Risk Factors Of Lower Extremity Atherosclerosis In Elderly Patients And Evaluation Of Clinical Pathway Of Traditional Chinese Medicine

Objective: 1.Retrospective analysis of lower extremities atherosclerosis disease(LEAD)and possible risk factors such as gender,age,smoking,hypertension,hyperuricemia(HUA),C-reactive protein(CRP)rise,fibrinogen(FIB)rise,and hyperhomocysteinemia(HHCY)were selected to screen for major risk factors for elderly LEAD.2.Retrospective analysis of the efficacy of the clinical pathway of elderly LEAD Chinese medicine,evaluation of its advantages and disadvantages,to provide a basis for the optimization and improvement of the path to promote clinical promotion and application.Method:1.A retrospective case-control study was conducted.From April 2014 to December 2018,107 elderly patients with LEAD who were admitted to the Geriatrics ward of Yueyang Hospital of Integrated Traditional Chinese and Western Medicine affiliated to Shanghai University of Traditional Chinese Medicine(inpatient group)and hospitalized during the same period.101 elderly patients with non-LEAD(control group)were included in the study.SPSS 21.0 statistical software was used to identify possible risk factors for elderly LEAD such as gender,age,smoking,hypertension,HUA,elevated CRP,elevated FIB,and HHCY.Logistic regression analysis.2.To collect elderly patients with LEAD who did not implement TCM clinical pathways by collecting medical history data from the Department of Geriatrics of Yueyang Hospital of Integrated Traditional Chinese and Western Medicine affiliated to Shanghai University of Traditional Chinese Medicine from April 2013 to April 2017.General clinical data,length of hospital stay,hospitalization expenses,TCM syndrome scores,TCM syndrome efficacy,and re-admission rate within three months of 100(normal group)and 100 elderly patients with LEAD who have implemented TCM clinical pathways(path group)Two years of prognosis.Result:The results of single factor unconditional logistic regression analysis showed that there were positive correlations between gender,age,smoking,hypertension and HHCY(P<0.05).However,there was no statistical difference between HUA,CRP and FIB(P>0.05).Learning meaning.Multivariate and unconditional Logistic stepwise regression analysis of gender,age,smoking,hypertension,and HHCY risk factors showed that the above risk factors were still selected(P<0.05),suggesting gender,age,smoking,hypertension,and HHCY are the risk factors of elderly LEAD.2.Compared with the path group,the general clinical data of the two groups were not significantly different and comparable.Comparing the hospitalization expenses of the two groups of patients,the average value of the total hospitalization expenses,examination fees,western medicine fees,and other expenses in the path group was 4,472.23 yuan,1098.45 yuan,2554.63 yuan,and 573.97 yuan,respectively.The difference was statistically significant(P<0.05).Although the conventional group of Chinese medicine was higher than the path group,the difference was not statistically significant(P>0.05).The total scores of TCM syndromes and the individual scores of the two groups were statistically significant(P<0.05).The differences between the two groups were statistically significant except for the TCM syndromes of chest tightness.(P<0.05),suggesting that both groups can improve the TCM syndrome total score and individual scores of elderly LEAD patients,except for chest tightness,the path group is superior to the conventional group.The TCM syndromes of the two groups were compared.The total effective rate of the conventional group was 85.0%,and the path group was 88.0%.The difference was statistically significant(P<0.05),and the path group was superior to the conventional group.The re-admission rate was compared between the two groups in the three-month period,21.0% in the conventional group and 12.0% in the path group.The difference was not statistically significant(P>0.05).The two-year prognosis of the two groups was statistically significant(P<0.05),and there was no significant difference in the incidence of lower extremity ulcer or gangrene and all-cause death(P>0.05),and the most common cause of death is due to acute cardiovascular and cerebrovascular events.Conclusion:1.Among the risk factors included in the study,gender,age,smoking,hypertension,and hyperhomocysteinemia were the main risk factors for lower extremity atherosclerosis.2.Under the premise of ensuring the clinical efficacy of TCM,the implementation of TCM clinical pathway can not only shorten the length of hospital stay,reduce the total cost of hospitalization,examination fees,western medicine fees,etc.,but also give full play to the characteristics of traditional Chinese medicine treatment,effectively alleviate clinical symptoms,Improve the prognosis for two years.