Study On Inflammatory Indexes And Etiological Characteristics Of Patients With Acute Exacerbation Of Chronic Obstructive Pulmonary Disease With Different TCM Syndrome Types

Objective: To analyze the inflammatory indexes,pathogenology and drug resistance of AECOPD patients with different TCM syndromic types in the respiratory department of our hospital,it is proposed to reveal the changes of inflammatory indexes and etiological distribution characteristics of AECOPD patients with different TCM syndromic types,in order to provide evidence for the empirical use of antibiotics,and give play to the characteristics and advantages of TCM in the treatment of AECOPD and drug-resistant bacteria infection.Method: From January 1,2020 to December 31,2020,patients who were diagnosed with AECOPD in the respiratory department of our hospital were collected.For eligible cases,an Excel data table was created,and the obtained data was summarized,and the data was analyzed by IBM spss 23 software.Results:1.The proportion of TCM syndromes of AECOPD was followed by phlegm-heat lung syndrome(39.4%),external cold and internal drinking syndrome(20.8%),turbid phlegm obstructing lung syndrome(18.1%),phlegm and blood stasis obstructing lung syndrome(9.3%),Yang-deficiency and water-flooding syndrome(6.0%),lung-spleen qi deficiency syndrome(3.7%),and lung-kidney qi deficiency syndrome(2.8%);2.There was statistical significance between AECOPD patients with Yang-deficiency water-flooding syndrome combined with pulmonary heart disease and AECOPD patients with external cold and internal drinking syndrome,phlegm turbidity blocking lung syndrome,phlegm-heat blocking lung syndrome,phlegm-stasis blocking lung syndrome,and lung-kidney qi deficiency syndrome with pulmonary heart disease(P<0.05);3.There was statistical significance between AECOPD patients with Yang-deficiency water-flooding syndrome combined with heart failure and AECOPD patients with external cold and internal drinking syndrome,phlegm turbidity blocking lung syndrome,phlegm-heat blocking lung syndrome with heart failure(P<0.05);4.In terms of WBC and Neut test values,there were statistical significance between AECOPD patients with phlegm-heat blocking lung and AECOPD patients with external cold internal drinking,phlegm turbidity blocking lung,phlegm-stasis blocking lung syndrome,and lung-kidney qi deficiency syndrome(P < 0.05).5.In terms of N% test value,there was statistical significance between AECOPD patients with lung-spleen qi deficiency syndrome and AECOPD patients with phlegm-heat blocking lung syndrome,Yang-deficiency and water-flooding syndrome,and lung-kidney qi deficiency syndrome;and between AECOPD patients with phlegm-heat blocking lung syndrome and AECOPD patients with external cold and internal drinking syndrome(P < 0.05).6.In terms of CPR test values,there were statistical significance between AECOPD patients with phlegm-heat blocking lung and AECOPD patients with external cold and internal drinking,phlegm-stasis blocking lung-kidney qi deficiency,and between AECOPD patients with Yang-deficiency and water-flooding syndrome and AECOPD patients with lung-kidney qi deficiency syndrome(P < 0.05).7.In terms of sputum culture,there were statistical significance between AECOPD patients with phlegm-heat blocking lung syndrome and AECOPD patients with external cold and internal drinking syndrome,and between AECOPD patients with phlegm turbidity blocking lung syndrome and AECOPD patients with Yang-deficiency and water-flooding syndrome and lung-kidney qi deficiency syndrome(P < 0.05).8.In this study,the positive rate of sputum culture was 19.91%,and 47 strains of 10 kinds of pathogens were detected..The drug resistance was high: Erythromycin,Ampicillin,Cefazolin Sodium and Cefuroxim.Conclusion:1.The proportion of AECOPD patients with Yang-deficiency and water-flooding syndrome combined with pulmonary heart disease was higher than that of AECOPD patients with external cold and internal drinking syndrome,phlegm turbidity blocking lung,phlegm-heat blocking lung,phlegm-stasis blocking lung-kidney qi deficiency syndrome.2.AECOPD patients with syndrome of yang-deficiency and water-flooding accounted for a greater proportion of patients with heart failure than those with phlegm-heat blocking lung syndrome and phlegm turbidity blocking lung syndrome;3.In terms of WBC and Neut test values,AECOPD patients with phlegm-heat blocking lung were higher than those with external cold and internal drinking,phlegm-turbidity blocking lung,phlegm-stasis blocking lung,and lung-spleen deficiency syndrome.4.In terms of N% test value,AECOPD patients with lung-spleen qi deficiency syndrome were lower than those with phlegm-heat blocking lung syndrome,Yang-deficiency and water-flooding syndrome,and lung-kidney qi deficiency syndrome.AECOPD patients with phlegm-heat blocking lung were higher than those with external cold and internal drinking syndrome.5.In terms of CPR test value,AECOPD patients with phlegm-heat blocking lung were higher than those with external cold and internal drinking,phlegm-stasis blocking lung and lung-kidney qi deficiency,and AECOPD patients with Yang-deficiency and water-flooding syndrome were higher than those with lung-kidney qi deficiency syndrome;6.In terms of the positive rate of sputum culture,AECOPD patients with phlegm turbidity blocking lung syndrome were higher than those with Yang-deficiency and water-flooding syndrome and lung-kidney qi deficiency syndrome;AECOPD patients with phlegm-heat blocking lung syndrome were higher than those with external cold and internal drinking syndrome;7.Among AECOPD patients in the respiratory department of our hospital,more sensitive antibiotics were selected for Gram-negative bacteria,such as third-generation cephalosporins,β-lactam enzyme inhibitor complex preparations,quinolones and carbapenems.Gram-positive bacteria can choose quinolones,vancomycins,semi-synthetic tetracyclines,etc.