The Study On Traditional Chinese Medicine Syndromes And Clinical Features Of The Community-acquired Pneumonia In Obese People

ObjectiveThis article takes community-acquired pneumonia patients as the research object and analyzes the differences in clinical characteristics of the obese group and the non-obese group,such as the Traditional Chinese Medicine(TCM)syndromes and common symptoms,signs,etiology,imaging,clinical tests,and disease evaluation related indicators to provide objective basis for the treatment of the community acquired pneumonia in obese people with TCM.MethodsA retrospective survey method was used to collect 109 inpatient patients who were discharged from the Department of Respiratory Medicine and Emergency Department of Guangdong Provincial Hospital of TCM and were diagnosed with community-acquired pneumonia from January 2019 to December 2019.The patients were grouped according to the BMI,BMI<25kg/m2 in the non-obese group,BMI>25kg/m2 is considered to be the obese group.Recording two groups of TCM syndromes manifestations and common symptoms,signs,etiology,imaging,clinical examination and disease evaluation indicators in order to explore TCM syndromes and clinical features of community acquired pneumonia in obese people preliminary.Results1.Baseline data:109 cases were divided into non-obese group and obese group,57 cases were in non-obese group,including 31 females and 26 males;52 cases were in obese group,including 28 female and 24 males.After statistical analysis,there had insignificant difference in the age,gender,hypertension,diabetes,coronary heart disease,hyperlipidemia,smoking history and drinking history between the two groups(P>0.05),which was comparable.2.Common clinical symptoms and signs:There had insignificant difference in clinical signs such as fever,cough,sputum expectoration,chest tightness,chest pain,increased respiratory rate(R>30 times/min),wet rales and other clinical signs between the two groups(P>0.05).3.Clinical test indicators:There had insignificant difference in WBC,PCT,NEUT%,LYM,blood gas analysis results between the two groups(P>0.05),and had significant difference in CRP between the two groups(P<0.05).4.Results of etiology and imaging:There had significant difference in the bacteria detection rate between the two groups(P<0.05),and had insignificant difference in the undetection rate,virus detection rate,fungal detection rate,mycoplasma detection rate and other pathogen detection rate.Besides,there had significant difference in the large shadow of the imaging findings between the two groups(P<0.05),and had insignificant difference in the small shadow,pleural effusion,and other imaging findings between the two groups(P>0.05).5.Other clinical indicators:There had significant difference in the CURB-65 score between the two groups(P<0.05),and had insignificant difference in days of hospitalization and antibiotic use and non-invasive assisted ventilation time between the two groups(P>0.05).6.Systemic symptoms:There had significant difference in fatigue,abdominal distension.loose stools,diarrhea,dry mouth,and bitter mouth between the two groups(P<0.05),and had insignificant difference in chills,nausea,headache,irritability,vomiting,constipation,anorexia,hiccups,palpitations between the two groups(P>0.05).7.Tongue and pulse conditions:There had significant difference between the two groups of tongues showed dim and dark red(P<0.05),and had insignificant difference between the two groups of tongues showed red and light red(P>0.05).As for the tongue coating,there had significant difference between the two groups showed greasy coating,while had insignificance in thick fur,yellow fur,white fur,thin fur,and little fur(P>0.05).In terms of pulse condition,there had significant in slippery pulse(P<0.05),while had insignificant difference in string pulse,rapid pulse,deep pulse,slow pulse and thready pulse between the two groups(P>0.05).8.The composition ratio of TCM syndrome types in the two groups:The distribution of TCM syndrome types in the non-obese group,in high to low order,were phlegm-heat obstructing lung syndrome>evil invading lung health syndrome>phlegm turbidity blocking lung syndrome>lung and spleen Qi deficiency syndrome>Qi Yin deficiency syndrome,while the distribution of TCM syndrome types in the obese group,in high to low order,were phlegm-heat obstructing lung syndrome>phlegm turbidity blocking lung syndrome>lung and spleen Qi deficiency syndrome>evil invading lung health syndrome>Qi Yin deficiency syndrome.9.Two groups of different TCM syndrome-type inflammation indicators:There had insignificant difference in the white blood cell count and procalcitonin between two groups of different TCM syndrome types(P>0.05),while had significant difference in the CRP between two groups of phlegm-heat obstructing lung syndrome,phlegm turbidity blocking lung syndrome and evil invading lung health syndrome(P<0.05).Conclusion1.Common clinical symptoms and signs of CAP in obese people,such as fever,cough,sputum,chest tightness and chest pain are not typical.2.CAP in obese people is clinically more prone to symptoms such as fatigue,abdominal distension,loose stools,diarrhea,dry mouth,bitter mouth,etc.Besides,the tongue color is mainly dark red and dull,the coating is greasy,and the pulse is mainly slippery.3.The key pathological factors of CAP in obese people were mainly phlegm,heat,dampness,blood stasis,and deficience.4.The distribution of TCM syndrome types in the CAP in obese people,in high to low order,were phlegm-heat obstructing lung syndrome>phlegm turbidity blocking lung syndrome>lung and spleen Qi deficiency syndrome>evil invading lung health syndrome>Qi Yin deficiency syndrome.5.CAP in obese people has higher CRP in phlegm-heat obstructing lung syndrome,phlegm turbidity obstructing lung syndrome,and evil invading lung health syndrome.6.CAP in obese people is mainly bacterial infection,with more severe inflammatory reaction,larger imaging lesion range,longer hospitalization days and antibiotic use days,and more serious condition.So it should be timely included obese patients who diagnosed with community-acquired pneumonia in the risk management population and pay close attention to the changes in patients’ conditions.