A Retrospective Analysis Of Clinical Features Of Chinese And Western Medicine Intervention Middle-aged And Old Pneumonia

Background:Pneumonia (root) refers to the terminal airways and alveoli, pulmonary interstitial inflammatory change, but by pathogenic microorganisms, physical and chemical factors, immune injury, caused by allergies and drug [1], is one of the common diseases in the elderly. Due to organ and system function in the elderly age sex, results in the decrease of the body’s immune defense function and respiratory function, and often merge many basic diseases, these all are the risk factors of pulmonary infection. Community-acquired pneumonia (CAP) has long been paying close attention to by many different professional society, and some learn to make the corresponding CAP guidelines, also the senile pneumonia as part of a large CAP crowd, but just passing in the guide of developing. At the same time, guangdong hospital according to CAP the guidelines formulated the corresponding CAP combining traditional Chinese and western medicine treatment of clinical path, the path is also not solve the problem of senile pneumonia is ignored. As pneumonia in the elderly high-risk groups, occupying the important status of the CAP. Therefore, to carry out the clinical features in patients with senile pneumonia and is very important for the study of Chinese and western medicine treatment situation, help to improve our CAP the improvement of the clinical pathway.Objectives:According to the characteristics of age group will be divided into the early stage of the elderly patients with pneumonia and elderly group, retrospective analysis the clinical characteristics of two groups, auxiliary examination results and the information such as the effect of clinical intervention, to explore the clinical characteristics of senile pneumonia, and to provide reference for the establishment of traditional Chinese and western medicine clinical diagnosis and treatment plan. Methods:By retrospective survey method. Medical record information collection table design. Collect jan01,2013-jan01,2014in guangdong hospital of respiratory diagnostic standard of pneumonia patients in the hospital as the research object, it according to the current standard of the old age group (45～59presenium for group A,60～89years old age group B), established by using EXCEL database, collect information of patients, record their gender, age, basic diseases, clinical symptoms, imaging characteristics, pathogen, TCM syndrome type and the intervention effect of traditional Chinese and western medicine information, using SPSS17.0sorts through the data and statistical analysis, the results of discussion and analysis.Result:1.Two groups of gender distribution, hospitalization days to compare all P<0.05, there was no statistically significant difference, the difference of two groups of age distribution (Z=18.404, P<0.05).2. With basic diseases, two groups of hypertension, hypertensive heart disease, coronary heart disease, respiratory failure, pulmonary tuberculosis, diabetes, cerebrovascular disease compared to P<0.05, the difference was statistically significant, there was no statistically significant difference comparing basis of other disease.3. In two groups of symptoms are fever, chest pain, shortness of breath, NaCha compare both P<0.05, the difference was statistically significant.4. The laboratory tests, two groups in neutral grain percentage, compared calcitonin original P<0.05, the difference was statistically significant, the rest of the inflammation index is not significant. In482cases of patients, sputum culture positive rate was21.2%. Elderly group of gram-negative bacteria infection the presenium group.5. The TCM syndrome type analysis, two groups in comparative empirical, factors, and the results are concluded that P<0.05, the difference was statistically significant. In pathological factors, two groups compare clip phlegm heat and blood stasis, clip to the, reached P<0.05, the difference was statistically significant. In virtual aspects, two groups of comparison, lungs and spleen deficiency, lung spleen and kidney, deficiency, reached P<0.05, the difference was statistically significant.6. The use of traditional Chinese medicine prescriptions, proportion of elderly group more for reed stems soup133(44.3%),27(9.0%), fructus forsythiae powder18(6.0%),6. Gentleman MaXingQin sweet soup soup16 (5.3%),2Chen Shang14(4.7%). More proportion of the early stage of the elderly group is reed stems soup67(37.0%),17(9.4%), fructus forsythiae MaXingQin sweet soup17(9.4%),15(8.3%),2Chen Shang check rinse10(5.5%).7. Comparing the two groups in the use of quinolone, beta lactam synthase inhibitors thatP<0.05, the difference was statisticallysignificant. The rest of the antibiotics alone there was no statistically significant difference compared.8. In the two groups in terms of treatment outcome, healing and effective frequency comparison, the results are concluded thatP<0.05, the difference was statistically significant.Conclusion:1.The incidence of a disease, included in the study of our number of pneumonia in patients with elderly group is the early stage of the elderly group and2.1times more likely to prompt the elderly group pneumonia incidence was significantly higher presenium group.2. With basic diseases, the elderly group the presenium group multiple, and mainly for disease of heart head blood-vessel. While presenium group in metabolic disease.3. The clinical symptoms, the elderly group shortness of breath, NaCha symptoms, digestive tract symptoms such as abdominal distension abdominal pain, nausea and vomiting are obvious, while chest pain group performance is at the early stage of the elderly, this research results are basically consistent with the literature, in the clinical treat older patients, to consider when faced with the above digestive tract symptoms in patients with pulmonary infection may, to perfect the relevant examination to avoid misdiagnosis and missed diagnosis.4. There are differences between the two groups in terms of inflammatory biomarkers and calcitonin original is similar between the two groups was statistically significant, considering for elderly patients with disease progression is fast, easy for the development of severe pneumonia, appear even sepsis. One in the white blood cell count, C-reactive protein and blood sedimentation aspects comparison results the two groups have no statistical significance, but overall the inflammation index as high as the elderly group, the reasons for the associated with elderly patients is relatively heavy.5. From the early stage of the elderly group of pathogens is given priority to with mycoplasma, elderly group with fungi (white candida yeast, yeast fungus, smooth candida), gram negative bacteria (pseudomonas aeruginosa, klebsiella pneumoniae, acinetobacter baumannii, gas enterbacteriaceae, freund’s citric acid bacillus) infection.6. Of TCM syndrome types, the early stage of the elderly group is given priority to with the empirical, the justification of the top five type, respectively is a lung phlegm indicates lung, wind hot, lung phlegm turbidity resistance, cold on lung qi deficiency and phlegm heat and blood stasis resistance resistance. Elderly group is given priority to with the empirical, factors, the main deficiency syndrome are two deficiency, qi deficiency, lung and spleen qi and Yin deficiency, lung spleen and kidney, etc;The empirical in phlegm heat and phlegm turbidity and blood stasis and damp turbidity, etc; The justification of the top five type of phlegm heat indicates respectively lung heat, wind made lung, lung and spleen qi deficiency and phlegm heat and blood stasis resistance two virtual, phlegm heat indicates lung, qi and Yin deficiency, phlegm heat indicates the lungs.7. Traditional Chinese medicine prescriptions, two groups the top three prescriptions used frequency are reed stems soup, fructus forsythiae, MaXingQin soup, tip pneumonia patients in acute stage is put to the underlying therapeutic principles. But in the use of tonic prescriptions (born6gentleman soup, pulse dispersion, yiqi decoction) in the aspects of elderly group than in the early stage of the elderly group, the tip in the treatment of elderly patients should pay attention to the centralizer tonify deficiency.8. Antibiotics application, presenium quinolone group to class for the first place, in accordance with CAP guidelines, conform to the hospital clinical pathway, illustrate the hospital for pneumonia in the elderly early group according to the guidelines for medication compliance is good. Elderly group in beta lactam type synthase inhibitor use frequency is more, and the latter than the former in terms of antibiotics is obviously, the elderly group and pneumonia in patients with gram-negative bacteria, and fungi.9. Two groups of curative effect evaluation of the early stage of the elderly group is better, that do not agree with two groups of the illness, related physical baseline also exist differences.