| ObjectivePneumonia is a common complication of patients with stroke sequela, many of which are older and having more basic diseases. Because of their physical barriers activities, they are in bed for a long time, and can easy cause aspiration by swallowing difficulties. They often accompany by factors such as malnutrition, low immunity, and easily deteriorate into severe pneumonia after infection. Meanwhile the mortality rate is high, the treatment is difficult, and the social and economic burden is heavy. The existing medical research suggests that the treatment of TCM on patients with stroke sequela of CAP is better than western medicine. So, based on the advantages of TCM, the integrative medicine and comprehensive treatment of a variety of ways is the trend of future research. But the existing diagnosis criteria of TCM syndrome on CAP is difficult to provide effective guidance for clinicians who want to treat patients with stroke sequela of CAP. To investigate the TCM syndrome types and clinical characteristics of patients with stroke sequela of CAP, the study analysis the information of TCM syndromes. This randomized, controlled trial study is to observe the clinical efficacy of patients with stroke sequela of CAP treated by supplemented xinglouchengqi decoction, and in order to lay the foundation that provide an effective combined Chinese and Western medicine for patients with stroke sequela of CAP.MethodsAll cases were collected from TCM Lung Disease Department of China-Japen Friendship Hospital from October2012to February2014. The information of TCM syndrome were investigated from the patients including144patients with stroke sequela of CAP and144cases of elderly suffered from CAP, who are from the same place, the same gender and the similar age. According to the random number table method,67patients with stroke sequela of CAP were phlegm-heat accumulation by the TCM syndrome differentiation, and were randomly divided into treatment group (n=34cases) and control group (n=33cases). All patients were received the western medicine treatment, while patients in treatment group were also given the treatment by supplemented xinglouchengqi decoction. After treated14days, the efficacy and adverse reactions were observed, including clinical effect, inflammatory index, TCM syndromes, symptoms, the cooling time, days of average be in hospital, activity ability of daily life (Barthel index), money of average be in hospital and record related adverse reactions. The datas were analyzed by SPSS17.0.Result1The TCM syndrome characteristics of patients with stroke sequela of CAP In addition to limbs movement disorder and dysphagia, patients with stroke sequela of CAP can have disturbance of consciousness, phlegm rale in the throat, abdominal distension, constipation, yellow tongue fur, pulse astringent or weak (P<0.05), while the elderly suffered from CAP can have cough, chest tightness, shortness of breath, lassitude, pulse string or rapid (P<0.05).Phlegm-heat accumulation by the TCM syndrome differentiation is the same as phlegm and blood stasis, and they are commonly in patients with stroke sequela of CAP (P<0.05). There is no significant difference between two groups of Qi and Yin deficiency syndrome (P>0.05), but the proportions of the two groups were high, the proportion of patients with stroke sequela of CAP is60.42%and the elderly suffered from CAP is50.69%.2The results of clinical research on the TCM treatment2.1Comparison of clinical efficacy in two groups after treatmentThe total efficacy rate including clinical cure, effectiveness and failure was94.12%in the treatment group, and the control group was75.76%, it was statistically significant difference (P<0.05).2.2Comparison of inflammatory indexes in two groups after treatmentThe inflammatory indexes in the two groups were significantly improved after treatment (P<0.05), but the improved degree of inflammation indexes in the two groups were similar (P>0.05).2.3Comparison of TCM syndrome scores in two groups after treatmentTCM syndrome scores in two groups after treatment were obviously decreased than before treatment, the difference was statistically significant (P<0.05), but compared with the control group, the difference of TCM syndrome scores in the treatment group was statistically significant (P<0.05).2.4Comparison of the symptoms and the cooling time in two groups after treatmentComparison of each symptom (fever, cough, sputum color, sputum volume, chest pain, mouth parched and tongue scorched, abdominal distension and constipation) in the two group after treatment, the treatment group had statistical significance in fever, sputum volume, abdominal distension and constipation (P<0.05), residual symptoms had no significant difference (P>0.05). In the same time the cooling time in the treatment group was shorter than the control group (P<0.05).2.5Comparison of the Barthel index scores in two groups after treatmentBarthel index scores in two groups were significantly improved after treatment (P<0.05), but the two groups had no statistical significance (P>0.05). 2.6Comparison of days and money of average be in hospitalComparison of days and money of average be in hospital, there were both significant difference between the treatment group and the control group (P<0.05).2.7Adverse reactionsTwo groups of patients during treatment showed no obvious adverse reaction.ConclusionPatients with stroke sequela of CAP are healthy energy deficiency and evil excess, healthy energy deficiency is Qi deficiency and Yin deficiency, and evil excess is phlegm-heat accumulation by the TCM syndrome differentiation. Evil excess is a common symptom in early disease, and blood stasis throughout the disease has always been.Based on the treatment of western medicine treatment, the clinical efficacy of patients with stroke sequela of CAP treated by supplemented xinglouchengqi decoction is better. The treatment of TCM can obviously improve the clinical symptoms and the clinical efficacy, shorten the hospital days, reduce hospitalization costs, effectively save the social medical resources, and high safety, worth further study and promotion. |
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