The Clinical Study On The Characteristic Of Triple Burner Syndrome In Sepsis

ObjectivesThrough clinical features of 57 cases of sepsis patients, which from general medicine section, ICU section, respiratory section, kidney section in our hospital in March 2009—2011. By pointing sepsis with wei qi ying xue,shangjiao zhongjiao xiajiao, Do the acute physiology and chronic health evaluationⅡand determination of the different time in patients with D-dimmer level. Then the related analysis aimed at understanding the distributed general pattern and the relationship with Prognosis in the visceral cavities (shangjiao zhongjiao xiajiao),to provide a new basis with diagnose and treatment sepsis in TCM theory.MethodsCollect 57 qualified cases, combine with symptom from book ("traditional Chinese medicine diagnosis") and clinical performance, then compile into questionnaires, including patients basic information, such as sex, age, past medical history and so on, symptom, tongue condition and pulse condition form four diagnosis methods of TCM into the branches within 24 hours by the weiqiyingxue differentiation and sanjiao differentiation, while 57 patients for the APACHEII score and determine D-dimmer level. Cases will be collected into the database, using statistical analysis software SPSS16 to analysis.Results1. Acording to the incidences of Sepsis patients:(1) Along with the growth Of the age is the number of sepsis has gradually increased. It shows the age is one of the most effective risk factors predicting the incidence and death of sepsis and severe sepsis; (2) The highest incidence of respiratory infection, indicating that respiratory infections (including upper respiratory infection and lung infection) and the incidence of sepsis is closely related to bacteria culture positive rate was 75.44%, which accounted for 17 cases of blood culture-positive patients with sepsis 29.8%, Gram-negative bacteria and fungi, a higher proportion. (3)Section ICU patients with sepsis APACHE II score mortality rates were higher than those of Nephrology, Punei Ke, Respiratory three sections, the relative critical condition. (4)D-dimer positive patients appears high proportion, indicating that disordered coagulation and fibrinolysis in septic patients with a high incidence of the phenomenon.2. From the sepsis syndrome features triple burner to see:in addition to fever, rapid pulse, tongue, dark red, sweating, moss yellow, purple tongue, slippery pulse common symptoms of diseases such as warm, but focus mainly on the symptoms of lung system And pericardial mind like symptoms, the focus was mainly gastrointestinal symptoms class, the next focus mainly liver and kidney deficiency and type symptoms. This clinical manifestation of sepsis and modern medicine there is general correspondence.3. Patients with sepsis tongue to tongue purple, dark red tongue, tongue withered, yellow fur, yellow greasy moss, moss less dominated by the number of pulse, slippery, thin, and deep pulse-based.4. The syndrome APACHEⅡscore in patients with sepsis:focus on the card (evil heat obstruct the lung) and the coke card (evil trap pericardium card) in patients with APACHEⅡscores, P<0.01; on a coke card (evil heat obstruct the lung) and in the coke, the next focal syndrome of APACHEⅡscores, P<0.01; The coke card (evil trap pericardium syndrome) and the focal syndrome of APACHEⅡscores, P<0.05; on a coke card (evil trap pericardium syndrome) and certificate under the coke APACHEⅡscore in patients, P> 0.05; in coke coke under license and permit comparison of patients with APACHEⅡscore, P<0.05. Spearman correlation analysis applications derived, triple burner syndrome was positively correlated with APACHEⅡ(P<0.01).5. The patients with sepsis syndrome compared D-dimer levels:the focus group (evil heat obstruct the lung) and the focus group (pericardium evil trap card) D-dimer levels in patients compared, P<0.05; on Focus group (evil heat obstruct the lung) and in the coke, the next focus group were compared D-dimer levels, P<0.05; the focus group (evil trap pericardium syndrome) and in the focus group of D-dimer levels in patients Comparison, P<0.05; the focus group (evil trap pericardium syndrome) and the next focus group of D-dimer levels were compared, P<0.05; in the focus group and the next focus group of patients compared D-dimer levels, P<0.05; application of Spearman correlation analysis obtained:Triple Burner differentiation of the syndrome and D-dimer was positively related to regular (P<0.01);6. APACHEⅡscore and D-diner level correlation analysis:The person correlation analysis obtained:D-diner levels were positively correlated with APACHEⅡ(P<0.01).7. Comparison of 28-day mortality:the focus group (evil heat obstruct the lung) 6.2%(1/16) mortality and on the focus group (pericardium evil trap card)44.4% (4/9) compared the mortality between the groups, There are differences (P <0.05); the focus group (evil heat obstruct the lung) 6.2%(1/16) mortality and the next focus group 66.7%(12/18) mortality in comparison, P<0.05, there are differences. Focus group in 28.6%(4/14) mortality and lower burner 66.7% (12/18) mortality in comparison, P>0.05, no difference. The focus group (pericardium evil trap card) mortality and mortality of under focus group, P>0.05. That the next focus group, the focus group, the focus (evil trap pericardium card) fatality rate higher than the focus group (evil heat obstruct the lung).8. Death group and survival group of D-diner levels, APACHEⅡscore of the comparison:D-diner level of death group, APACHEⅡscore was higher than the survival group (P<0.05).Conclusion1. Sepsis is a Chinese medicine "fever" category. Pathological process of sepsis syndrome in the coke and the triple burner card (evil heat obstruct the lung) a focus on the card (evil trap pericardium card), one on the coke-basically the same process under the coke. In the clinical work that can be used in triple burner models of sepsis syndrome.2. Triple burner with sepsis syndrome tongue, pulse distribution, suggesting the diagnosis and treatment of sepsis, in addition to conventional treatment in accordance with, the course of the disease should initially focus on phlegm, resuscitation, Tongue diarrhea, the latter should focus on Yin Yi Gas, such as nursing care righteous intervention to improve clinical efficacy.3. Correlation obtained, triple burner syndrome and APACHEⅡscore, D-diner levels are positively correlated. The focus group (evil heat obstruct the lung) in patients with sepsis, APACHEⅡscore low, D-diner levels are low, the mortality rate is low; and the focus group (evil trap card pericardium), patients with lower coke, APACHEⅡscore high, D-diner levels are high, and high mortality. Clinical will combine all three; will help to more accurately determine the severity and prognosis of sepsis.4. Dialectical theory of discourse with a triple burner incidence of sepsis in the development process, according to the results of these differentiation, we can use Chinese medicine to the different stages of sepsis targeted treatment.