The Study Of The Common Syndrome Elements And Identification Criteria Of Stroke-associated Severe Pneumonia Based On Latent Class Analysis

Objective:To explore the syndrome elements of stroke-associated severe pneumonia,establish the identification standard of stroke-related severe pneumonia,provide objective basis for accurate clinical syndrome differentiation treatment,and promote the objective and standardized development of syndrome differentiation.Methods:1.230 patients with stroke-related severe pneumonia hospitalized in the South Intensive Care Unit of the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine were collected from January 2017 to December 2021,and the information of four methods of examinations in TCM and some physical signs of 230 patients were extracted from the electronic medical records.Lantern5.0 was used to analyze the data according to occurrence frequency(>10%)of symptoms and signs and the relevant structure model was established.The structure diagram,mutual information curve and latent class probability distribution table of latent variables and explicit variables were analyzed.The results were interpreted using TCM basic theories.The common syndrome elements of stroke-associated severe pneumonia were obtained.2.Comprehensive cluster analysis was conducted for the syndrome elements obtained and related latent variables,and the comprehensive clustering model,mutual information curve and probability distribution table were established as well.Lanten5.0 software was employed to analyze the clinical features of each syndrome elements and the identification criteria with a threshold value were determined.Results:1.A total of 78 relevant clinical manifestations were performed.And 21 latent variables and 46 subtypes were obtained.The disease syndrome elements of stroke-associated severe pneumonia were preliminarily obtained as follows:phlegm syndrome,heat syndrome,wetness syndrome,qi deficiency syndrome,Yin deficiency syndrome and Yang deficiency syndrome.2.Through comprehensive cluster analysis,the preliminary identification criteria of stroke-associated severe pneumonia were as follows:phlegm syndrome(threshold:26):sticky phlegm(22),slippery veins(5),thick greasy moss(5),phlegm(4),chord veins(3);Heat syndrome(threshold value:21):yellow urine(6),dry mouth and thirst(6),yellow moss(7),red tongue(5),rapid pulse(5),red face(4),dry stool(4),yellow phlegm(4),irritability(3),fever without sweat(3),constipation(2),nasal flaring(2),palpitation(1);Wetness syndrome(threshold value:38):hyperactivity of bowel sound(19),loose stool(18),epigastric depression(2),anorexia(2);Qi deficiency syndrome(threshold:6.3):weak pulse(6.2),pale tongue(18),spontaneous sweating(3.6),dilute phlegm(2.8),heavy pulse(2),shortness of breath(1.9),reduced bowel rumble(1.8),pale lips(1.8),loose stool(0.7),fatigue(0.6),palpitation(0.5),sallow complexion(0.1);Yin deficiency syndrome(threshold:46.6):flushed complexion(10),less moss(17.6),thin veins(17),emaciated body(5.4),red tongue(5.2),body twitching(0.9);Yang deficiency syndrome(threshold:15.4):wetness and coldness around the body(7.9),pale complexion(7.5),scattered mottling around the body(5.9),weak pulse(3.9),urinary and fecal incontinence(3.5),poor urination(3.8),pale tongue(2),frequent urination(1.9),dilute phlegm(0.1),loose stool(0.1).Conclusions:1.The latent structure method was used to analyze the symptoms and signs of 230 cases of stroke-associated severe pneumonia,and the common syndrome elements of stroke-associated severe pneumonia were extracted as follows:phlegm syndrome,heat syndrome,wetness syndrome,qi deficiency syndrome,Yin deficiency syndrome and Yang deficiency syndrome.2.Through the method of comprehensive cluster analysis,the identification standard of disease syndrome elements of stroke-associated severe pneumonia was preliminarily established to provide objective basis for clinical syndrome differentiation.