Observation Of Curative Effect Of Shanyaohuatan Recipe On Senile Severe Pneumonia With Qiyinliangxu Tanreyunfei Syndrome

Objective:In this study,a randomized controlled clinical trial was conducted to observe the efficacy of Shanyaohuatan recipe on senile severe pneumonia with Qiyinliangxu Tanreyunfei syndrome,so as to provide new ideas and references for the treatment of senile severe pneumonia.Methods:64 elderly patients with severe pneumonia were selected from the Department of critical medicine,Wangjing hospital,Chinese Academy of traditional Chinese medicine from January 2019to January 2020.Inclusion criteria:age≥65 years old,in line with the diagnosis criteria of severe pneumonia,syndrome type in line with the syndrome of Qi and yin deficiency,phlegm and heat accumulation in the lung;exclusion criteria:special infection,primary immune deficiency disease,patients with immunosuppression,people with mental illness,alcoholism or drug addiction,and people who are allergic or allergic to the drug.This study is a randomized controlled study.64 patients were divided into control group(32 cases)and treatment group(32 cases).The control group was treated by western medicine.On the basis of Western medicine,the treatment group was treated by tutor’ s experience decoction of ShanyaoHuatan Decoction was decocted to 100ml,orally or by nasal feeding twice a day.The observation period of the treatment group and the control group was 7 days.Before and 7 days after treatment,TCM symptom scores,CPIs scores and MODS scores were compared between the two groups vital signs(T,MAP,oxygenation index)and inflammatory indexes(WBC,CRP,PCT,IL-6)were compared before treatment,on the third and seventh days after treatment.On the 7th day of treatment,the time of using ventilator was compared.The data were analyzed by spss23.0 software.The independent sample t-test of measurement data in accordance with normal distribution was used.If the data were not in accordance with normal distribution or grade data,the nonparametric test was used.The counting data or composition ratio are tested by χ2 test,and if χ2 test condition is not satisfied,Fisher exact probability method would be used.Results:1General data comparisonA total of 64 patients were included,32 in the treatment group,3 in which died;32 in the control group,2 in which died,and 1 in which fell off.There were 29 cases in the treatment group,18 males and 11 females,aged75.44±6.21 years,16 males and 13 females in the control group,aged 74.41±7.69 years.The age,gender,basic diseases and smoking history of the patients in the treatment group and the control group were compared.There was no significant difference in age and gender between the two groups(P>0.05).Thecre was no significant difference in the past diseases(including hypertension,hyperlipidemia,type 2 diabetes,coronary heart disease,chronic obstructive pulmonary disease)and smoking history between the two groups(P>0.05).Among the 64 patients,3 patients died in the treatment group,2 patients died in the control group,and 1 died.There were 29 patients in the treatment group,18 males and 11 females,aged 75.44±6.21 years,16 males and 13 females,74.41 ±7.69 in the control group.The age,sex,underlying diseases,and smoking history of patients in the treatment and control groups were compared,and there was no significant difference in age and gender between the two groups(P>0.05).There were no significant differences in the distribution of past diseases(including hypertension,yperlipidemia,type 2 diabetes,coronary heart disease,chronic obstructive pulmonary disease)and smoking history(P>0.05).There was no statistical difference in the individual points and total points of TCM symptoms and western medicine indicators between the two groups of patients before treatment(P>0.05).There was no significant difference in TCM symptom score,vital signs(T,MAP,oxygenation index),western medicine observation(WBC,CRP,PCT,IL-6,MODS score,CPIs score)between the two groups before treatment(P>0.05).2 Comparison of observation indexesThe effective rate of TCM was 82.7%in the treatment group and 55.2%in the control group.By χ2 test,the effective rate of the treatment group was better than that of the control group and had statistical significance(P<0.05).As for the total score of TCM symptoms,there was a significant difference between the two groups before and after treatment(P<0.05),and the score in the treatment group was significantly lower than that in the control group.Compared with the control group,the effect of the treatment group was better than that of the control group(P<0.05).There was no significant difference in other symptom scores(P<0.05).Compared with the observation indexes of Western medicine,in MODS score,CPIs score,CRP,PCT and IL-6,the improvement degree of the treatment group was better than that the control group,and the difference between the two groups was statistically significant(P<0.05);there was no statistical significance in the improvement of WBC indexes between the two groups(P>0.05).Comparison of vital signs:the improvement of body temperature and oxygenation index in the treatment group was significantly better than that in the control group,and the difference between the two groups was statistically significant(P<0.05).There was no significant difference in the effect of the two groups on the average arterial pressure(P<0.05).There was no significant difference in the use time of ventilator between the two groups after 7 days of treatment(P>0.05).Conclusion:Traditional Chinese medicine Huatan Decoction Combined with western medicine is better than western medicine in improving symptoms,stabilizing vital signs,reducing inf lammation index,MODS score and CPIs score.