| BackgroundThe incidence of pneumonia caused by ESBLs producing drug-resistant bacteria is increasing.There are many risk factors,such as wide range of risk factors,wide resistance range,long delay in diagnosis and treatment,long course of anti infection treatment,high price and high mortality.It has become an important clinical problem which seriously threatens human health.Combined with modern research found that drug resistant bacteria pneumonia with phlegm heat in the lung,a syndrome of wind heat invading lung evolved,also visible heat closed pericardium,the middle is a critical period of change whether there is evidence,trying to take a license from the invasion of other syndromes evolved in the late two Qi and Yin deficiency.Traditional Chinese medicine has the effect of anti bacterial activity and immune function,and it can get better curative effect in the treatment of drug-resistant bacteria pneumonia.At present,the syndrome studies of drug-resistant bacteria pneumonia mainly focus on the infection caused by a certain type of drug-resistant bacteria,and seldom relate to the relationship between a certain drug resistance mechanism and the syndrome.Therefore,TCM emphasizes differentiation and treatment,explores the underlying mechanism of a disease based on the general view,and a certain mechanism of bacterial resistance may be related to the pathogenesis of traditional Chinese medicine.This study mainly from the risk of producing ESBLs common antibiotic resistant bacteria pneumonia factors and clinical manifestations of angle,discuss TCM syndrome of ESBLs producing common antibiotic resistant bacteria pneumonia characteristics and core diseases,to provide reference basis for common drug resistant bacteria pneumonia for further treatment of traditional Chinese and Western medicine ESBLs.ObjectiveTo investigate the general information,past medical history,clinical manifestation,laboratory examination,imaging examination and drug sensitivity test of pneumonia caused by ESBLs drug-resistant bacteria,we investigated the characteristics and TCM syndrome characteristics of pneumonia caused by ESBLs drug-resistant bacteria.Method1.Review of Drug-resistant bacteria pneumonia in recent 10 years related literature at home and abroad,experts consultation and feasibility analysis,and combined with the clinical features of Pneumonia caused by ESBLs resistant bacteria,at the same time,according to the state administration of traditional Chinese medicine in 1994,editor of "standard of diagnosis of disease and curative effect of traditional Chinese medicine" and in 2002,zheng xiaoyu,editor of "Chinese medicine new medicine clinical research guiding principles(try out)",to develop the scale of Pneumonia caused by ESBLs resistant bacteria of TCM syndrome types.2.Using a retrospective study method,From January 2015 to December 2017,the First Affiliated Hospital of Beijing University of Chinese Medicine Department of respiration,Dongzhimen Hospital Department of nephropathy,emergency department,ICU,EICU,CCU,produce patient diagnostic information of traditional Chinese medicine and other,related clinical data of hospitalized pneumonia caused by drug-resistant bacteria ESBLs,In detail,the"TCM syndrome type questionnaire for pneumonia caused by ESBLs resistant bacteria" was completed in detail.3.Using the Excel table to establish the related database,The general,medical history,clinical symptoms,Drug sensitivity test,laboratory examination,imaging examination results,TCM syndrome type,etc.and symptoms of a clinical case,enter the document and check it one by one to ensure the accuracy of the data.4.The use of SPSS20.0 software package for clinical data were analyzed by frequency,frequency to do descriptive statistical analysis,statistical analysis method based on Spearman correlation analysis the correlation,all statistical tests were two-sided test,P<0.05 for correlation with statistical significance.The statistical method of chi square test was used to make a difference analysis between groups.P<0.05 was different and had statistical significance.Result1.Evaluation of pneumonia caused by ESBLs resistant bacteria:The mortality of pneumonia caused by ESBLs resistant bacteria was high,about 23.64%.2.General situation of pneumonia caused by ESBLs resistant bacteria:Most of the pneumonia caused by ESBLs resistant bacteria occurred in the elderly over 80 years old,accounting for about 40.91%of the total.The average age was 77 + 10.33 years.Among the 110 cases of pneumonia caused by ESBLs resistant bacteria,67.30%were male and 32.70%were women.3.The risk factors of pneumonia caused by ESBLs resistant bacteria:a variety of basic diseases and complications,the history of repeated attacks of pneumonia,the frequent use of beta lactamases,cephalosporins and quinolones is an important risk factor for the disease.Among the patients with pneumonia caused by ESBLs resistant bacteria,there are at least 3 basic diseases,and the most basic diseases have 12 basic diseases.A large majority of patients have 7.54 + 2.07 basic diseases.The proportion of the respiratory system,the cardio cerebral vascular system and the endocrine system is high.Cerebrovascular disease,hypoproteinemia,coronary atherosclerotic heart disease,interstitial pneumonia and electrolyte disorder are the most common.And the incidence of complications is high.The three most common complications are hypokalemia,hyponatremia and atrial fibrillation,but the incidence of respiratory failure and acid-base balance is less;97.27%of the patients with pneumonia caused by ESBLs-resistant bacteria were used antibiotics and used more than 20%of the common antibiotics.The frequency of use is from high to low in order to be beta lactamases.carbapenem rings,cephalosporins,quinolones,and continuous application of antibiotics for 8-14 days(about 29.09%of the total).4.The clinical features of pneumonia caused by ESBLs resistant bacteria:ESBLs producing bacteria caused by pneumonia often cough and sputum,sputum color is yellow,sticky or brushed like phlegm,sputum volume,difficult to expectorate,wheezing,shortness of breath,fever,sweating,chest pain,lassitude,consciousness disorder,anorexia,thirst,constipation as the main clinical manifestations.The tongue with red tongue,yellow greasy moss,moss less or no moss most common.The pulse is most common in pulse chords,slippery,thin,and number.The clinical symptoms of different sex and age were not different,and there was no statistical significance.5.Characteristics of TCM syndrome type of pneumonia caused by ESBLs resistant bacteria:The most common TCM Syndromes of pneumonia caused by ESBLs resistant bacteria were Qi Yin two deficiency syndrome and phlegm heat syndrome,and two or three types of syndromes appeared at the same time in most patients.The distribution of the syndrome is not related to age,and there is no significant difference from sex,but there is a significant difference with the prognosis of the disease.Conclusion1.The death rate of pneumonia caused by ESBLs resistant bacteria is high,and most of them occur in the elderly over 77 years old,and the male is more common than women.It often has a variety of underlying diseases and complications,recurrent pneumonia,frequent use of beta lactamases,cephalosporins,quinolones and other risk factors.2.The characteristics of TCM syndrome of ESBLs producing bacteria pneumonia:cough,expectoration,sputum color is yellow,sticky or brushed like phlegm,sputum volume,difficult to expectorate,wheezing,shortness of breath,fever,sweating,chest pain,lassitude,consciousness disorder,anorexia,thirst,constipation as the main clinical manifestations.The tongue with red tongue,yellow greasy moss,moss less or no moss most common.The pulse is most common in pulse chords,slippery,thin,and number.The clinical symptoms of different sex and age were not different,and there was no statistical significance.3.The most common TCM syndrome types of pneumonia caused by ESBLs resistant bacteria were Qi Yin two deficiency syndrome and phlegm heat syndrome,and two or three types of syndromes appeared at the same time in most patients.The distribution of the syndrome is not related to age,and there is no significant difference from sex,but there is a significant difference with the prognosis of the disease. |
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