Objective To investigate the traditional Chinese medicine(TCM)syndromic characteristics and prog-nosis of patients with severe community-acquired pneumonia(SCAP)under observation in the emergency department.Methods A retrospective study was conducted on 278 patients with community-acquired pneumonia(CAP)admitted to the emergency department of the Third Affiliated Hospital of Beijing University of Chinese Medicine between August 1,2018,and December 31,2022.The TCM syndrome and pattern characteristics and prognosis of these patients were ana-lyzed.Results A total of 278 cases were included,comprising 146 males and 132 females,with an average age of 83.18±8.86 years.Among them,97.48％had underlying diseases,with hypertension being the most common.SCAP patients,com-pared to those with non-severe community-acquired pneumonia(NSCAP),exhibited a higher frequency of fever,altered consciousness,increased heart rate and respiratory rate,pulmonary moist rales and rhonchi,multi-lobar involvement,pleu-ral effusion,elevated white blood cell count(WBC),neutrophil percentage(NEUT％),C-reactive protein(CRP),and blood urea nitrogen(BUN),along with lower albumin(ALB)levels.In terms of TCM,SCAP patients were more likely to present with symptoms such as shortness of breath,emaciation,excessive sputum,yellow sputum,clouded consciousness,thready and rapid pulses,while the frequency of dry stools was lower than NSCAP patients.The most common TCM syn-dromes in SCAP patients were phlegm-heat obstructing the lungs and phlegm-turbidity obstructing the lungs.SCAP pa-tients were also more prone to heat entering the pericardium syndrome,associated with poorer prognosis.Conclusion SCAP patients under emergency observation are predominantly elderly individuals with underlying diseases.Their syndromic man-ifestations are characterized by coughing,expectoration,and excessive phlegm,with common TCM syndromes being phlegm-heat obstructing the lungs and phlegm-turbidity obstructing the lungs.SCAP patients are more likely to develop symp-toms indicative of heat entering the pericardium,such as clouded consciousness and shortness of breath,resulting in higher mortality rates.
关键词
急诊科/重症社区获得性肺炎/证候/中医证型/预后/炎症因子
Key words
Emergency Department/Severe Community-acquired Pneumonia/Syndrome/Traditional Chinese Medicine Syndrome Pattern/Prognosis/Inflammatory Factor
维普
万方数据