Type 2 Diabetes Mellitus Elderly Pneumonia Syndrome Law Studies

ObjectiveIn this study, we tried to explore the distribution law of symptoms, tongue and pulse, syndrome elements of the Type 2 diabetic patients with senile pneumonia, so as to find out the key pathogenesis of this disease, and try to improve the standardization of the syndromes diagnosis.And further more, to verify the effects of type 2 diabetes with senile community-acquired pneumonia treated with Qiyin-Sanliangsan Fomula through a clinical study.MethodsThis study is divided into two clinical parts:1.A TCM syndrome information questionnaire was used to Collect the clinical symptoms and the four diagnostic information of 179 cases of the Type 2 diabetic patients with senile pneumonia. We compare the informations with the diagnosis standards of syndrome elements. After statistical analysis of those datas, we can summarize the distribution law of the symptoms, tongue and pulse manifestation, syndrome type and the syndrome elements of this disease.2.Through an randomized controlled clinical study of 60 cases of Type 2 diabetic patients with senile community-acquired pneumonia to verify the effects of Qiyin-Sanliangsan Fomula in treating type 2 diabetes with senile community-acquired pneumonia.Results1.Syndromes study based on the 179 cases of Type 2 diabetes with senile pneumonia:(1) The highest incidence season was in spring and winter. (2) Symptoms analysis:Fever often existed, but the level of fever was usally not high.The temperature was mostly between 37.3℃and 38℃; There was not much sputum while coughing, and cough was often getting worse at night. Yellow sputum was often seen, meanwhile, the sputum was viscosity and was difficult to come out. And other symptoms, such as dry stool, thirst, lack of appetite, wheezing, shortness of breath and fatigue were the main concomitant symptoms. Tongue manifestation:Dark tongue and yellow greasy moss were the most tongue manifestation.Pulse manifestation:Wiry pulse was the most common one, followed by slippery pulse and thread pulse.(3)TCM Syndrome analysis:The most common independent syndromes were Phlegm and heat obstructing the lung, and Insufficiency of both Qi and Yin, which followed by phlegm-damp obstructing the lung, Wind-heat attack the lung, Dryness of the lung fluid, exuberant heat of both the lung and the stomach, and Heat closure of pericardium was relatively less common. The most common composite syndromes were Phlegm-heat, Phlegm-damp and Blood stasis on the basis of Insufficiency of both Qi and Yin. The occurrence frequency of disease location were as follows:lung, spleen, kidney, liver, heart.The occurrence frequency of syndrome factor of disease nature were as follows: fire heat, qi deficiency, phlegm damp, blood stasis, qi stagnation, yang deficiency, blood deficiency, dry.2.Clinical observation in 60 cases of type 2 diabetes with senile community-acquired pneumonia treated by Qiyin-Sanliangsan Fomula:7 days after treatment:the difference of efficiency between treatment group (68.3%) and control group (58.3%) was statistically significant (P<0.05);14 days after treatment:the difference of efficiency between treatment group (88.3%) and control group (71.7%) was statistically significant (P<0.05) too.It shows that the efficiency of treatment group are better than the control group both in 7days and 14days treatment. After treatment, the symptom scores of heat, cough and expectoration significantly decreased, with a significant difference in the decrease of these three symptoms scores between the two groups (P<0.05);The symptom scores of chest pain was no significant difference (P>0.05).It shows that the improvement of treatment group was larger than the control group on the symptoms of fever, cough, expectoration. But there was no difference in the improvement of chest pain;The improvement rate of syndrome scores of the treatment group (93.4%) was better than the control group (76.9%), and the differences between these two groups was statistically significant.Conclusion1.The occurrence frequency of disease location from high to low were as follows:lung, spleen, kidney, liver, heart.The occurrence frequency of syndrome factor of disease nature from high to low were as follows:Phlegm heat, Qi deficiency, Yin deficiency, Blood stasis;The most common Syndrome type was:phlegm-heat stasis along with blood stasis, and Qi and Yin deficiency.2.Qiyin-Sanliangsan Fomula was effective in treatment of type 2 diabetes with senile community-acquired pneumonia, and it was prominent in improving the main symptoms and in the improvement rate of syndrome scores.