Clinical Characteristics And TCM Syndromes Of Infectious AECOPD Caused By Common Pathogens

Research purposes:To summarize the clinical features of acute exacerbation of infectious chronic obstructive pulmonary disease(AECOPD)caused by common pathogens in our department,to provide evidence-based evidence for empirical anti-infective treatment,to improve the accuracy and pertinence of treatment,and to reduce the abuse of antibiotics;explore the relationship between different pathogens and TCM syndromes of infectious AECOPD,provide a reference for TCM syndrome differential treatment,and give full play to the advantages of TCM in anti-infective treatment.Research methods:A retrospective research method was used to take hospitalized patients with infectious AECOPD as the research objects.First,they were grouped and sorted according to the types of pathogens,the distribution of pathogens was summarized,and common pathogens were screened out;collect fever and body temperature level in the early stage of admission(≤3 days),inflammatory factor levels(PCT,CRP,WBC,NEUT,NEUT%,MONO,MONO%,LYM,LYM%),arterial blood gas analysis(PO2,PCO2),pulmonary function Indicators(FVC%pred,FEV1%pred,FEV1/FVC),complications and comorbidities,etc.Statistically analyze the clinical characteristics of infectious AECOPD caused by different pathogens;at the same time,collect patients’ TCM symptoms,tongue and pulse,and summarize their syndrome types,explore the relationship between different pathogen types and TCM syndromes.Research results:1 Distribution of pathogens in hospitalized patients with infectious AECOPD in our departmentCommonly detected pathogens of single infection includes influenza virus(Flu),Haemophilus influenzae(Hin),Mycoplasma pneumoniae(MP),Candida albicans,etc.The common types of mixed infection are mixed infection of virus and atypical bacteria,multiple bacteria Mixed infection,mixed infection of virus and bacteria,etc.Flu,Hin and MP were the three most common pathogens in hospitalized patients with infectious AECOPD in our department.2 Clinical features of infectious AECOPD caused by common pathogensClinical features of infectious AECOPD caused by common pathogens Flu infection is seasonal.The infection rate is high in winter and spring.Patients have abrupt onset and fever.The body temperature is usually between 38.5 and 39℃.It is often accompanied by muscle aches and sputum,LYM%decreased slightly,PCT,WBC count,NEUT count,NEUT%did not increase.In patients with Hin infection,it is common to expect a large amount of sputum,chromoxanthin,anorexia,and abdominal distension.Laboratory examinations often show that PCT,CRP,WBC count,NEUT count,and NEUT%are significantly increased,and LYM%is decreased.MP infection is prone to occur in winter and autumn,and the onset is relatively slow.Patients often have dry cough with little or no sputum,sore throat,and fever.Laboratory examinations often show a slight increase in CRP,NEUT count,and NEUT%,and a slight decrease in LYM%,WBC count,PCT normal or slightly elevated.3 Distribution pattern of TCM syndromes in infectious AECOPD caused by common pathogensThe three groups of patients all involved lung,spleen and kidney.The TCM syndromes of the patients in the Flu group and the Hin group were mainly the syndrome of phlegm-heat obstructing the lung.The Flu group was mostly associated with the syndrome of wind-cold bundling the lung,and the Hin group was often associated with the deficiency of the lung and spleen.The Lung heat injury syndrome was more common in MP group.Conclusions:Flu,Hin and MP are the three most common pathogens in hospitalized patients with infectious AECOPD in our department,and they have their own clinical characteristics and TCM syndromes.AECOPD occurs in winter and spring,with acute onset,fever,body temperature higher than 38.5℃,accompanied by muscle pain,mild increase in CRP,mild decrease in LYM%,and when PCT,WBC and NEUT counts and NEUT%do not increase,Flu infection can be prioritized.When the patient has a large amount of expectoration,chromophore and stickiness,anorexia,abdominal distension,accompanied by a significant increase in PCT,CRP,WBC and NEUT counts,NEUT%,and a decrease in LYM%,Hin infection can be given priority.Occurs in autumn and winter,with slow onset,dry cough with little or no sputum,sore throat,with mildly elevated CRP,NEUT count,NEUT%,slightly decreased LYM%,normal or mildly elevated WBC count and PCT,MP infection can be prioritized.In terms of TCM syndromes,the three groups of patients all involved the three viscera of lung,spleen and kidney.In the Flu group and the Hin group,the syndrome of phlegm-heat obstructing the lung was the main syndrome,and the combination of Flu was mostly combined with the syndrome of wind-cold binding the lung,and the deficiency of the lung and spleen were common in the Hin group.The Lung heat injury syndrome was more common in MP group.