Study On Distribution Of TCM Syndrome Of Bronchiectasis In Hohhot Area

Objective To retrospectively analyze and summarize the clinical characteristics,epidemiological data and TCM syndromes distribution of bronchiectasis patients in Hohhot area,so as to provide clinical basis for the standardization and standardization of TCM syndromes of bronchiectasis.Methods Through the integration of related literature material,make the bronchiectasis questionnaire of syndromes,adopt the method of retrospective study,collected in January 2015 to December 2020 in our hospital outpatient and ward clear diagnostic information for patients with bronchiectasis,descriptive statistical analysis method to summarize the clinical distribution of the bronchiectasis,and USES the clustering analysis dimension reduction bronchiectasis syndromes of characteristics and clinical situation.Results 1.Basic information: A total of 369 cases were collected,including 225 patients in acute attack stage and 144 patients in remission stage.Chronic obstructive pulmonary diseases(COPD),Chronic bronchitis,bronchial asthma,Chronic pulmonary tuberculosis,pulmonary heart disease and other diseases were mainly combined in acute and remission stage.Of the 225 patients in acute stage,167 underwent sputum culture examination,of which 61 were positive(36.53%),47 were Gram-negative bacteria(77.06%),and 28 were mainly Pseudomonas aeruginosa(45.90%),2 were Gram-positive bacteria(3.27%),and 12 were fungi(19.67%).In the acute stage,154 patients developed lung function,including 86 patients with obstructive ventilation dysfunction(55.84%),5 patients with restrictive ventilation dysfunction(3.24%),25 patients with mixed ventilation dysfunction(16.23%),and 14 patients with diffuse dysfunction(9.09%).In the acute phase of 225 patients,101patients(44.89%)developed bronchiectasis in both lungs,68 patients(30.22%)developed bronchiectasis in the left lung,and 56 patients(24.89%)developed bronchiectasis in the right lung.In the acute stage,all patients were treated with antibiotics and expectorant drugs.Among them,levofloxacin,ceftazidime and cefoperazone and sulbactam sodium ranked the top three in the frequency of antibiotics use,while ambroxol,bromoxine and carboxymethastan ranked the top three in the frequency of expectorant drugs use.2.Clinical syndrome differentiation and distribution of TCM syndromes: TCM syndromes in patients with acute stage can be divided into syndrome of phlegm and heat obstructing the lung,syndrome of phlegm and turbidity obstructing the lung,syndrome of deficiency of lung and kidney,syndrome of deficiency of lung and spleen qi,syndrome of liver fire making the lung,syndrome of Yin deficiency and fire swelling,syndrome of wind-cold making the lung,and syndrome of wind-heat making the lung.The TCM syndrome types in the remission stage can be divided into the syndrome of deficiency of lung and spleen qi,the syndrome of deficiency of lung and kidney,the syndrome of phlegm and heat obstructing the lung,the syndrome of phlegm and turbidity obstructing the lung,and the syndrome of Yin deficiency and fire.3.Cluster analysis results showed that patients in the acute stage were grouped into five categories: the first category was phlegm heat obstructing lung syndrome,the second category was phlegm turbidity obstructing lung syndrome,the third category was lung qi deficiency syndrome,the fourth category was Yin deficiency fire abundant syndrome,and the fifth category was liver fire invading lung syndrome.Patients in remission stage are also grouped into five categories,the first category is lung qi deficiency syndrome,the second category is phlegm turbidity lung obstruction syndrome,the third category is liver fire incurring lung syndrome,the fourth category is phlegm heat obstructing lung syndrome,and the fifth category is Yin deficiency fire burning syndrome.4.Use of prescriptions: the top three decoction recipients in the acute stage included 75 cases of Sangbaipi Decoction(33.33%),30 cases of Qingjin Huatan Decoction(13.33%),and24 cases of Erchen Decoction and Sanziyangqin Decoction(10.67%).The top three decoction for patients in remission stage were Bufei Decoction in 26 cases(18.06%),Shenling Baizhu Powder in 20 cases(13.89%),Erchen Decoction and Sanzi Yangqin Decoction in 18 cases(12.50%).Conclusion 1.Distribution bronchiectasis clinical syndrome types of TCM syndrome differentiation in Hohhot,according to the acute phase is given priority to with phlegm heat indicates the lungs,and at the same time see lung spleen kidney deficiency,remission is given priority to with lung spleen-deficiency,and miscellaneous phlegm heat and phlegm turbidity,proving lung deficiency,phlegm hot temper always throughout the disease,the pathogenesis of the disease for lung spleen-deficiency,phlegm heat indicates,the disease of sex of this virtual to real.2. The distribution of TCM syndromes in clinical syndrome differentiation is confirmed by cluster analysis,which provides mathematical basis for clinical syndrome differentiation.3.The TCM syndrome type in the acute stage of bronchiectasis is mainly phlegm-heat obstruction to the lung.The TCM prescriptions are added and subtracted with mulberry baipi decoction as the basic formula to clear away heat and dissolve phlegm,and at the same time,less ingredients are added to replenish qi,reflecting the meaning of "treating qi first when treating phlegm,and eliminating phlegm when qi is smoothing".Alleviation period is mainly lung qi deficiency,treatment attaches importance to invigorating spleen,nourishing lung and tonifying kidney,using bufei decoction and shenling baizhu powder as the basic formula for addition and subtraction,plus heat clearing,nourishing Yin products,both the symptoms and root causes of treatment,reflecting the meaning of "spleen nourishing,soil from gold",is of great benefit to guiding clinical treatment of bronchiectasis.