Study On The Correlation Between TCM Syndrome Types Of Sepsis And Procalcitonin And Blood Lactic Acid

Objective:The purpose of this study was to observe,analyze and discuss the correlation between different TCM syndromes of sepsis and PCT and LAC values in diagnosis and prognosis,and to explore the value of PCT and LAC for sepsis.Methods:104 ICU inpatients from suzhou hospital of traditional Chinese medicine affiliated to nanjing university of traditional Chinese medicine from June 2017 to January 2019 were selected,including 104 patients with sepsis.The names,gender,age,body temperature,respiration and other general information of the patients were collected.The laboratory data of WBC,CRP,d-dimer and BNP were collected.SOFA score and APACHEII score were completed according to the collected data.According to TCM classification criteria,the included cases were divided into three groups:heat syndrome,blood stasis syndrome and deficiency syndrome.According to the 28-day prognosis,the cases were divided into the death group and the survival group,and the cases were divided into the sepsis group and the sepsis shock group according to the diagnostic criteria of western medicine.The dynamic and venous blood of the patients on the 1st,3rd and 5th days was collected and sent to the laboratory department of our hospital to determine the PCT and LAC values,analyze the correlation between TCM syndrome types of sepsis,PCT and LAC,and analyze the collected data with spss22.0 professional statistical software.To conform to the normal distribution of variables measurement data with normal distribution mean+/-standard deviation(X±S)said,the comparison between the groups using analysis of variance;Pearson chi-square test was used to determine the correlation between TCM syndromes and western medicine syndromes of sepsis.Anova of repeated measurements was used to determine the correlation between TCM syndromes and PCT and LAC multi-time point measurements.Comparison of diagnostic efficacy and prognostic efficacy was achieved by drawing ROC curve.P<0.05 was considered statistically significantResults:1.The difference in the incidence and mortality of shock among different TCM syndromes of sepsis was statistically significant(p<0.05),indicating different severity of the three syndromes.2.The collected PCT values of 1,3 and 5 days were compared with those of different TCM syndromes by repeated measurement analysis of variance.PCT values of patients with three different syndromes showed significant difference on the first day(p<0.001).Sepsis patients with different TCM syndrome types 1,3,5 days of concentration variation trend is different,heat syndrome group of PCT values gradually decline in 1,3,5 days,there was an obvious statistical significance difference(p<0.05),and blood stasis syndrome group of PCT value decreased from 1,3,5 days is not obvious,no statistical significance(p>0.05),and deficiency syndrome group of PCT value is very obvious,3 to 5 days of significant difference(p<0.001).3.Repeated measurement anova was performed on the LAC values on day 1,3 and 5 of patients in different TCM syndromes groups.It can be seen that LAC values in different TCM syndromes groups have a similar change trend.The lactic acid value of the deficiency syndrome group on day 1 was significantly higher than that of the remaining two groups(p<0.05),and there was no significant difference between heat syndrome and blood stasis syndrome.There was no significant difference among the three groups on day 3 and day 5(p>0.05).4.According to one-way anova,APACHEII score,SOFA score,PCT value on the first day,and LAC value on the first day are related to TCM typing.By drawing ROC curve,comparing their diagnostic efficacy for TCM syndrome severity of sepsis,it can be seen that:The area AUC under the curve of the PCT value on the first day was 0.796,and its 95%confidence interval was 0.704-0.888.When it was at the optimal cut-off value of 29.12,its sensitivity was 0.656,and its specificity was 0.861.By observing the trend of ROC curve and comparing the results,it can be known that the PCT value on the first day has the strongest diagnostic efficacy for the severity of TCM syndromes,and its sensitivity is stronger than LAC value and APACHEII score on the first day,and its specificity is stronger than all other indicators.Conclusion:1.PCT can be used as an objective index to help TCM dialectical classification and play a role in western medicine diagnosis.2.LAC can also be used as an important indicator of TCM classification and severity of western medicine.3.Changes of PCT and LAC values over time combined with TCM typing can better guide treatment and determine prognosis.