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Influenza A H1N1 influenza with severe clinical features of critically ill patients in Western medicine syndrome and treatment of the

Author: SunYinXiang
Tutor: WangYuGuang
School: Beijing University of Traditional Chinese Medicine
Course: Chinese medical science
Keywords: pandemic (H1N1) 2009 clinical features TCM Pattern Integrated Medicine Treatment
CLC: R511.7
Type: Master's thesis
Year: 2010
Downloads: 64
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Abstract

Background:In 2009, a novel influenza A (H1N1) virus swept the world, resulted the first influenza pandemic since 1968. Its clinical features and characteristics are not quite like the seasonal flu, with more severe or even critical cases emerged. TCM had taken part in the management of the disease. Yet, we are not clear about its regular pattern of TCM transmission and transmutation, or which groups of people do severe cases tend to gather, or risk factors for severe cases transmit into critical cases.Objective:To summarize the epidemiology of severe or critical cases, explore the dynamic progression and its regular symptom presentation along with the development of disease. And finally propose a basic TCM method for the management of the disease.Method:In this retrospective study,175 severe pandemic (H1N1) 2009 laboratory confirmed cases hospitalized before Jan.27th 2010 in Beijing Ditan Hospital and Chengdu Infectious Disease Hospital were selected. Fill in the case report form according to patients’medical records. Using Epidata 3.0 software for data input. Analyze the data with SPSS 17.0 software package for patients’baseline data, underlying medical conditions, symptoms. And explore its TCM characteristics according to these data.Results:In the 175 severe or critical pandemic (H1N1) 2009 cases,112 cases are male. Patients are concentrated between 5 to 44 years of age. Pregnancy, COPD, cardiovascular diseases, diabetes, liver diseases, renal diseases, hematologic diseases and overweight are risk factors for patients to turn out a severe case, with a total mortality rate of 10.3%. The symptoms most commonly observed are fever, cough, and stethocatharsis. Patients’tongue color mostly are from pink to red and return to pink at last. Patients’tongue f fur can transfer from a thick turbid one in the early phase to a thin or even a peeled one. Patients’pulse conditions mostly are slippery and rapid, but in the later phase of the course, someone can present a fine pulse.Conclusions:Underlying medical conditions are the intensive factor for a patient to transform into severe case, develop a critical illness, or even result a death. But the damage caused by pandemic (H1N1) 2009 virus is mainly due to the direct or indirect lung injuries, not the deterioration of patients’underlying diseases. The TCM transmission and transmutation course of severe cases mainly correlates with transmutation of regular warm disease, as from Defense, Qi, to Nutrient and Blood. The TCM mechanism of the disease can be described as heat-toxin congesting the lung and blocking the lung. Diffusion and downbear deficiency of lung, and cause a binding of toxin and stasis. Toxin damages the lung vessel, and cause a deficiency in lung management of Qi, or even exhaustion of life essence. Integrated Medicine treatment could be a life saving method for patients.

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CLC: > Medicine, health > Internal Medicine > Infectious disease > Viral infections > Influenza
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