The Tongfu Xiere Recipe On Septic Rats Acute Lung Surfactant Protein Expression In Research And Experience Of Clinical Application

BackgroundSepsis is a severe infection, severe trauma, severe acute abdomen, large operation after surgical critical illness often accompanied by complications, is also induced by septic shock, multiple organ dysfunction syndrome (MODS) are important causes of. Epidemiological study showed that, in recent years the incidence of sepsis has continued to rise, and the case fatality rate does not fall high, on human health has posed the serious threat to. Surgical acute abdominal sepsis morbidity due to gastrointestinal lesions causing intraabdominal infection and pathogenesis, causes gastrointestinal mucosa barrier is impaired, leading to intestinal endotoxin translocation into the circulatory system, endotoxin in the lungs accumulate, leading to acute lung injury. The sepsis and sepsis-induced lung injury in the understanding, diagnosis and treatment have made great progress, but the effect is not exact, and the combination of traditional Chinese and Western medicine treatment is the treatment of sepsis and acute lung injury and other complications are important measures. Combination of traditional Chinese and Western medicine TCM treatment based on syndrome differentiation and microscopic pathology change the combination in the treatment of sepsis, flexible processing, for the treatment of sepsis has provided a new way.Research purposesObservation of effect of Tongfu Xiere therapy for acute abdominal sepsis clinical effect, and by animal experimental observation of effect of Tongfu Xiere Decoction on sepsis in rat pulmonary surfactant protein A expression in rat, to understand the effect of Tongfu Xiere method to sepsis and its treatment of acute lung injury mechanism, the exploration of Chinese" a fundamental solution, anxious to preserve Yin" therapeutic principle, ultimately for the research and development of traditional Chinese medicine new technology in the treatment of sepsis and acute lung injury to provide scientific theoretical basis.Research Methods1、Animal experiment:By the Guangzhou University of Chinese Medicine Animal Center purchased SPF120SD rats according to block randomization method were randomly divided into normal control group, sham operation group, model of saline control group, model of traditional Chinese medicine, in low, Medium, high dose group, the experimental group according to the Chaudry reported in the cecal ligation and perforation methods of making rat model of sepsis; made by Tongfu Xiere Method of traditional Chinese medicine gavage dynamic observation of traditional Chinese medicine on sepsis in rat model of pulmonary tissue pathology score effects, using the Western blot method and RT-PCR method multi level detected the expression of SP-A in lung, study the effect of Tongfu Xiere Decoction on sepsis in rat model of pulmonary SP-A on the expression of.2、Clinical application:Application of Tongfu Xiere therapy in treating acute abdominal sepsis, selection of two surgical abdomen sepsis syndrome differentiation in TCM belongs to Neire Yongsheng, Changre Fushi syndrome patients, routine treatment of Western Medicine on the basis, according to the effect of Tongfu Xiere method treatment based on syndrome differentiation, giving the effect of Tongfu Xiere method of traditional Chinese medicine or enema, combined acupuncture and external application of traditional Chinese medicine; observed in patients with exhaust defecation recovery time, acute lung injury recovery time, and complication (adhesion intestinal obstruction, pulmonary infection, wound infection).The results1、The results of animal experiments:Models of saline group, and model in low, medium, high dose group of rat serum procalcitonin, endotoxin, pulmonary tissue pathology score were lower, p<0.05, illustrate the effect of Tongfu Xiere methods of Chinese medicine can reduce sepsis rats in vivo calcitonin and endotoxin concentration, reduce sepsis caused by acute pulmonary edema. Model of Chinese medicine group comparison shows that, in a certain range of concentrations, traditional Chinese medicine concentration increased with sepsis rats serum procalcitonin, endotoxin concentrations inversely, and pulmonary edema is proportional to the degree of improvement; sepsis in rat lung tissue SP-A expression level of mRNA were increased, BALF. The expression levels of SP-A were lower, with p<0.05, calcitonin and endotoxin results, can be illustrated, rat lung tissue SP-A expression level of mRNA and sepsis and sepsis induced acute lung injury severity varies inversely with BALF, and the expression of SP-A in volume is proportional to.2、Clinical results of treatment:Surgical acute abdomen complicated by sepsis in patients with12cases,7cases were randomly divided into the treatment group and5cases in the control group, treatment group6cases of successful conservative treatment,1cases of transit operation therapy; admission of4cases pulmonary injury, alleviate the average time was8h; exhaust time averaged16.4h; defecation time average28.6h; while in the control group3cases of successful conservative treatment,2cases of transit operation; at the time of admission of3patients with lung injury, alleviate the average time was13.6h; exhaust time averaged23.8h; defecation time averaged39.2h.ConclusionsEffect of Tongfu Xiere methods of Chinese medicine can reduce sepsis in rat plasma endotoxin and procalcitonin levels, improve rat systemic inflammatory response, reducing endotoxin translocation, thereby inhibiting the development of sepsis; on the degree of lung injury, reduce inflammation of lung tissue edema, protection of lung function, the increase in SP-A expression, maintain good alveolar compliance, thereby ease due to sepsis induced acute lung injury.Clinical treatment of patients with sepsis, acute abdomen clinical manifestations most belongs to the traditional Chinese medicine in the Neidu Yongsheng accumulation of syndromes of TCM syndrome differentiation and treatment, appropriate Qingre Jiedu, Tongli Gongxia, applying effect of Tongfu Xiere method in adjuvant treatment of surgical acute abdomen in sepsis, to early remission of abdominal distention abdominal pain symptoms, promote the recovery of gastrointestinal function, promote early exhaust defecation, reduction of intestinal endotoxin translocation, ameliorates endotoxin on the body symptoms of poisoning, which attenuates the systemic inflammatory response syndrome, remission in the early stage of acute lung injury, reduce the eomplications, improve clinical curative effect.