Clinical Research On Therapeutic Effect Of Changweishu On Septic Patients With Gastrointestinal Dysfunction

Objective: to explore the clinical curative effect of Changweishu in treating septic patients with gastrointestinal dysfunction by studying therapeutic effect of Changweishu on the treatment of septic patients with gastrointestinal dysfunction and observing its impact on TNF-α 、 IL-6 、HMGB-1、DAO and D-lactate.Methods: the fifty cases being observed were all septic patients with gastrointestinal dysfunction admitted in the emergency intensive care unit from September 2013 to June 2015. In accordance with the random number table, these case, numbered in sequential order, were randomly divided into an experimental group of 25 cases and a control group of 25 cases. The results of statistic analysis showed that there were no significant differences between the two groups in terms of age, gender, protopathy, APACHEⅡ scores and so on(P>0.05). Therefore, the two groups were comparable. The conventional western medicine treatment combined with Changweishu(one dose of concentrated decoction of 150 ml for every day) were given to the experimental group through nasogastric tubes.(the medicine referred is Rhizoma et Radix Rhei for 9g, Dandelion 20 g, Ophiopogonis tuber 15 g, Pericarpium citri reticulatae viride 15 g, Angelica 15 g, Erythro- white peony root 12 g, Szechwan lovage rhizome 9g, Agrimony 20 g, CoPtis 6g, QingXia 6g, Snakegourd fruit 15 g, Sanguisorba 20 g, PORIA from Yunnan of China 20 g. they were all thick fried by our hospital manufacturing laboratory). The control group was treated with the conventional western medicine. To observe the incidence of MODS and mortality, scoring changes relating to APACHEⅡ and gastrointestinal dysfunction, DAO, D-lactate, as well as changes for inflammatory factors including TNF-α, NF-IL-6、HMGB-1 and then evaluate the clinical effect of Changweishu on improving cases’ gastrointestinal function after five days of treatment in both groups.Results:1 comparison of MODS ratio and mortality rate in two groups:the MODS ratio for the experimental group is 32% and 60% for the control group, and there was significant statistical difference(P<0.05); the mortality rate for the experimental group is 28% and 56% for the control group, and there was significant statistical difference(P<0.05). It revealed that the curative effect of Changweishu on the MODS ratio and mortality rate in the experimental group was better than that in the control group。2 comparison of APACHEⅡ scoring changes in two groups: in the treatment group, the APACHEⅡ scores before and after treatment were respectively 16.48±1.56 points 、 10.72±1.24 points, there was significant statistical difference(P<0.05);in the control groups, APACHE Ⅱscores were respectively 16.64±1.96 points 、 11.48±0.96 points, and thus statistical difference was significant(P<0.05); Through comparison of the two groups after treatment, there was significant statistical difference(P<0.05). It showed that disease severity of cases in both groups were eased after treatment. But the curative effect in the experimental group was better than that in the control group.3 comparison of scoring changes relating to gastrointestinal dysfunction: the scores for the experimental group before and after treatment were 2.32±0.63 points、1.00±0.87 points respectively and there was significant statistical difference(P<0.05); in the control group, the scores were 2.16±0.75 points 、 1.56±0.96 points respectively and the statistical difference was significant(P<0.05). Through comparison of the two groups after treatment, there was significant statistical difference(P<0.05). It showed that gastrointestinal dysfunction of cases in both groups were alleviated after treatment. But the curative effect in the experimental group was superior to that in the control group.4 comparison of the content changes of DAO、D-lactate in cases’ serums in two groups: in the experimental group, serum DAO content before and after treatment was 28.32±4.06、4.84±1.57 respectively and there was significant statistical difference(P<0.05); serum D-lactate levels before and after treatment were 7.68±1.07、6.10±1.07 and there was significant statistical difference(P<0.05); in the control group, serum DAO levels before and after treatment were 27.48±4.12、6.32±2.97 respectively and there was significant statistical difference(P<0.05); serum D-lactate levels before and after treatment were 7.71±1.00 、 6.71±0.98, there was significant statistical difference(P<0.05); there was significant difference between the two groups after treatment. It revealed that the content of DAO、D-lactate in cases’ serums were all decreased in both groups. Whereas the curative effect in the experimental group was superior to that in the control group.5 comparison of the content changes of TNF-α、IL-6、HMGB-1 in cases’ serums in two groups: in the experimental group, serum TNF-α content before and after treatment was 45.36±7.93 、 20.55±4.40 respectively, there was significant statistical difference(P<0.05); in the experimental group, serum IL-6 content before and after treatment was 160.64±18.61、67.48±10.36, there was significant statistical difference(P<0.05); in the experimental group, serum HMGB-1 levels before and after treatment were 45.76±8.02 、19.27±3.72, there was significant statistical difference(P<0.05); in the control group, serum TNF-α content before and after treatment was 42.75±8.58、24.60±8.67, there was significant statistical difference(P<0.05); in the control group, serum IL-6 levels before and after treatment were 161.60±17.34、75.28±15.27, there was significant statistical difference(P<0.05); in the control group, serum HMGB-1 content before and after treatment were 45.51±8.29、23.32±7.66, there was significant statistical difference(P<0.05); There existed significant difference between the two groups after treatment. It revealed that the content of TNF-α,IL-6 and HMGB-1 in cases’ serums were all decreased in both groups. Whereas the curative effect in the experimental group was better than that in the control group.6 comparison of the gastrointestinal efficacy after treatment in two groups: the total effective rate for the experimental group was 80% and 48% for the control group. There was significant difference between the two groups(P<0.05). It revealed that the treatment adopted in the experimental group can effectively improve the gastrointestinal dysfunction of septic patients and thus its curative effect is better than that in the control group.Conclusions: this study reveals that Changweishu can significantly improve gastrointestinal function and prognosis of septic patients with gastrointestinal dysfunction and its mechanism of action may be the reason that Changweishu can effectively inhibit inflammatory mediators like TNF-α、IL-6、HMGB1.