Retrospective Analysis Of Clinical Efficacy And The Medication Rule Of TCM Of 243 Cases With Acute Exacerbation Of Bronchiectasis

Objective:This study is aim to retrospective analysis of clinical efficacy of 243 cases with acute exacerbation of bronchiectasis,through observation and comparison of the inflammatory indicators,symptoms and signs of admission and discharge,obtained data on the differences in clinical efficacy by TCM combined with West Medicine compared with Western medicine alone.Further explore the rules of the treatment of acute exacerbation of bronchiectasis,explore core drug pairs and core prescriptions,and provide new ideas for the clinical use of traditional Chinese medicine in the treatment of the disease.Method:This study included 243 cases of acute exacerbation of bronchiectasis hospitalized in Hubei Provincial Hospital of TCM from January 2018 to December 2020.They were divided into observation group and control group,and the medical records were collected using Microsoft Excel.145 cases with complete laboratory examination data were selected and further divided into integrated traditional Chinese and western medicine treatment group(117 cases)and western medicine treatment group(28 cases),use IBM SPSS Statistics 26.0 statistical software to perform statistical analysis on the admission and discharge TCM syndrome scores and related indicators of the two groups.If p<0.05,the difference is considered to be statistically significant,otherwise the difference is considered to be not statistically significant;The data of observation group of effective cases were cleaned,using cluster analysis and correlation analysis to summarize the rules of drug administration.Results:1.In the acute exacerbation period of bronchiectasis,females and middle-aged and elderly patients are the main patients,and the BMI index of the normal population is lower than that of the normal population.There is an obvious relationship between the incidence and temperature,and it is usually aggravated when the precipitation increases and the temperature changes suddenly.Hypernutrition and hypermetabolic diseases are the main comorbidities,and 22.6% of the patients have a history of old pulmonary tuberculosis.2.Pulmonary infection is the main factor that aggravates the admission of patients with this disease.Anti-infective treatment and symptomatic supportive treatment are routinely used on admission.Among them,traditional Chinese medicine combined with western medicine treatment has obvious differences in reducing white blood cell count,absolute value of neutrophils,and neutrophil percentage compared with simple western medicine;it is better than western medicine treatment group in improving the symptoms and signs of patients with traditional Chinese medicine.3.Inpatients with bronchial expansion in this hospital are mainly the syndrome of phlegm-heat obstructing lung(67.5%),syndrome of dryness invading lung(11.5%),syndrome of deficiency of lung yin(8.6%),and syndrome of phlegm-damp obstructing lung(8.2%);The tongue is mainly red,light red,and dark red;The texture of the tongue coating is usually thin,greasy and thick;the color of the coating is divided into yellow and white;the pulse condition is often seen as stringy,thin,and several.the most commonly used drugs are Armeniaca amara semen,Poria,Rhizoma pinelliae preparata,Tangerine peel,Licorice;the medicinal properties are mainly cold,warm,andcalm;the medicinal taste is mainly sweet,bitter,and pungent;The trend of the channel tropism are mostly Lung meridian of hand-taiyin,Stomach meridian of foot-yangming,and Spleen meridian of foot-taiyin;Drugs,resolving phlegm and relieving cough and asthma,heat-clearing drugs,and tonics for deficiency syndromes are most used;Using cluster analysis to find that high frequency Chinese medicine can divided into seven types,which including replenishing blood and tonifying Yin、clearing lungs、promoting Qi circulaion、invigorating Qi、clearing heat-phlegm、resolving phlegm and relieving cough,promoting production of body flu.Using association rules and complex network analysis to find 12 core drug pairs and 4 new prescriptions.Conclusion : Bronchiectasis tends to occur in middle-aged and elderly women.During the acute attack,external pathogens are the inducement.Turbid phlegm and phlegm heat are the main pathological factors throughout the pathological process.The invasion of external pathogens into the inside is easy to turn into the syndrome of internal heat,combined with turbid phlegm to block the lungs,The development of phlegm-heat obstructing the lung,so in clinical practice,syndrome of phlegm-heat obstructing lung is the most witnessed syndrome type.Therefore,the doctors in Hubei provincial hospital of TCM treating the syndrome of phlegm-heat obstructing lung,syndrome of dryness invading lung,syndrome of deficiency of lung yin,and syndrome of phlegm-damp obstructing lungetc with Clear lungs and resolve phlegm,Clear dryness、nourish lungs and stop bleeding,Nourish yin、 clear lung and stop bleeding,Dry dampness and resolve phlegm,etc.All patients are treated with anti-infective drugs to suppress the fever and aggravate phlegm dampness.Therefore,the commonly used drugs can be used to form Erchen Decoction to dry dampness and resolve phlegm.In addition,patients with this disease have a long course of disease.The basic pathogenesis is the mixture of deficiency and excess.It is based on the deficiency of lung,spleen,qi and yin,so in the acute exacerbation period,it also takes care of nourishing yin and nourishing deficiency.