Clinical Study On The Effect Of Respiratory Function In Patients With Acute Respiratory Distress Syndrome Caused By Sepsis With The Combination Of Acupuncture With Medicine Xuanfei Tiaochang Method

BackgroundThe pathogenesis of acute respiratory distress syndrome(ARDS)is various,and sepsis is the main cause.In the multiple organ damage caused by sepsis,the most vulnerable target organ is lung,so ARDS is the earliest complication.The incidence rate of ARDS caused by sepsis is fast and rapid.Now western medicine is mainly supported by respiratory support and other symptomatic supportive treatment.However,its morbidity and mortality remain high.There are still many difficulties to overcome.Traditional Chinese medicine often treats severe lung diseases with the method of lung and intestines,while Xuanfei tiaochang formula has the effect of relieving diarrhea,qingrejiedu,yiqi centralizer,and acupuncture at Zusanli has the function of strengthening the spleen and helping to move,strengthening the vital energy and removing pathogenic factors.Therefore,this paper discusses the influence of acupuncture and medicine combined with Xuanfei tiaojiang on the patients with ARDS of sepsis,so as to improve the new thinking for the treatment of ARDS of sepsis.ObjectiveTo observe the effect of acupuncture and medicine combined with Xuanfei tiaochang method on respiratory function of ARDS patients with sepsis,as well as the influence on mortality,mechanical ventilation time,inflammatory response index and other indicators.It can give full play to the advantages of traditional Chinese medicine in the treatment of ARDS.MethodsAccording to the envelope,the patients with ARDS who meet the inclusion criteria were randomly divided into two groups:the control group and the treatment group.The control group was given conventional western medicine treatment according to the existing evidence-based medicine basis;the treatment group was given acupuncture and medicine combined with Xuanfei tiaochang method intervention on the basis of the control group;the two groups were observed 28 day mortality rate,ICU mortality rate,respiratory function,mechanical ventilation time,SOFA score,APACHE Ⅱ score,inflammatory response and immune system,and other indicators were analyzed statistically and finally evaluated clinically.Results1.76 cases were included in this study,of which 2 cases in the control group and 2 cases in the treatment group dropped out due to their own reasons,the clinical data collection was incomplete,and there was no available data to be excluded;another 2 cases in the control group who did not meet the conditions after entering the group were finally excluded.Finally,70 cases were included,36 in the treatment group and 34 in the control group.2.Baseline comparison before inclusion:there was no statistical difference between the two groups in general conditions(P>0.05);the two groups of patients with sepsis ARDS were graded,and the main participants in this study were moderate(control group:50.0%,treatment group:66.7%)ARDS patients,and there was no statistical difference between the two groups(P>0.05);blood gas analysis,respiratory support mode,SOFA score before treatment There was no significant difference in APACHE Ⅱ score,Murray score,lac value,inflammatory index and immune index(P>0.05).3.Main curative effect index:PaO2/FiO2 on the 5th day after treatment in both groups were significantly higher than before,and the differences were statistically significant(P<0.01).The difference in oxygenation index before and after treatment between the two groups was not statistically significant.Academic significance(P>0.05).4.Secondary efficacy index:(1)Respiratory function indicators:①There was no statistically significant difference in blood gas analysis indexes between the two groups before and after treatment(P>0.05);②Comparison of respiratory frequency at the same time point between the two groups of patients before and after treatment.There was a significant difference in the respiratory frequency on the 5th day after treatment(P<0.05);③Comparing the mechanical ventilation time of the two groups,the noninvasive mechanical ventilation time of the treatment group was less than that of the control group,the difference was statistically significant(P<0.05);There was no significant difference in mechanical ventilation time,invasive mechanical ventilation time and high-flow humidifier ventilation time(P>0.05).(2)Inflammation index and immune index:Differences in inflammation indexes CRP,PCT,IL-6,WBC,and NEU before and after treatment between the two groups were not statistically significant(P>0.05);immune indexes CD3+,There was no statistically significant difference between CD3+,CD3+CD4+,CD3+CD8+,CD3+CD4+/CD3+CD8+,IgA,IgG,IgM,C3,C4 and CH50(P>0.05).5.Other effect evaluation indexes:there was no significant difference in SOFA score,APACHEII score,Murray score and Lac score between the two groups before and after treatment(P>0.05).Compared with the control group,the fatality rate of ICU in the treatment group was significantly lower than that in the control group(P<0.05).Compared with the control group,the fatality rate of ICU in the treatment group was significantly lower than that in the control group(P<0.05).There was no significant difference in 28-day mortality between the two groups(P>0.05),but there was a tendency to reduce 28-day mortality in the treatment group(22%in the treatment group and 38%in the control group).6.Safety evaluation index:there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05);there was no significant difference in WBC,PLT,ALT,Cr abnormalities between the two groups after treatment(P>0.05).7.Index of Health Economics:the total hospitalization days in the treatment group were less than those in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in ICU hospitalization days,ICU hospitalization expenses and total hospitalization expenses(P>0.05).Conclusion1.The combination of acupuncture and medicine can improve the respiratory frequency of ARDS patients with sepsis,relieve the patients’respiratory distress,reduce the fatigue of respiratory muscles,and improve the respiratory function to a certain extent;2.The combination of acupuncture and medicine can reduce the ventilation time of non-invasive ventilator of ARDS patients with sepsis;3.The combination of acupuncture and medicine can improve the respiratory rate of ARDS patients with sepsis.4.The combination of acupuncture and medicine can reduce the total hospitalization days of ARDS patients,to some extent,it can reduce the economic burden of patients and their families.