Dissertation > Medicine, health > Chinese Medicine > TCM EMERGENCY

The Clinical Study on the Characteristic of Triple Burner Syndrome in Sepsis

Author ChenZuo
Tutor ZhangDan
School Guangzhou University of Traditional Chinese Medicine
Course Traditional Chinese Medicine
Keywords Sepsis Sanjiao dialectical D-dimer
CLC R278
Type Master's thesis
Year 2011
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The purpose of this study by March 2009 -2011 in March in the hospital ICU Division, the respiratory, Pu Neike Nephrology, 57 cases of sepsis patient clinical characteristics analysis, and Wei Qi Ying Xue, triple burner syndrome type APACHE Ⅱ score of the various syndromes patients, syndromes patients was measured D-dimer levels, and correlation analysis was done to explore of sepsis sanjiao syndrome type of syndrome distribution characteristics and its relationship with the prognosis for the TCM treatment of sepsis, provided a new basis. The method of this study were collected to meet the conditions of the patient's clinical data of 57 patients with sepsis, the combination of symptoms and clinical Diagnostics of Chinese Medicine, \records of patients' gender, age, previous history of the case, into the Division within 24 hours Wei Qi Ying Xue, triple burner dialectical, while 57 patients APACHE Ⅱ score measured D-dimer levels. The collection of cases entered into the database, using statistical analysis SPSS16 software, concluded. Results from the analysis of the incidence of sepsis patients: (1) increase with age, the incidence of sepsis number gradually increased age predict sepsis and severe sepsis, and death is the most effective one of the risk factors. (2) the highest incidence respiratory infections, respiratory infections (including upper respiratory infections and lung infections) and are closely related to the occurrence of sepsis pathogens culture positive rate was 75.44%, of which 17 cases of positive blood cultures accounted sepsis 29.8% of the patients, a higher proportion of Gram-negative bacteria and fungi. (3) ICU Branch septic patients APACHE II score, mortality rates were higher than the Department of Nephrology of Pu Neike, Department of Respiratory three sections, the condition is relatively critical. (4) a high proportion of D-dimer-positive patients, indicating that sepsis patients coagulation and fibrinolysis disorders occur rate. Viewed from the the sepsis sanjiao syndrome characteristics: In addition to fever, rapid pulse, dark red tongue, sweating, moss, yellow, purple-red tongue, slippery pulse of warm diseases common symptoms, coke mainly Pulmonary symptoms and symptoms of pericardial conscious class focus performance the symptoms of gastrointestinal classes, under the coke mainly for liver and kidney deficiency like symptoms. This roughly corresponding with modern medicine clinical manifestations of sepsis. 3. Sepsis patient Tongue to tongue purple, dark red tongue, tongue withered, yellow moss yellow greasy moss, little coating the main pulse to slip, fine sunken pulse-based. 4. Syndrome in septic patients APACHE Ⅱ score comparison: APACHE Ⅱ score comparing patients on coke card the (evil thermal obstruct the lung) and on coke certificate (the evil trap pericardial card), P lt; 0.01; on the the focus card (evil hot obstruct pulmonary card) with the coke, coke under permit patients the APACHE Ⅱ score comparing P lt; 0.01; on coke card (evil trap pericardial card) and in focus permit patients APACHE Ⅱ score comparison, P lt; 0.05; on coke card (evil trap pericardial syndrome) and in patients with APACHE Ⅱ score card under the coke, P gt; APACHE Ⅱ score of 0.05; the focus card with coke under license patients comparing P lt; 0.05. Application Spearman correlation analysis of the triple burner dialectical was positively correlated with APACHE Ⅱ (P lt; 0.01). D-dimer levels. Syndrome in patients with sepsis comparison: Comparison of D-dimer levels in patients on the focal group (evil heat obstruct the lung) and on the focal group (the evil trap pericardial card), P lt; 0.05; focal group (evil heat obstruct the lung) and coke, the next focus group of patients with D-dimer levels compare P lt; 0.05; focal group (the evil trap pericardial card) with coke patients D- the dimer level P lt; 0.05; Comparison of D-dimer levels on the focal group (the evil trap pericardial card) and the next focus group patients, P lt; 0.05; D-dimerization of the in-focus group with the next focus group patients body compared to P lt; 0.05; application Spearman correlation analysis: sanjiao dialectical Syndromes and D-dimer levels were positively correlated with the law (P lt; 0.01); of APACHE Ⅱ score and D-dimer levels Correlation Analysis: Application pearson correlation analysis: D-dimer levels were positively correlated with APACHE Ⅱ (P lt; 0.01). From 7.28 days mortality: mortality on the focal group (evil heat obstruct the lung), 6.2% (1/16) on coke group the (evil trap pericardial card) 44.4% (4/9) mortality compared between the two groups case fatality rate of mortality and under-focus group difference (P lt; 0.05); previous the coke group (evil hot obstruct the lung), 6.2% (1/16), 66.7% (12/18), P lt; 0.05, there differences; mortality and under-focus group focus group and 28.6% (4/14) 66.7% (12/18) mortality comparison, P gt; 0.05, no difference; on coke group (the evil trap pericardial card) mortality Comparison of mortality rate under the coke, P gt; 0.05. That the next focus group, in focus groups on coke mortality (the evil trap pericardial card) higher than the previous focus group the (evil thermal obstruct the lung). Death group and survival group D-dimer levels, APACHE II score comparison: the deaths set of D-dimer levels, APACHE Ⅱ scores were higher than the survival group (P lt; 0.05). Conclusion 1. Sepsis is a the TCM \Sepsis pathological process sanjiao dialectical on coke card the (evil thermal obstruct the lung) on ??coke certificate (the evil trap pericardial card), on coke - coke - coke process are basically the same. In clinical work, the the triple burner dialectical mode used in sepsis. With sepsis sanjiao permit tongue and pulse distribution characteristics, prompt diagnosis and treatment of sepsis, except in accordance with the conventional treatment, the early course of disease should pay attention to heat phlegm, resuscitation Tongfu diarrhea, the late should focus on AIDS Yin Qi, nursing care righteousness therapeutic intervention to improve the clinical efficacy. 3. Analyzes sanjiao dialectical and APACHE Ⅱ score, D-dimer level are positively correlated. On focus group (evil heat obstruct the lung) in patients with sepsis, of APACHE Ⅱ score low D-dimer levels are also low, low mortality; on the focal group (the evil trap pericardial card), in patients with middle and lower coke of APACHE Ⅱ score high D-dimer levels were also high, and high mortality. Clinical will combine the three, will help more accurately determine the severity and prognosis of sepsis. 4 with the triple burner dialectical theory of discourse sepsis occurrence development process, according to the results of these dialectical, we can use Chinese medicine on the different stages of sepsis targeted therapy.

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