Professor Zhou Zhongying’s Academic Experience In The Treatment Of Community Acquired Pneumonia

Objective:Based on the medical records data mining method,Professor Zhou Zhongying explored the academic experience in distinguishing and treating exogenous cough with fever,and carried out the clinical efficacy observation of "Shuangli Shuangjiefang" in the treatment of community-acquired pneumonia and lung and stomach fever.Methods:(1)Select Zhou Zhongying’s database of cases of exogenous cough and fever,and sort out a total of 188 cases with a total of 237 consultations according to the inclusion criteria and elimination criteria,and enter the electronic form to establish the relevant database.Using frequency analysis,factor analysis,and association rule methods,data analysis is conducted on various aspects such as pathogenesis,prescriptions,medication,and core prescriptions,and complex network technology is used to establish core drug networks and community models.(2)Design clinical efficacy observations,divide the cases into a test group and a control group,the control group uses conventional Western medicine treatment,and the experimental group combines Professor Zhou Zhongying’s empirical prescription "external and internal double solutions" on the basis of conventional Western medicine treatment.After treatment,the treatment effect,fever time,improvement of symptoms of traditional Chinese medicine,chest CT,and changes in inflammation before and after were statistically compared.The statistical data of SPSS20.0 software were used for statistical analysis.The t-test was used when the variance of the measurement data was uniform.The non-parametric test was used when the normal distribution was not met.Results:1.Data mining results of exogenous cough with fever(1)General situation:There are 188 cases of exogenous cough with fever,including 75 males and 113 females,for a total of 146 consultations.The oldest is 86 years old and the youngest is 4 years old.The average age was 39.1 ± 20.9 years.The main underlying diseases of the patients were asthma(15 times,emphysema(10 times),chronic hepatitis B(9 times),pulmonary heart disease(6 times),and diabetes(5 times).(2)Symptom distribution:Symptoms with a frequency of more than 50 times in 237 medical records are:fever(215 times),cough(208 times),sore throat(86 times),dry mouth(76 times),nasal congestion(55 times),sputum quality sticky(55 times).The tongue image frequency is greater than 10 times:red tongue(174),dark red tongue(51);yellow fur(197 times),thin fur(156 times),greasy fur(158 times),light yellow fur(12 times).Those with a pulse frequency greater than 50 times are thin(131 times),slip(117 times),and count(72 times).(3)Pathogenesis distribution:There are 39 kinds of pathogenesis descriptions in 237 medical records,including wind evil(53.59%),loss of guardianship(28.27%),unclear lung gas(21.94%),lung heat Yun(18.57%)and damp heat(11.39%).The pathological factors of the true disease are wind(73.42%),heat(63.29%),wet(21.94%),summer heat(14.77%),phlegm(13.50%),cold(8.44%),and the disease is mostly virtual They are Qi deficiency(16.03%),Yin deficiency(9.28%),and body deficiency(10.27%).Most of the disease sites are lung(71.31%),surface(39.66%),stomach(16.88%),and Shaoyang(5.49%).(4)Drug analysis①Distribution of medicines and sexual taste to menstruation:The medicines used more than 100 times(including 100 times)in 237 medical records are:Nanshashen(159 times),Qianhu(156 times),licorice(148 times),Campanulaceae(148 times),almonds(140 times),Fritillaria thunbergii(139 times),Scutellaria(126 times),Pinellia(116 times),Forsythia(110 times),Solidago(106 times),mulberry leaves(103 times).The medicinal properties are mainly cold and cold(55.71%)and warm(28.57%).The medicinal flavor is mainly bitter(50%),sweet(48.57%)and spicy(47.14%).The meridian of medicine is mainly the lung meridian(68.57%)and the spleen,stomach and large intestine meridian(87.14%).②Drug factor analysis:analyze 70 kinds of drugs whose frequency is more than 10 times.A total of 11 common factors were extracted,such as:Factor 1 is composed of Elsholtzia,Talc,Soybean Roll,Agastache,Artemisia annua,Magnolia officinalis,Perrin,and Mint;Factor 2 is composed of tempeh,schizonepeta,mulberry leaf,loquat leaf,Scutellaria baicalensis,mulberry white skin;factor 3 is composed of bamboo,orange peel,Coptis chinensis,Poria,Magnolia.③Analysis of drug association rules:Use association rules to analyze the relationship between common pathological factors,pathogenesis and drugs.Such as:medicines closely related to wind evils:chrysanthemum,mulberry leaf,fritillaria,solidago,platycodon grandiflorum,Qianhu,forsythia,almond,orange peel.The medicines that are closely related to the internal content of lung fever are:bergamot,dandelion,flea break,loquat leaf,Scrophulariaceae,and burdock seed.④Group analysis of drug communities:divided into five groups.For example,group one consists of addition and subtraction of Huopu Xialing soup,Yinqiaosan,Jingfangdabiao soup,gardenia and black bean soup,group two consists of addition and subtraction of Huanglian Wendan soup,Bupleurum yuj intang,and Zhishigualou soup.⑤ The core drug composition:Radix Adenophorae,Campanulaceae,Qianhu,almond,Fritillaria thunbergii,mulberry leaf,forsythia,ginger,pinellia,orange peel,Magnolia officinalis,licorice,scutellaria baicalensis,goldenrod.2.Clinical efficacy observation results:Fifty-eight cases that met the inclusion criteria were included in the study,and no cases of shedding or rejection were included.They were divided into a test group and a control group,including 29 cases in the test group and 29 cases in the control group.There was no statistically significant difference between the two groups in terms of gender,age,height,weight,and other general conditions.There was no significant difference between the two groups in patients’ temperature at admission,course of disease before admission,and total score of syndromes at admission(P>0.05).The fever reduction time in the test group was 1.72 ± 0.70 days,and the fever reduction time in the control group was 2.34 ± 0.97 days.It was statistically significant that the test group was superior to the control group.The treatment effect of the two groups suggested that the experimental group was better than the treatment group(P=0.027<0.05).Chest CT changes did not differ between the two groups(P>0.05).The symptom scores of the two groups on the 4th and 7th days of treatment showed that both groups were able to relieve symptoms well.On the fourth day,the total symptom score(4.93 ± 1.53 points)of the test group was lower than that of the control group(6.72 ± 2.52 points),and the difference was statistically significant(P=0.002<0.05).Group fast.The speed and degree of improvement of the symptoms of fever,anorexia,and constipation in the experimental group were better than those in the control group.There was no significant difference in infection indexes between the two groups before treatment and the 4th day of treatment(P>0.05).However,the improvement of infection index in the experimental group was better than that in the control group(P=0.023<0.05).Conclusion:(1)The cause of exogenous cough accompanied by fever is that Wei Qi is weak for a while,which makes the external evil invade and attack the human body.The main pathogenesis of wind and evil is affected,and the guard is lost.This is the initial pathogenesis of this disease.Other pathogenesis may have lung heat content,damp heat content and so on.The disease is mainly related to the lung,but also related to the gastrointestinal tract.Pathological factors wind,heat(heat),dampness,heat,phlegm,dampness.The principle of treatment is to remove evil spirits as the first principle,and use complex methods to seek both solutions.The core drugs are Radix Adenophorae,Campanulaceae,Qianhu,Almond,Fritillaria thunbergii,Mulberry leaf,Forsythia,Ginger,Pinellia,Orange peel,Magnolia officinalis,Licorice,Scutellaria baicalensis,Goldenrod.(2)Professor Zhou Zhongying based on the superficial and internal solutions,Khan and Qingxia four methods combined with academic ideas to develop the "superficial and internal solutions" combined with Western medicine routine treatment of community-acquired pneumonia in the rate of improvement of fever,anorexia,constipation symptoms,The degree of improvement and the degree of improvement of CRP were better than those of the control group treated with Western medicine alone.