Summarize The TCM Syndrome Types Of Stroke Associated Pneumonia And Observe The Clinical Effect Of Integrated Traditional Chinese And Western Medicine Treatment

Objective: 1 Observe the distribution of SAP TCM syndromes and accompanying symptoms,analyze the correlation between TCM syndromes and accompanying symptoms,and provide an objective basis for studying the characteristics of SAP TCM syndromes.2 Observe the impact of different treatment plans on SAP clinical prognosis and core indicators,summarize the use of traditional Chinese medicine,and provide a preliminary basis for prospective clinical research on integrated traditional Chinese and Western medicine treatment of SAP.Methods: 1 Using retrospective survey methods to investigate the inpatients diagnosed with SAP in the emergency ward of the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine from January 2017 to September 2019.Collect the patient's general condition,traditional Chinese medicine syndrome,treatment method,laboratory test results,clinical symptoms improvement,prognosis and other contents,and fill the results into the designed questionnaire.After establishing the original clinical database,import the data into SPSS 22.0,summarize the distribution of TCM syndromes and accompanying symptoms in SAP patients,and examine the relationship between the distribution of TCM syndromes and the age,gender,stroke type,and whether there are accompanying symptoms or the types of accompanying symptoms.According to the treatment measures taken by clinicians according to the situation of the patients,the patients were naturally divided into two groups,a total of 48 cases in the combined traditional Chinese and western medicine treatment group,and a total of 59 cases in the western medicine treatment group.The clinical cure rate is the main observation indicator;the patient's antibiotic use time,clinical symptom improvement(fever time and phlegm disappearance time),lung rales disappearing time and other indicators,and laboratory indicators related to pneumonia infection(leukocyte Changes in counts,C-reactive protein,procalcitonin,and lactate dehydrogenase)were secondary observation indicators.The results of the clinical indicators of the two groups were imported into SPSS 22.0 to analyze the difference in clinical cure rate between the two groups,as well as the differences in the duration of antibiotic use,improvement of clinical symptoms,and improvement of laboratory indicators in the two groups.3 The cases in the integrated traditional Chinese and western medicine treatment group were divided into two groups according to the type of traditional Chinese medicines: traditional Chinese medicine decoction group and traditional Chinese medicine group.In terms of differences,the main drug usage rules and the combination of empirical drug combinations in the basis of SAP's syndrome differentiation and treatment are obtained.Results: 1 The incidence of SAP is significantly increased in elderly patients and male patients.2 The distribution of SAP TCM syndromes of patients from high to low is as follows: phlegm-heat obstructing the lung(28.97%),syndrome of pulmonary stagnation of phlegmdampness(21.50%),syndrome of qi deficiency of the lung and spleen(18.69%),syndrome of qi-yin deficiency(12.15%),syndrome of wind and cold invasion of lung(8.41%),syndrome of exogenous cold-evil and internal fluid-retention(7.48%),syndrome of evil sink and healthy atmosphere collapse(1.87%),syndrome of heat entering the pericardium(0.93%).The distribution of accompanying symptoms is that nearly half of the patients have accompanying symptoms,the incidence of blood stasis syndrome is about 29%,and the incidence of fu-organ syndrome is about 19%.3 There was real correlation between patients with accompanying symptoms,and blood stasis syndrome,and the of the fu-organ syndrome and the distribution of TCM syndromes in SAP patients(p<0.05).Syndrome of qi deficiency of the lung and spleen and syndrome of qi-yin deficiency have the lowest probability of having both blood stasis syndrome and the fu-organ syndrome.The distribution of blood stasis syndrome is seen in all other syndromes except for the two serious types of syndrome of evil sink and healthy atmosphere collapse and syndrome of heat entering the pericardium,and it is the most common in the syndrome of pulmonary stagnation of phlegm-dampness.The fu-organ syndrome mainly occurs in the three syndrome types of syndrome of phlegm-heat obstructing the lung,syndrome of wind and cold invasion of lung and syndrome of exogenous cold-evil and internal fluid-retention,and it has the highest frequency in syndrome of phlegm-heat obstructing the lung.4 The cure rates on the 7th and 14 d groups of the integrated traditional Chinese and western medicine group and western medicine group,the integrated traditional Chinese and western medicine group were more higher(p < 0.05).In terms of improvement of observation indexes,after 7 days of treatment,the infection indexes of the integrated traditional Chinese and western medicine group were lower than those of the Western medicine group,and the difference in white blood cell count,C-reactive protein and procalcitonin between the two groups was statistically significant(p<0.05),but on the 14 th day,there was no significant difference in the infection index results between the two groups(p > 0.05),and the results were not statistically significant.In addition,the integrated traditional Chinese and western medicine treatment is superior to the western medicine treatment in terms of intravenous antibiotic use time and total antibiotic use time,clinical symptom improvement time(fever time and sputum disappearance time),and lung rales disappearance time.The differences were statistically significant(p<0.05).5 Compared with the traditional Chinese medicine decoction group and the Chinese patent drug group,the cure rate was compared at 7 days(p<0.05),and the difference was statistically significant.The difference was not statistically significant at 14 days(p> 0.05).6 Among the prescriptions for dialectical treatment,the most frequently used licorice roots are the top 20 drugs used in addition to the licorice roots: Codonopsis,Poria,Bupleurum,Mulberry,Houttuynia cordata,Magnolia officinalis,reed root,Citrus aurantium,Qing Pinellia,Atractylodes,Winter Melon Seeds,Atractylodes,Melon,Atractylodes Rhizome,Rhizoma Imperatae,Bitter Almond,Fritillaria thunbergii,Amomum,Scutellaria,Scutellaria,Peach Kernel.The results of drug analysis show that heat-clearing drugs are used the most,mainly including heat-clearing and detoxifying drugs,heat-clearing purgative powders,heat-clearing blood-cooling medicines,heat-clearing and dampness medicines.In addition,the frequency of use in the top five is: heat-clearing drugs,Qiinvigorating drugs,humidifying drugs,diuretic swelling drugs and antitussive and antiasthmatic drugs.Conclusion: 1 The distribution of SAP TCM syndromes from high to low is: syndrome of phlegm-heat obstructing the lung > syndrome of pulmonary stagnation of phlegm-dampness > syndrome of qi deficiency of the lung and spleen > syndrome of qi-yin deficiency > syndrome of wind and cold invasion of lung > syndrome of exogenous cold-evil and internal fluid-retention > syndrome of evil sink and healthy atmosphere collapse > syndrome of heat entering the pericardium.In the distribution of accompanying symptoms,the incidence of the two syndromes of blood stasis syndrome and fu-organ syndrome is relatively high,accounting for about half of the total number of cases.2 Both the integrated traditional Chinese and western medicine treatment and Western medicine are effective in treating SAP,but the integrated traditional Chinese and western medicine treatment is more effective than simple Western medicine treatment in antiinfection,and it takes less time for each infection index to return to normal levels.And in improving the use of drugs,as well as improving clinical symptoms,lung signs are superior to pure Western medicine treatment,it can be considered that the integrated traditional Chinese and western medicine treatment can shorten the course of SAP and improve the cure rate of SAP.3 The overall effect of traditional Chinese medicine decoction treatment based on syndrome differentiation is better than traditional Chinese medicine treatment,which can shorten the course of SAP and improve the short-term cure rate.4 The treatment of SAP is mainly based on the principle of resolving phlegm and removing pathogenic heat,replenishing qi and spleen,diuresis-removing dampness,relieving cough and asthma.The main drugs used are mulberry skin,houttuynia cordata,reed root,winter melon seeds,dangshen,poria,atractylodes,sunburn Licorice,raw Astragalus,Atractylodes,Scrophulariaceae,Magnolia officinalis,Citrus aurantium,Bupleurum,Pinellia chinensis,Sangbaipi,bitter almond,tangerine peel,melon radix,fritillaria,etc.,and according to the specific situation of the patient during treatment Dialectical additions and subtractions are adopted,and symptomatic drug compatibility is adopted to achieve the goal of treating both the symptoms and the symptoms.And it is recommended to flexibly add or subtract drugs based on SAP syndrome type,accompanying symptoms,clinical symptoms and disease outcome.