| (A)Distribution characteristics of TCM syndromes in sepsis caused by severe pneumonia.ObjectiveTo collect the data of TCM four diagnosis in patients with sepsis caused by severe pneumonia,observe the distribution of syndrome elements,and obtain the characteristics of TCM syndrome types,so as to provide some ideas for TCM diagnosis and treatment in the field of critical diseases.MethodsThis research is a retrospective study.All cases were collected from ICU of the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine,which met the established diagnostic,inclusion and exclusion criteria.Collect the general information,basic medical history,four diagnosis information of traditional Chinese medicine,prognosis and so on,filled into the corresponding questionnaire,established a database,and imported into SPSS21.0 software for analysis,the distribution of corresponding syndrome elements was obtained,and the TCM syndrome types were summarized.Results1 General informationA total of 172 patients with severe pneumonia associated sepsis were included in this part.154 patients were over 60 years old,accounting for 89.53%.The main age group was70～79 years old,accounting for 38.95%.There was no significant difference in age between male and female patients(P >0.05).In the basic medical history,hypertension was the most common,accounting for 55.23%.A total of 76 patients died after 28 days in ICU,with a mortality rate of 44.19%.2 The traditional Chinese medicine aspect(1)A total of 95 TCM four diagnostic information were collected,a total of 2530 cases.(2)Traditional Chinese medicine symptom,unconsciousness,shortness of breath,breathlessness,white phlegm,skin petechias,lip cyanosis,anorexia,phlegm between the larynx,cough is common symptoms.(3)Traditional Chinese medicine symptom,red tongue,greasy tongue coating,slippery pulse,stringlike pulse is common tongue pulse.(4)Syndrome elements:The top four syndrome elements of disease location were lung,mind,kidney,spleen-stomach,accounting for 91.86%,73.26%,62.21% and 60.47%respectively.The top four disease nature of syndrome elements were the retention of phlegm and fluid,Qi deficiency,fire evil,blood stasis,accounting for 88.37%,76.16%,66.28% and54.07% respectively.(5)The most common TCM syndrome type of severe pneumonia associated sepsis are internal obstruction of poison and blood stasis,deficiency of qi and phlegm stagnation,deficiency of body fluid and excess of viscera,excessive heat toxin,deficiency of Yin and Yang.Conclusion1 Sepsis caused by severe pneumonia in unconsciousness,shortness of breath,breathlessness,white phlegm,skin petechias,lip cyanosis,anorexia,phlegm between the larynx,cough,red tongue,greasy tongue coating,slippery pulse,stringlike pulse is the common TCM four diagnostic.2 The main disease-organs of sepsis caused by severe pneumonia is lung,which is closely related to heart,kidney and spleen-stomach.The common disease nature of syndrome elements are the retention of phlegm and fluid,Qi deficiency,fire evil and blood stasis.3 The most common TCM syndrome type of severe pneumonia associated sepsis are internal obstruction of poison and blood stasis,deficiency of qi and phlegm stagnation,deficiency of body fluid and excess of viscera,excessive heat toxin,deficiency of Yin and Yang.(B)To observe the clinical efficacy of Xuebijing injection in patients with sepsis caused by severe pneumonia and blood stasis syndrome differentiation of traditional Chinese medicine.ObjectiveTo observe the clinical efficacy of Xuebijing injection in patients with sepsis caused by severe pneumonia whose TCM syndrome differentiation was blood stasis syndrome,and to verify the improvement of clinical prognosis and relevant laboratory indicators,so as to provide a basis for the treatment of sepsis caused by severe pneumonia with integrated Chinese and Western medicine.MethodsA retrospective study was conducted in this study.According to the established criteria for diagnosis,inclusion and exclusion,a total of 41 patients with sepsis caused by severe pneumonia whose TCM syndrome differentiation was blood stasis syndrome were collected from ICU of the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine from December 2018 to December 2020.The patients were naturally divided into control group(n=21)and experimental group(n=20)according to whether they were treated with Xuebijing injection or not.General information of patients before treatment,basic medical history,laboratory indicators related to admission,28 day mortality and laboratory indicators after treatmentwere collected.SPSS21.0 software was used for analysis to observe whether the clinical laboratory indicators and prognosis were improved.Results1 Baseline comparisonThe baseline to compare two groups of patients ingeneral condition(sex,age),admission score(APACHE-II score,SOFA score),basic medical history,admission laboratory indicators(white blood cell,neutrophil percentage,procalcitonin,blood lactic acid,D-dimer,platelet,fibrinogen)had no statistical significance(P>0.05).2 Inflammation markers(1)White blood cells:After treatment,the white blood cells in both groups were improved compared with before(P < 0.05).The decrease of WBC in experimental group was more obvious than that in control group(P<0.05).(2)Neutrophil percentage:The percentage of neutrophils in experimental group after treatment was significantly lower than that in control group(P<0.05).(3)Procalcitonin:The level of procalcitonin in the experimental group was lower than that in the control group after treatment(P<0.05).3 Blood lactic acidBlood lactic acid was improved in both groups compared with before(P < 0.05).The improvement of blood lactic acid in the experimental group was better than that in the control group(P<0.05).4 Blood coagulation markers(1)D-dimer:After treatment,D-dimer in both groups was improved compared with before(P<0.05).The D-dimer in the experimental group was significantly improved than that in the control group(P<0.05).(2)Platelet:Platelet in the control group was significantly decreased compared with before(P < 0.05),while platelet in experimental group was not significantly decreased compared with before(P>0.05).(3)Fibrinogen:Fibrinogen decreased in both groups(P<0.05),and the decrease in control group was more obvious than that in experimental group(P<0.05).5 The 28-day mortality rateThe 28-day mortality rate of experimental group was 30.00%.The 28-day mortality rate of the control group was 42.86%.The improvement of prognosis has not reached statistical significance(P>0.05).ConclusionFor patients with sepsis caused by severe pneumonia and TCM dialectical syndrome of blood stasis,Xuebijing injection combined with Western medicine treatment can improve Inflammation markers(White blood cells,neutrophil percentage and Procalcitonin),blood lactic acid,blood coagulation markers(D-dimer),and reduce the consumption of blood clotting substances(Platelet and Fibrinogen). |
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