The Study Of Clinical Effect Of Evodia Hot Iron Therapy On Gut-liver Axis Dysfunction In Postoperative Cirrhotic Portal Hypertension Patients

ObjectiveScientifically evaluate the effects of Evodia hot iron therapy of TCM on improving the "gut-liver" axis with portal hypertension, which is aim to explore effects of Evodia hot iron therapy under the guidance of the theory of Chinese medical surgery, to interpret the scientific substance of the spleen and stomach theory of TCM.MethodsSelect cirrhosis and portal hypertension cases accepted Laparoscopical splenectomy and pericardial decascularization surgery for the study were randomly divided into two groups, Evodia hot iron group and blank control group. Observe preoperational heart rate, body temperature; take the blood sample on preoperative and the1th,3rd,5th days after surgeries, to test biochemistry, liver function, complete blood count, record perioperative complications such as:death, multiple organ dysfunction, hepatic encephalopathy, portal vein thrombosis, abdominal infecions and so on. Take the sample of plasma endotoxin(LPS) on1th,5th days after surgeries.Results1. Treatments group and control group on admission clinical data such as age, sex, etiology, and preoperative liver function Child-Pugh classification, combined with hypersplenism had no significant differences in the situation.2. There were no preoperative death, multiorgan failure, bleeding after surgery, anesthesia cardiovascular accidents and hepatic encephalopathy, hepatorenal syndrome. Postoperative pulmonary infection, pleural effusion had happened on sixes cases, four in treatment group and two in control groups.3. The treatment group compared with control group on heart rate, body temperature contrast:1th and3rdafter surgery, the heart rate of the treatment group came faster than the control group with statistical significance (p <0.05).4. Comparison of postoperative WBC(White Blood Cell) count after surgery on1th,3rd,5th, had shown that there is no significant difference between treatment group and control group.5. Comparison of pre-post operative liver function (AST, ALT, TBIL, ALB, PT) between treatment group and control group had shown that four groups elevated than the ones preoperative on AST, ALT, TBIL, PT, ALB; the treatment group was coming down on1th,3rd,5th postoperate in ALT, AST, PT, TBIL than the control group with statistical significance (p<0.05).6. Comparison of pre-post operative gastrointestinal function between treatment group and control group:(1) the treatment group was quicker in both bowel sounds recovery and the first time exhaust with statistical significance(p<0.05);(2) compare of gastrointestinal abnormalities contrast shown that fewer rate of vomiting happen in the treatment group with statistical significance (p<0.05);7. Comparison of intestinal barrier function (plasma endotoxin LPS) between treatment group and control group shown that the treatment group repaired quicker than the control group on5th postoperative compared with1th result with statistical significance (p<0.05);ConclusionThe surgery of laparoscopic pericardial decascularization had been lauch extended in China; therefore, how to solve the problem of mucosal barrier, gastrointestinal motility, immune dysfunction had became difficult and hot target by clinicians. Evodia hot iron therapy of TCM external had achieved huge effect on gastrointestinal recovery. In this study we speculated Evodia hot iron therapy can improve portal hypertension gut-liver axis dysfunction through this prospective randomized controlled trial, combined with our department research foundations.