The Influence Of Integrated Traditional Chinese Medicine With Western Medicine On Th1/Th2,HLA_DR And Treg In The Patients Of Sepsis With Acute Lung Injury/acute Respiratory Distress Syndrome (ALI/ARDS)

Objective: Through continuous observe the natural regulatory T (Treg) percentages, T lymphocyte subsets (TH1/TH2) changes, and CDl4 + monocyte human leukocyte antigen DR (HLA-DR) expression rate of change after ALI / ARDS in Sepsis patients, especially patients with severe sepsis discussion the relationship between the Imbalance of immune parameters and sepsis and its clinical value, analysis the changes of immune parameters and immune function of the impact on disorder of the immune inflammatory response and prognosis in septic patients, the influence of severe intra-abdominal infections, significant " large intestine visceral symptom "disease with ALI/ARDS pertaining to changes in conditions, and healing effect mechanism of clinical observation and research. In order to provide basis for"Lung being Connected with Large Intestine"theory.Methods: 30 patients collected within March 2010 to March 2011 from the general surgery ward and ICU in First Affiliated Hospital of Dalian Medical University(Patients met the following criteria: age 18 to 70years old adult patients, has a "large intestine viscera symptom" merged with ALI / ARDS patients, in line with YangMing fuviscera excess and asthma syndrome; the patient's APACHEⅡscore≥6 points; Obtain the consent of the patient's family) were randomly divided into the western medicine treatment group (western medicine routine treatment with placebo) and integrated traditional Chinese medicine with western medicine treatment group (western medicine routine treatment with clear lung bearing gas particle). Placebo: Control drug: one granule that have no therapeutic effects but it's shape is similar to the Therapeutics; Therapeutics: clear lung bearing gas particles(Components: Fructus Trichosanth, Pinellia ternata, Rhubarb, Fructus aurantii immaturus, Magnolia officinalis, Coptis);Drug administration way: oral/ nasogastric /enema; 2 times/day for seven days. Select the period of 15 age-matched healthy subjects as the control group. The patients were observed and compared consecutively in 1^st , 3^rd , 7^th and 14^th day during treatment with important functional indexes (Test of blood biochemical, Routine test of the blood, Routine urinalysis, Routine test of the ordure) and symptoms with functional damages (including abdominal pain, abdominal distension, bowel sound change, arterial blood gas analysis, etc) and immune functional tests(TH1/TH2 determination, Treg percentage, and CDl4+ HLA DR expression rate change of immunological indexes, APACHE II scores, etc).Results: (1) HLA-DR expression rate comparison; Western medicine therapy group were significantly lower than control group (P<0.01), integrated traditional chinese medicine with western medicine treatment group on 1^st, 3rd, 7^th day were below the control group (P<0.01) but within 14^th day there was no difference (P>0.05), HLA-DR expression rate of integrated traditional Chinese medicine with western medicine treatment group on 1^st day was lower than western medicine group but within 14^th day of integrated traditional Chinese medicine with western medicine treatment group significantly higher than western medicine group (P<0.05). On the 3^rd day the two groups had no difference (P>0.05).(2) Treg cells share comparison; Western medicine group on the 14^th and integrated traditional Chinese medicine with western medicine treatment group on the 3rd, 7^th were respectively significantly higher than control group (P<0.05), first three time points of the Western medicine treatment group and the Integrated traditional Chinese medicine with western medicine treatment group on the1^st,14^th were no difference compared with normal control group(P>0.05). Integrated traditional Chinese medicine with western medicine treatment group significantly higher than western medicine treatment group on the 7^th (P<0.05), whereas on 1^st,3rd,14^th the two groups had no difference (P>0.05).(3)Ratio of Th1/Th2 comparison; Western medicine group compared on the 14^th day with integrated traditional Chinese medicine with western medicine treatment group, significantly higher than control group (P < 0.05), Western medicine group with the first three time points were no difference compared control group (P> 0.05), Integrated traditional Chinese medicine with western medicine treatment group compared with control group on 3^rd and 14^th showed no difference (P>0.05), Western medicine group compared with integrated traditional Chinese medicine with western medicine treatment group had no difference (P>0.05).Conclusion:1. HLA - DR expression rate drop in septic patients with ALI/ARDS.2.Treg cells percentage and Th1/Th2 ratio increased in septic patients with ALI/ARDS.3.Integrated traditional Chinese medicine with western medicine treatment is better than western medicine treatment in improving the immune functions for septic patients that provide a basis for"Lung being Connected with Large Intestine"theory.