Retrospective Analysis Of Diagnosis And Treatment Characteristics Of Non-severe CAP Inpatients Treated With Integrated Traditional Chinese And Western Medicine

Objective The medical records of patients who were first diagnosed with community-acquired pneumonia（non-severe）in the Department of Pulmonary Diseases and Diabetes in Enshi Tujia and Miao Autonomous Prefecture Nationalities Hospital from January 2019 to December 2021 were collected.In other aspects,through retrospective analysis,to understand the actual diagnosis and treatment of non-severe CAP inpatients in our hospital,summarize the experience of traditional Chinese and Western medicine treatment,explore the rules of traditional Chinese medicine and prescription,and provide data reference for the follow-up diagnosis and treatment of CAP patients.Methods The collected cases were from January 1,2019 to December 31,2021,in the Department of Pulmonary Diseases and Diabetes,Enshi Tujia and Miao-Autonomous Prefecture Nationalities Hospital.The first western medicine diagnosis wasnon-severe CAP inpatients at the time of discharge.The "Information Form for Retrospective Analysis of Community-Acquired Pneumonia Treated by Integrated Traditional Chinese and Western Medicine" was uniformly formulated,and an Excel database was established according to the content of the patient data in the "Information Form",and the general basic data,medical record data,doctor’s order data,and examination result data of the included patients were filled in in detail.Statistical analysis was performed using SPSS21.0 by including the patient data after exclusion criteria.Results 1.A total of 500 cases were collected in this study,and a total of 486 patients were included after inclusion and exclusion,including 242 male patients（49.79%）and 244 female patients（50.21%）,with a sex ratio of 1:1;the average age was 60.97±15.77 years old,with the highest proportion of 46-69 years old;83.13% of the patients had a smoking history;64.61% of the patients used resident medical insurance to settle bills;a total of 144 patients（29.63%）had the disease in spring,which is the season of high incidence of CAP;60.08% of the patients The patients had past diseases,such as hypertension（117cases,24.07%）,is chemic cerebrovascular disease（78 cases,16.05%）,chronic bronchitis（56 cases,11.52%）,diabetes（39 cases,8.02%）,Coronary heart disease（32cases,6.58%）was the most common;the average hospital stay was 9.17±3.55 days,and the proportion of 6-10 days（289 cases,59.47%）was the highest.2.The western medicines given in the western medicine treatment plan are mainly antibiotics,expectorants,bronchodilators,hormones,and stomach-protecting medicines.The antibiotics used were mainly levofloxacin（347 cases,71.40%）,piperacillin sodium/tazobactam sodium（133 cases,27.34%）,cefoperazone sodium and sulbactam sodium（43cases,8.85%）;Prednisolone（73 cases,15.02%）;phlegm-relieving drugs were eucalyptus and pinene（257 cases,52.88%）;bronchodilators were doxofylline（344 cases,70.78%）,compound methox-yphenamine（143 cases,52.88%）;pantoprazole（68 cases,13.99%）.Western medicine symptomatic and supportive treatment was mainly oxygen inhalation（430 cases,88.5%）.3.The TCM diagnosis was mainly cough disease（265 cases,54.53%）,wind-warm lung-heat disease（140cases,28.81%）,cold disease（25 cases,5.14%）,and the TCM syndrome was phlegm dampness syndrome（172 cases,35.39%）,phlegm-heat syndrome（115 cases,23.66%）,and phlegm-turbid syndrome（48cases,9.88%）.96.91% of the patients used proprietary Chinese medicines,including Tanreqing Injection（455 cases,93.62%）,Shenqi Yifei Syrup（272 cases,55.97%）,Qiangxiao cough syrup（240 cases,49.38%）,Qinggan oral liquid（48 cases,9.88%）was the main one.96.29% of the patients used the characteristic treatment of traditional Chinese medicine in our department,mainly acupoint sticking（451 cases,92.80%）and traditional Chinese medicine foot bath（22cases,4.53%）.The utilization rate of TMC reached 56.38%,and the categories of traditional Chinese medicines were mainly phlegm relieving,cough-relieving and asthma-relieving drugs（1239 frequency,48.70%）,tonic drugs（354 frequency,3.92%）,and heat-clearing drugs（268 frequency,10.53%）.Arrangement of TCM properties:Warm > Ping > Cold > Hot > Cool;Arrangement of TCM flavors: Bitter >Acrid > Sweet > Light.Mainly attributed to the Lung,Spleen and Stomach meridians.High-frequency TCM include Gancao,Fuling,Chenpi,Banxia,Jiegeng,Zisuzi,Baizhu,Baijiezi,Xinren,and Houpu;commonly used drug pairs are Laifuzi-Zisuzi-Baijiezi,Suzi-Baizhu-Cangzhu-Ganjiang.4.The WBC,N%,CRP,PCT and ESR inflammatory indexes of the patients after treatment with effective integrated traditional Chinese and western medicine were significantly decreased（P<0.001）.Conclusion 1.Non-severe CAP diseases tend to occur in spring.Most of the hospitalized patients are elderly patients with a high smoking rate.The type of medical insurance is mainly resident medical insurance,and the general hospitalization time is6-10 days.The common underlying disease among CAP hospitalized patients is hypertension,chemic cerebrovascular disease,chronic bronchitis,diabetes and coronary heart disease.2.The western medicine treatment programs of our department are mostly antibiotics,phlegm-reducing drugs,and bronchiectasis,and the symptomatic and supportive treatment methods are mostly oxygen therapy and atomization,which are generally consistent with the recommendations of relevant guidelines.3.The TCM diagnosis of non-severe CAP is mainly based on "cough" and "wind-warming and lung-heat disease",and the syndromes are mainly phlegm-damp syndrome,phlegm-heat syndrome and phlegm-turbid syndrome.The main Chinese patent medicines used are Tanreqing Injection,Shenqi Yifei Syrup,Shabai Langanlang Syrup,Qiangxiao Cough Syrup,Qinggan Oral Liquid and Xiaoyanjiedu Oral Liquid.Commonly used traditional Chinese medicines are mainly based on cough,phlegm and asthma medicines.The medicinal properties are more gentle and mild,the medicinal taste is more bitter and acrid,and most of them return to the lung meridian Laifuzi-Zisuzi-Baijiezi,Suzi-Baizhu-Cangzhu-Ganjiang.4.Non-severe CAP patients can effectively reduce the levels of WBC,N%,CRP,PCT and ESR inflammatory indicators while improving the symptoms of patients after receiving the treatment of integrated traditional Chinese and Western medicine.