| Objective:To explore TCM syndrome differentiation and syndrome characteristics of hospital-acquired drug-resistant bacterial pneumonia,and to analyze its correlation with inflammatory indicators(WBC,CRP,PCT)and basic diseases,so as to lay a foundation for TCM clinical diagnosis and treatment and further research.Methods:Collected through scale of syndromes in January 2020-December 2020 in jiangmen wuyi traditional Chinese hospital diagnosed with hospital acquired drug resistance bacteria pneumonia patients' general information,basic diseases,clinical symptoms and inflammation index(the WBC,CRP and PCT),sputum culture and drug susceptibility results,such as database,set up by using the Excel table using SPSS19.0on statistical analysis of count data comparison with chi-square,multiple sets of measurement data with the single factor analysis of variance,with P < 0.05 for the difference is statistically significant.Systematic clustering was used for cluster analysis.Ward method was used as clustering method,and square Euclidean distance was used as measurement standard.Results:1.A total of 136 patients with hospital-acquired drug-resistant bacterial pneumonia were collected.Most of them were elderly males,with an average age of74.34 ± 11.56,and males accounted for 63.24%.Department of encephalopathy(46.32%)accounted for the majority of the departments,with multiple basic diseases and multiple invasive operations.2.The most common symptoms are cough,fever,yellow phlegm,wheezing,chest tightness,fatigue,less qi lazy speech,red tongue,yellow greasy moss,slippery pulse,etc.;According to the summary of symptoms: the first type of disease syndrome elements are phlegm heat,wind heat,disease location syndrome elements in the lung;The second type of syndrome elements are phlegm heat,qi deficiency,phlegm dampness,and the disease site syndrome elements are in the lungs and spleen.The third type of syndrome elements are phlegm heat,blood stasis and spleen deficiency,and the disease site syndrome elements are located in the lungs and spleen.The fourth type of syndrome elements are Qi deficiency,solid heat deficiency and Yin deficiency,and the disease position syndrome elements are mainly in the heart and lung;3.In the distribution of various TCM syndromes,the syndromes of phlegm-heat obstructing the lung accounted for 38.24%,the syndromes of qi and Yin deficiency accounted for 15.24%,the syndromes of wind-heat invading the lung accounted for13.97%,the syndromes of phlegm-dampness obstructing the lung accounted for11.76%,the syndromes of high heat in the lung and stomach accounted for 8.82%,the syndromes of heat clogging the pericardium accounted for 5.88%,and the syndromes of pathogenic obstruction accounted for 5.88%;4.There was no difference in WBC(F=1.102 P=0.310)and CRP(F=1.236 P=0.292)among all syndromes;There were differences in PCT(F=44.514 P=0.000)among syndromes.5.The top five complicated basic diseases were cerebrovascular disease(82.35%),hypertension(80.88%),diabetes mellitus(39.71%),anemia(37.50%)and respiratory failure(37.50%);The syndrome of phlegm-heat obstructing lung was the main type in all the complicated basic diseases,and there was no difference between each syndrome type and each basic disease(P ?0.05).6.Gram-negative bacteria were the majority(82.66%),Acinetobacter baumannii was the most common,followed by Klebsiella pneumoniae(29.41%),Pseudomonas aeruginosa(18.82%),Staphylococcus aureus(17.34%),Escherichia coli(10.70%);The distribution of drug-resistant bacteria among different syndromes of traditional Chinese medicine(P=0.316 ? 0.05)was not statistically significant,indicating that there was no correlation between the distribution of drug-resistant bacteria among different syndromes.Conclusion:Among the patients with hospital-acquired drug-resistant bacterial pneumonia,phlegm-heat accumulation of lung syndrome was the most common TCM syndrome type.There were no differences in WBC and CRP among all syndrome types,but differences in PCT among all syndrome types.The syndrome of phlegm and heat obstructing the lung was more common in the complicated basic diseases,and there was no difference in the basic diseases among different syndrome types.There was no difference in the types of drug-resistant bacteria among TCM syndromes.Most of them are elderly people.It is possible that the constitution of deficiency of both Qi and Yin is the susceptible constitution of hospital acquired drug-resistant bacterial pneumonia.Gram-negative bacteria were the main drug-resistant bacteria,Acinetobacter baumannii was the most common.Invasive operation and associated cerebrovascular disease are the risk factors.The basic pathogenesis of hospital-acquired drug-resistant bacterial pneumonia is positive-deficiency-evil-hiding and feeling. |
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