Significance Of Traditional Chinese Medicine Excess And Deficiency Syndrome Element For Prognosis Of The Patients With Sepsis And Its Correlation Analysis Between Neutrophil/lymphocyte Ratio

Objective1.To explore the clinical significance of syndrome differentiation of deficiency and excess in sepsis by analyzing the correlation between syndrome differentiation of deficiency and excess in sepsis and disease severity and clinical prognosis.2.To clarify the value and significance of neutrophil/lymphocyte(NLR)in syndrome differentiation of deficiency and excess of sepsis and judgment of disease changes.MethodClinical data of 99 patients with sepsis admitted to Guangdong Hospital of Traditional Chinese Medicine from March 2016 to December 2018 were retrospectively collected,including admission symptoms,signs,organ f’unction,acute physiology and chronic heal th score(APACHE-Ⅱ score),sequential organ failure assessment score(SOFA score),treatment methods,neutrophil neutrophil count(NEU),lymphocyte count(LYM),serum lactic acid(LAC),hypersensitive C-reactive protein(CRP),Procalciton in(PCT),7-day fatality rate and 28-day fatality rate were measured,and other indicators exept prognostic information were collected before and after the change of illness.According to the criteria of syndrome difforentiation,the physicians with certain clinical experience can differentiate the deficiency and excess of sepsis according to the four diagnostic information collected.The differences of symptoms,signs,laboratory indicators,organ functions,scores and prognosis between the two groups were compared.Logistic regression analysis was carried out on the indicators with statistical significance to clarify the factors related to syndrome differentiation of deficiency and excess,and then to explain the clinical significance of syndrome differentiation of deficiency and excess.At the same time,according to whether there is transformation of deficiency syndrome and disease change in the course of disease,the dynamic changes of the above indicators in different groups were compared,and the significance of NEUT,LYM,neutrophil/lymphocyte(NLR)in syndrome differentiation and disease change of sepsis was emphatically analyzed.SPSS17.0 was used for statistical analysis.The test level of alpha was P<0.05,indicating that there was a significant difference between groups.Result1.A total of 99 cases of sepsis were included in the medical records.Among them,there were 36 cases in deficiency syndrome group,20 males and 16 females,with an average age of 76.03±14.66 years;63 cases in the empirical group,24 males and 39 females,with an average age of 75.33±12.57 years.There was no significant difference between the two groups in sex,age,underlying diseases and infection sites P>0.05.2.There were significant differences in SOFA score,NEUT,LYM,NLR,mechanical ventilation and the use of vasoactive drugs between the two groups(P<0.05).In deficiency syndrome group,SOFA score,NEUT and NLR were higher,LYM was lower,and more mechanical ventilation and vasoactive drugs were used.Further logistic regression analysis showed that NEU and NLR were more correlated with the syndrome differentiation of deficiency and excess of sepsis(P<0.05),and ROC curve showed that the area under the curve was the largest when NLR was used to judge the syndrome of deficiency of sepsis.3.There was no significant difference between the groups of NEU,LYM and NLR(P>0.05).Further analysis of the change characteristics of NEU,LYM and NLR in different trends showed that the changes of NEU and NLR were more obvious before and after the change from severe to light group than those of sepsis(JY0.05).Conelusion1.The deficiency syndrome of sepsis is related to the severity of the disease.When deficiency syndrome 1s prominent,organ dysfunction and immunosuppression may be more serious.2.NLR is of certain significance in judging the syndrome differentiation of deficiency and excess in sepsis.With the increase of NLR,the possibility of deficiency and excess in sepsis is greater.It has certain reference value for the combination of syndrome differentiation of sepsis and laboratory indicators,and is conducive to the objectification of syndrome differentiation of deficiency and excess in sepsis.3.NEU,LYM,and NLR are not only helpful to the syndrome differentiation of deficiency and excess of sepsis,but also helpful to evaluate the dynamic changes of NEU and NLR during the treatment of sepsis.The obvious decrease of NEU and NLR may indicate the further development of sepsis.