Correlation Of Chinese Medical Evidence And Inflammatory Indexes In Adults With Non-severe Community-acquired Pneumonia

Objective:To investigate the relationship between each TCM evidence type and C-reactive protein(C-reactive protein,CRP),procalcitonin(PCT),white blood cell count(WBC),percentage of neutrophils(NEU%),lymphocytes(LYM%),lymphocytes(LYM%),lymphocytes(NEU%),and lymphocytes(LYM%)in non-severe community-acquired pneumonia(NSCAP).The correlation between each TCM evidence type and inflammatory indexes such as C-reactive protein(CRP),Procalcitonin(PCT),White blood cell(WBC),Percentage of neutrophils(NEU%),Lymphocytes(LYM%),Eosinophilic granulocyte(EOS),etc.,in order to better guide the clinical evidence.in order to better guide clinical evidence typing and treatment and improve the clinical efficacy of TCM.Methods:a retrospective study was used to collect the data of adult NSCAP patients hospitalized from June 2021 to December 2022.The patients were re-classified according to the relevant TCM guidelines of community-acquired pneumonia,and the general data,main symptoms and inflammatory indexes such as CRP,PCT,WBC,NEU%,LYM%and EOS were statistically analyzed.Results:1.A total of 316 cases were included in this study,including 175males(55.38%)and 141 females(44.62%).The youngest was 18 years old,the oldest was 98 years old,the average age was 61.53±18.94 years old;the incidence rate was the highest in spring(37.97%),followed by winter(28.80%);the number of hospitalization days was 0<n≥7(41.14%),and 63cases(19.94%)had a personal history of smoking.2.The distribution of NSCAP TCM syndrome types is as follows:phlegm blocking lung syndrome(49.05%)>phlegm-heat obstructing lung syndrome(19.30%)>external cold and internal heat syndrome(18.67%)>wind-heat attacking lung syndrome(12.97%).3.There were significant differences in age,smoking history and seasonal distribution of NSCAP among the four syndrome types,but there was no significant difference in sex and hospitalization course.The highest average age distribution was phlegm-turbid lung syndrome(64.03 years old);the highest proportion of smoking history was external cold and internal heat syndrome(33.90%);the syndrome types with higher incidence in the four seasons were spring-phlegm-heat obstructing the lung(55.74%),summer-wind-heat attacking the lung(29.27%),autumn-external cold and internal heat(18.64%),winter-turbid phlegm blocking the lung(33.55%).4.In the statistics of the main symptoms of the included cases,297patients had cough(93.99%),264 patients had expectoration(83.54%),104patients had yellow sputum(32.91%),121 patients had dyspnea(38.29%),140 patients had chest pain(44.30%),and the minimum body temperature was 36.2℃,the maximum was 41℃,and the average was 37.85±1.28℃.5.There were significant differences in expectoration,yellow sputum,chest pain and the distribution of body temperature among the four groups of NSCAP,but there was no significant difference in cough and dyspnea.The syndrome of phlegm-heat obstructing the lung has the most expectoration(91.80%)and yellow sputum(73.77%),the syndrome of wind-heat attacking the lung has the most chest pain(58.54%),and the average body temperature distribution of external cold and internal heat syndrome is the highest,39.14℃.6.According to the score of the extent of involvement of chest CT imaging lesions,it was found that the extent of chest CT lesions of NSCAP was less than 30%.There were 212cases(67.09%).The chest CT imaging of the four syndrome types had no statistical significance(P>0.05).7.There was significant difference in the distribution of PCT,CRP and WBC among different syndrome types of NSCAP,but there was no significant difference in NEU%,LYM%and EOS.8.PCT level:the average PCT distribution of the four syndrome types was in the following order:wind-heat attacking lung syndrome(0.528ng/m L)>phlegm-heat obstructing lung syndrome(0.467ng/m L)>external cold and internal heat syndrome(0.466ng/m L)>phlegm-turbid lung obstruction syndrome(0.265ng/m L).There was a significant difference between the syndrome of turbid phlegm blocking the lung and the syndrome of external cold and internal heat(P<0.05).9.CRP level:the average CRP distribution of the four syndrome types was in the following order:external cold and internal heat syndrome(59.54mg/L)>phlegm-heat obstructing lung syndrome(58.25mg/L)>wind-heat attacking lung syndrome(54.10mg/L)>phlegm-turbid lung obstruction syndrome(41.48mg/L).There was a significant difference between the syndrome of phlegm-heat obstructing the lung and the syndrome of turbid phlegm blocking the lung(P<0.05).10.WBC level:the average WBC level distribution of the four syndrome types is as follows:wind-heat attacking lung syndrome(12.49×10^~9/L)>external cold and internal heat syndrome(12.17×10^~9/L)>phlegm-heat obstructing lung syndrome(11.59×10^~9/L)>turbid phlegm blocking lung syndrome(10.33×10^~9/L).There was a significant difference between the syndrome of turbid phlegm blocking the lung and the syndrome of external cold and internal heat(P<0.05).Conclusion:1.The collected cases are mainly composed of syndrome of turbid phlegm blocking the lung,syndrome of phlegm-heat obstructing the lung,syndrome of external cold and internal heat,and syndrome of wind-heat attacking the lung."wind pathogen"and"heat pathogen"are important pathogenic factors of NSCAP,and"phlegm"and"heat"are the main pathological factors of its development.2.The age of the patients,personal history of smoking and the season of onset all have influence on the formation of NSCAP syndrome.3.The symptoms of expectoration,yellow sputum and chest pain and the distribution of body temperature are different in different syndrome types of NSCAP.The symptoms of expectoration and yellow phlegm are the most in the syndrome of phlegm-heat obstructing the lung,the chest pain is the most in the syndrome of wind-heat attacking the lung,and the average body temperature distribution is the highest in the syndrome of external cold and internal heat.In the process of clinical medication,it should vary from person to person,dialectical medication,not one party and one disease.4.Each syndrome type of NSCAP is correlated with the horizontal distribution of PCT,CRP and WBC.The horizontal distribution of PCT,CRP and WBC can provide some reference for the syndrome differentiation of NSCAP TCM syndrome.