The Study Of TCM Syndrome Type And Related Risk Factors For Sepsis Induced Cardiac Dysfunction

ObjectiveA retrospective study was carried out to investigate the distribution characteristics of TCM syndromes and syndrome factors of the patients with sepsis,and the risk factors and prognosis of the patients with cardiac dysfunction induced by sepsis.MethodsA total of 226 patients with sepsis and sepsis with were selected from January 2012 to December 2016 in the intensive care unit of Guangdong Provincial Hospital of Chinese Medicine.The general information,physical and chemical indexes and main clinical symptoms of patients were recorded,and then to summarize the characteristics of TCM syndromes and syndrome elements.At the same time,clinically relevant prognostic indicators,such as LVEF,NT-proBNP,CRP,procalcitonin,albumin,APTT,lactic acid,APACHE score,SOFA score,were recorded to establish the clinical database.Then using software for statistical analysis to screen the TCM syndromes and other risk factors of cardiac dysfunction induced by sepsis,and the mortality rate of the general population and the patients of different TCM syndrome types were observed.Results1.In a total of 226 patients with sepsis,the syndrome of intermingled deficiency and excess was the most,accounting for 60.9%,followed by the excess syndrome,accounting for 31.5%,and the deficiency syndrome was 7.6%.9 basic syndromes of TCM were recorded in the study population,the total frequency was about 582,and the most frequent occurrence was Qi-deficiency syndrome(21.6%),heat syndrome(16.5%)and phlegm syndrome(15.8%).In the group of sepsis with cardiac dysfunction,the main syndromes were the syndrome of intermingled deficiency and excess,while the general sepsis group was mainly based on the syndrome of intermingled deficiency and excess,and excess syndrome.There were statistical differences in the distribution of Qi-deficiency syndrome and blood stasis syndrome in the two groups(P<0.05).2.According to the related factors of cardiac dysfunction induced by sepsis patients,single factor regression analysis found that patients with excess syndrome when admission or transformation,recent surgery,history of coronary heart disease and chronic kidney disease had statistical significance(P<0.05).Then we brought the factors above into the logistic regression model,and found that the history of coronary heart disease and chronic kidney disease were risk factors for the patients with heart dysfunction induced by sepsis.3.Compared with the non-heart dysfunction group,the mortality rate of the heart dysfunction group was higher,the difference was statistically significant(P<0.05).There were statistically significant differences in mortality between the three syndrome groups of all the patients included in the study(P<0.05),and the order of mortality rate from high to low was acute deficiency syndrome,the syndrome of intermingled deficiency and excess and excess syndrome.Conclusions1.The TCM syndrome types of patients with sepsis or sepsis with heart dysfunction were mainly based on the syndrome of intermingled deficiency and excess,and patients with sepsis complicated with cardiac dysfunction were more likely to suffer from the pathologic factors of Qi-deficiency and blood stasis.2.Medical history of coronary heart disease and chronic kidney disease are dependent risk factors for the patients with sepsis who prone to cardiac dysfunction.3.Compared with acute deficiency syndrome and the syndrome of intermingled deficiency and excess,the patients with excess syndrome when admission or transformation had a lower risk of death.