Retrospective Analysis Of Diagnosis And Treatment Characteristics Of 1582 Inpatients With AECOPD Treated By Combination Of Traditional Chinese And Western Medicine

ObjectiveThrough the retrospective analysis of the cases of acute exacerbation of chronic obstructive pulmonary disease((acute exacerbation chronic obstructive pulmonary disease,AECOPD)diagnosed in the Department of Respiratory Medicine of Guangdong Integrated traditional Chinese and Western Medicine Hospital from April 2015 to January 2019,to understand the current situation of diagnosis and treatment of AECOPD in this hospital,and to explore the prescription and medication rule of traditional Chinese medicine in the treatment of AECOPD in this hospital,and even to provide evidence-based medicine data support for the formulation and further optimization of the diagnosis and treatment plan of integrated traditional Chinese and western medicine for AECOPD in the future.MethodsIn this study,the medical records of patients with acute exacerbation of chronic obstructive pulmonary disease diagnosed by the Department of Respiratory Medicine of Guangdong Integrated traditional Chinese and Western Medicine Hospital from April 2015 to January 2019 were collected,and the basic information of patients,the diagnosis of traditional Chinese and western medicine and the use of drugs were collected.Microsoft Office Excel 2017 was used to establish a database,and SPSS19.0 was used for statistical analysis.Results1.A total of 1582 cases were collected,including 1344 males(84.96%)and 238 females(15.04%),with a male-to-female ratio of 5.66:1;the age distribution of 60-80 patients was the largest,with an average age of 72.68±8.77 years;77.50%of the patients had a history of smoking;winter(465 cases,29.39%)was the season with high incidence of AECOPD.The average length of stay in the hospital is 10.18±4.99 days,and employee medical insurance(61.88%)and resident medical insurance(28.57%)are the main types of reimbursement.2.Cardiovascular disease is the most common concomitant disease in AECOPD.Pulmonary heart disease(446 cases,28.19%)and type Ⅱ respiratory failure(331 cases,97.64%)are common concomitant diseases.3.The main western medicine treatment schemes in this hospital are bronchodilator,antimicrobial agents,glucocorticoid and expectorant.The main antimicrobial agents were penicillins(1322 cases,83.57%)and quinolones(885 cases,55.94%).Glucocorticoids were mainly methylprednisolone(1290 cases,81.54%).Bronchodilators were mainly theophylline(1162 cases,73.45%)and compound methoxyphenamine(1021 cases,64.54%).The main expectorant was ambroxol hydrochloride(1212 cases,76.61%).4.After treatment,the infection indexes such as white blood cells,lymphocytes,eosinophils,granulocytes,hypersensitive C-reactive protein and procalcitonin were significantly improved compared with those before treatment(P<0.01).It is suggested that the anti-infective effect of integrated traditional Chinese and western medicine is obvious.5.The syndrome differentiation of traditional Chinese medicine is mainly divided into two syndrome types:phlegm-heat obstructing the lung(854 cases,53.98%)and phlegm-dampness blocking the lung(377,23.83%).6.Chuankezhi injection,Simo decoction,Qirong Runchang oral liquid and Maren Runchang pills are commonly used proprietary Chinese medicines in clinic.Traditional Chinese medicine package treatment,Chuankezhi acupoint injection,acupoint application,magnetic bead pressing ear point,direct current drug iontophoresis therapy and acupoint application are commonly used external treatment methods of traditional Chinese medicine.7.The application rate of traditional Chinese medicine in the hospital reached 84.45%.In clinic,there are mainly drugs for resolving phlegm and relieving cough and asthma,tonifying deficiency,regulating qi,clearing heat and relieving appearance.10 kinds of traditional Chinese medicines are commonly used:licorice,Pinellia ternata,ephedra,almond,mulberry bark,perilla seed,Scutellaria baicalensis,Poria cocos,Trichosanthes.The taste of the medicine is mainly bitter,pungent and sweet,warm,cold and flat are the main medicinal properties,and the meridians of the lung,spleen and stomach and large intestine are the main meridians.Cluster analysis shows that the commonly used drug combinations are:ephedra-almond,Pinellia ternata-licorice,Trichosanthes-Houttuynia cordata-Fructus Aurantii-orange,Poria cocos-tangerine peel,semen Raphani-mustard seed-perilla seed.Conclusion1.AECOPD mainly occurs in elderly males and usually occurs in winter.The western medicine treatment plan of AECOPD in this hospital is mainly bronchodilator,antimicrobial agents,glucocorticoid and expectorant,in which the selection of antibiotics basically follows the recommendations of the guidelines,and the application of bronchodilators and hormones are not completely consistent with the recommendations of the guidelines.2.The main types of AECOPD are phlegm-heat obstructing the lung andphlegm-dampness blocking the lung.Expectorant antitussive and antiasthmatic drugs are mostly used in the treatment,mainly warm drugs,and drugsare mainly meridians of the lung.Commonly used drug combinations are:ephedra-almond,Pinellia ternata-licorice,Trichosanthes-Houttuynia cordata-Fructus Aurantii-orange red,Poria cocos-tangerine peel,semen Raphani-mustard seed-perilla seed.