignant tumors is higher.Virus pathogens are mainly infected with parainfluenza virus,influenza virus B,and influenza virus,and adenovirus,cytomegalovirus,and rubella virus are less.Abnormalities such as WBC,NEUT,RBC,Hb,PaCO2,TBIL,LAC,PT,INR,D-Dimer,PCT,Hs-CRP and other factors have significant effects on elderly patients with viral and bacterial pneumonia(P0.05)).Fever has a certain significance for judging whether elderly pneumonia is associated with viral infection.Diabetes,abnormal blood carbon dioxide partial pressure,abnormal lactic acid,and abnormal total bilirubin increase the risk of developing viral pneumonia,which may be an independent risk factor for viral and bacterial pneumonia.2.The characteristics of TCM syndromes of senile virus with bacterial pneumonia are the virtual standard,and the disease is mainly in the lung,spleen and kidney.Symptoms and signs can be used as the main differential symptoms of TCM syndrome differentiation of viral and bacterial pneumonia.In the main basic syndromes of traditional Chinese medicine,the two groups of patients were mainly lung qi deficiency,spleen qi deficiency and phlegm heat syndrome.In terms of clinical common syndrome,the virus-combined bacterial pneumonia group and the simple bacterial pneumonia group mainly consisted of hot and dry lung,wind-heat lung,lung spleen qi deficiency. |
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