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| Distribution characteristics and prognostic relevance of traditional Chinese medicine syndrome elements in drug-resistant gram-negative bacilli pneumonia |
| Hits 563 Download times 232 Received:February 18, 2025 |
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| DOI
10.11656/j.issn.1672-1519.2025.06.05 |
| Key Words
pneumonia;drug-resistant gram-negative bacilli;traditional Chinese medicine syndrome element;prognosis |
| Author Name | Affiliation | E-mail | | LI Yang | Beijing University of Chinese Medicine, Beijing 100029, China | | | WU Zhisong | Dongfang Hospital of Beijing University of Chinese Medicine, Beijing 100078, China | | | LIU Zhaoheng | College of Life Science, Beijing University of Chinese Medicine, Beijing 102488, China | | | CAI Yaodong | Beijing University of Chinese Medicine, Beijing 100029, China | | | DUAN Xueguang | Dongfang Hospital of Beijing University of Chinese Medicine, Beijing 100078, China | | | NIU Jie | Dongfang Hospital of Beijing University of Chinese Medicine, Beijing 100078, China | | | JIAO Yang | Dongfang Hospital of Beijing University of Chinese Medicine, Beijing 100078, China | yangjiao2013@sina.cn |
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| Abstract
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| [Objective] To summarize the distribution characteristics of traditional Chinese medicine syndrome elements in drug-resistant gram-negative bacilli pneumonia and the prognosis-related risk syndromes，and to provide reference for clinical diagnosis and treatment. [Methods] The information from the four diagnostic methods of traditional Chinese medicine was collected from 91 hospitalized patients with drug-resistant gram-negative bacilli pneumonia. Correlation and cluster analyses were used to summarize the distribution characteristics of syndrome elements. Multivariate regression analysis was applied to analyze the correlation between syndrome elements and prognosis. [Results] In this study，most patients were aged 80 to 89 years. A total of 97 strains and 6 types of drug-resistant bacteria were cultured from respiratory specimens. The top three were pseudomonas aeruginosa，klebsiella pneumoniae，and acinetobacter baumannii. The detection rate of multi-drug resistant bacteria was 69.2%. The main syndrome elements in 91 patients were qi deficiency，lung，kidney，phlegm，blood deficiency，and fluid retention，with the disease nature being a mixture of deficiency and excess. Based on association rules and complex network analysis，the syndrome elements of patients with drug-resistant gram-negative bacilli pneumonia were centered on lung，kidney，qi deficiency，and phlegm，forming six strong links：lung-phlegm，kidney-qi deficiency，lung-qi deficiency，qi deficiency-phlegm，kidney-phlegm，and lung-kidney. Cluster analysis yielded five groups of syndrome elements：G1（lung-phlegm-qi deficiency-kidney），G2（fluid retention-blood deficiency-spleen-heart），G3（yang deficiency-collapse syndrome），G4（yin deficiency-heat），and G5（blood heat-blood stasis）. Multivariate regression analysis showed that yang deficiency（OR=8.377，P=0.001），blood stasis（OR=8.093，P=0.023），spleen（OR=5.146，P=0.003），and collapse syndrome（HR=3.364，P=0.002） were independent risk factors for the prognosis of drug-resistant gram-negative bacilli pneumonia. [Conclusion] The nature of drug-resistant gram-negative bacilli pneumonia is deficiency in the root and excess in the branch. The disease affects the lung and kidney，with qi deficiency as the root cause and phlegm as the branch manifestation. It is characterized by lung and kidney qi deficiency and internal accumulation of phlegm. Patients with yang deficiency，collapse syndrome，blood stasis，and spleen involvement should be closely monitored and actively treated to improve prognosis. |
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