Study on relationships between traditional Chinese medicine syndromes and oxygenation index, lactic acid, D-dimer in patients with severe pneumonia

  Objective  To study relationships between traditional Chinese medicine (TCM) syndromes and oxygenation indexp_a(O₂)/F_iO₂, lactic acid (Lac), D-dimer (D-D) in patients with severe pneumonia.

  Methods  A total of 118 patients with severe pneumonia were selected as study objects, and their distribution characteristics of TCM syndromes were observed. APACHE Ⅱscores, blood routine examination, levels of C-reactive protein (CRP), p_a(O₂)/F_iO₂, Lac, D-D, serum total bilirubin (TBil) and serum creatinine (Cr) were measured.

  Results  Out of 118 patients with severe pneumonia, there were 68 cases(57.63%) with phlegm-heat accumulating in lungs syndrome, 25 cases (21.19%) with phlegm-dampness obstructing lungs syndrome, 14 cases (11.86%) with heat closure pericardium syndrome, and 11 cases (9.32%) with interior invasion of pathogen and vital qi collapse syndrome. The APACHE Ⅱ scores, the levels of white blood cell count(WBC), CRP, D-D and TBil in the patients with interior invasion of pathogen and vital qi collapse syndrome and heat closure pericardium syndrome were significantly higher, and the levels of p_a(O₂)/F_iO₂ were significantly lower than those with phlegm-dampness obstructing lungs syndrome and phlegm-heat accumulating in lungs syndrome (P < 0.05). The levels of Lac and Cr in patients with interior invasion of pathogen and vital qi collapse syndrome were higher than those with other syndromes(P < 0.05). The levels of WBC and CRP in patients with phlegm-heat accumulating in lungs syndrome were significantly higher than those with phlegm-dampness obstructing lungs syndrome (P < 0.05); the levels of D-D in patients with interior invasion of pathogen and vital qi collapse syndrome were significantly higher than those with heat closure pericardium syndrome (P < 0.05).

  Conclusion  At admission, TCM syndromes of patients with severe pneumonia mainly include phlegm-heataccumulating in lungs, phlegm-dampness obstructing the lungs, heat closure pericardium, and interior invasion of pathogen and vital qi collapse, and the most commonly occurring syndrome is phlegm-heat accumulating in lungs. The detection of p_a(O₂)/F_iO₂, Lac and D-D levels has certain reference value for TCM syndrome differentiation.