The Study On The Relationship Between The TCM Syndrome Type And Coagulation Indexes And Inflammation Indexes In Elderly Patients With Community-acquired Pneumonia

ObjectiveUsing statistical methods to investigate the elderly community-acquired pneumonia of TCM syndrome type distribution,and explore the outcome between inflammation indexes(e g,white blood cell count,neutrophilic granulocyte percentage,lymphocytes percentage,procalcitonin,c-reactive protein)and blood coagulation indexes(e g,PT,APTT,FIB.DDI).And to study the correlation among TCM syndrome type,blood coagulation index,and inflammation index.To provide some suggestions for the treatment of elderly community-acquired pneumonia with coagulation dysfunction.MethodsBased on the inclusion and exclusion criteria,300 patients who were older than 65 years old meeting criteria were collected.All the patients were diagnosed CAP in the first affiliated hospital of guangzhou university of TCM between January 2015 and December2020.According to the criteria of TCM syndrome type,dialectical medical patterns were re-established.Information of patients’ general conditions,tongue,inflammation index and blood coagulation index,CURB65 grade were collected.Finally using SPSS25.0 statistical software for analysis.Results1.In terms of the distribution of TCM syndrome type,among the 300 patients,the phlegm heat syndrome accounted for the highest propotion.2.There was no statistical difference in age and tongue among different TCM syndrome types in elderly CAP patients,but there was statistical difference between genders.Male patients with phlegm heat syndrome were more than other Syndromes.3.There was no statistical difference in WBC test value among patients with different TCM syndrome types.But there were statistical differences in inflammatory indexes such as NEU%,LYM%,PCT and CRP.The test values of NEU%,PCT and CRP in patients with phlegm heat syndrome were higher than those in other statistically different groups.4.There were statistical differences in blood coagulation indexes such as PT,APTT,FIB and DDI among different TCM syndrome types,while PT,APTT,FIB and DDI of patients with phlegm heat syndrome were higher than those of other TCM Syndrome types with statistical differences.5.There were no statistical differences in test values of PT,APTT and FIB between patients with and without stasis and dark tongue,but there were statistical differences in DDI values.DDI level was higher in the group with stasis dark tongue.6.There were no statistical differences in test values of APTT and DDI among the elderly patients with different CURB65 rating group,but there was statistical difference in PT value and FIB value.Patients in the high-risk group had higher PT value and lower FIB value.7.The test value of PT,APTT,FIB and DDI was positively-correlated to the value of WBC,NEU%,PCT and CRP,but negatively correlated to LYM%.The correlation coefficient between PCT and PT,APTT,DDI was maximum.and FIB had the largest correlation coefficient with WBC.Conclusion1.The TCM syndrome type of elderly CAP patients is most commom with phlegm heat syndrome,while the majority male patients with phlegm heat syndrome.2.Compared with other syndromes,patients with phlegm heat syndrome have more differences in the blood coagulation indexes and inflammation indexes,and have a greater possibility of developing into severe diseases.3.The higher value of PT and lower value of FIB were correlated to highest CURB65 grade.The elderly CAP patients with higher PT and lower FIB was more likely to become severe illness.4.The correlation coefficient between PCT and PT,APTT,DDI was maximum.PCT was more sensitive in predicting the changes of blood coagulation indexes than other inflammation indexes.FIB was positively-correlated to the value of WBC,so it was not only a blood coagulation index,but also a diagnostic index of inflammatory response.