Clinical Research Of Changwei Shu Combined With Conventional Western Medicine Therapy In Treating Sepsis Patients With Intestinal Dysfunction

Objective: To observe the clinical curative effects of Changwei Shu combined with conventional western medicine therapy in treating the sepsis patients with intestinal dysfunction,and to explore its mechanism of intervention by studying the changes in white blood cell(WBC)count,procalcitonin(PCT)level,intra-abdominal pressure(IAP),intestinal dysfunction scores and scores of acute physiology and chronic health evaluation(APACHE II)before and after treatment.The study aims to provide a new thought for the treatment of intestinal dysfunction in sepsis.Methods: This study was performed in intensive care unit(ICU)of Hebei provincial hospital of Traditional Chinese Medicine.120 cases who fulfilled with the new criteria of sepsis were enrolled from September 2014 to September 2016.The total of 120 cases were randomly divided into treatment group and control group,60 patients in each group.The control group was given conventional western medicine therapy,and the treatment group was given Changwei Shu combined with conventional western medicine therapy.After treatment for 7 days,the clinical efficacy and safety were evaluated by observing the changes in WBC count,PCT level,IAP,intestinal dysfunction scores and scores of APACHE II.Results:1 Comparison of baseline data: There were 36 males and 24 females aged from 18 to 89 in the treatment group,with a mean age of(55.33±14.59).In the control group,there were 32 males and 28 females.The age of them ranged from 21 to 90,with an average age of(56.26±13.94).There was no significant difference of the two groups in gender,age and other general data(P > 0.05).2 Comparison of treatment completion of two groups: For one casedropped out and one was excluded from the treatment group,and 4 cases dropped out and 2 were excluded from the control group,a total of 58 cases in the treatment group and 54 in the control group were included into the study at the end of the trial.3 Comparison of clinical efficacy of two groups: After treatment,the total effective rate of the treatment group was 91.38% and that of the control group was 88.89%,the difference being significant(Z =-2.471,P < 0.05).4 Comparison of WBC count,PCT level and IAP before and after treatment of two groups: There was no significant difference in WBC count,PCT level and IAP of the two groups before treatment(P > 0.05).After treatment,WBC count,PCT level and IAP of the two groups were improved(P < 0.01 compared with those before treatment),and the improvement of the treatment group was superior to that of the control group(P < 0.01).5 Comparison of intestinal dysfunction scores and APACHE II scores before and after treatment of two groups: There was no significant difference in intestinal dysfunction scores and APACHE II scores of the two groups before treatment(P > 0.05).After treatment,intestinal dysfunction scores and APACHE II scores of the two groups were decreased(P < 0.01 compared with those before treatment),and the decrease of the treatment group was superior to that of the control group(P < 0.01).6 Adverse reactions: During the treatment,4 cases from the treatment group had nausea,and 5 cases from the control group had nausea,and the symptoms disappeared spontaneously one week later.No obvious changes were found in the hepatic and renal function of the two groups.Conclusion: Changwei Shu combined with conventional therapy exerts an effect on reducing the inflammation,improving the intestinal function,and relieving the illness severity of sepsis patients with intestinal dysfunction.