| Objective1.Clinical study to explore the distribution of TCM syndromes of septic acute lung injury,in order to better understand the nature of septic acute lung injury and guide clinical diagnosis and treatment.2.Animal experiments were conducted to explore the mechanism of ginkgo biloba extract injection on septic acute lung injury in rats.Methods1.Clinical study:using the retrospective study method,by searching the electronic medical record system of the affiliated Hospital of Shandong University of traditional Chinese Medicine,the cases of patients with sepsis with acute lung injury from June 2016 to December 2019 were collected according to the case inclusion criteria.Collect the basic information of patients and symptoms,signs,tongue,pulse and other four diagnostic information,fill in the TCM syndrome questionnaire,summarize the classification of syndromes,use SPSS22.0 software statistical analysis to explore the distribution of syndromes and the relationship between syndromes and related factors.2.Experimental study: ninety-six rats were divided into sham operation group,sepsis group,prevention group and treatment group according to 24 rats in each group.the sepsis group,prevention group and treatment group were established into septic acute lung injury model by cecal ligation and puncture.Saline or ginkgo biloba extract injection was injected 6 hours before and 0.5hours after modeling,and the survival rate of rats was observed.Blood samples from abdominal aorta were taken to determine the levels of IL-6 and TNF-αin serum,MDA concentration and SOD activity in lung tissue were measured,and the differences between groups were observed.Results1.Clinical research1.1 General Information A total of 90 patients with septic acute lung injury were collected.Among them,52% are men and 48% are women.The 28-day survival patients accounted for 57%,the average age was 58.88 ±18.825 years old,and the 28-day death patients accounted for 43%,with an average age of 69.48 ±17.380.The age of onset ranged from 24 to 96 years old,and the average age of onset was 63.59±18.855 years old.There were 32 patients in the 61-80 age group,followed by 22 patients in the 81-100 age group,22 patients in the 41-60 age group,and 14 patients in the 21-40 age group.There was a negative correlation between survival rate and age growth.Hypertension and cardio-cerebrovascular diseases accounted for a large proportion of the main underlying diseases,including 54 cases of hypertension,43 cases of coronary heart disease,29 cases of cerebral infarction and 26 cases of diabetes.1.2 Clinical symptoms and syndromes(1)Among the clinical symptoms,shortness of breath and cough accounted for 68.8% and 62.2%,respectively.(2)According to the single syndrome,there were 47 cases of heat toxin syndrome,37 cases of phlegm heat syndrome,30 cases of blood stasis syndrome,23 cases of viscera syndrome,21 cases of qi deficiency syndrome,14 cases of phlegm turbid syndrome,4 cases of yang deficiency syndrome and 3 cases of yin deficiency syndrome.(3)From the perspective of compound syndrome,the highest proportion of the two syndromes was 56.7%.There were 9 cases of heat toxin syndrome + viscera syndrome,9 cases of heat toxin syndrome + phlegm heat syndrome,9 cases of qi deficiency syndrome + blood stasis syndrome,6 cases of phlegm heat syndrome+ viscera syndrome,6 cases of qi deficiency syndrome + phlegm turbid syndrome,5 cases of heat toxin syndrome + blood stasis syndrome,4 cases of phlegm turbid syndrome + blood stasis syndrome,1 case of qi deficiency syndrome + yin deficiency syndrome,1 case of yin deficiency syndrome and 1 case of yang deficiency syndrome.The combination of one syndrome and three syndromes accounted for 22.2% and 21.1%,respectively.There were 10 cases of heat toxin syndrome,7 cases of phlegm heat syndrome and 3 cases of Yang deficiency syndrome.The compound order of the three syndrome types was heat toxin syndrome + phlegm heat syndrome + viscera syndrome,heat toxin syndrome +phlegm heat syndrome + blood stasis syndrome,4 cases of qi deficiency syndrome+ phlegm turbid syndrome + blood stasis syndrome,and 1 case of qi deficiency syndrome + yin deficiency syndrome + blood stasis syndrome.(4)Among the syndromes of deficiency and excess,there were 65 cases of excess syndrome(72.2%),20 cases of mixed syndrome of deficiency and excess(22.2%),and 5 cases of deficiency syndrome(5.6%).Among them,39 cases survived with empirical evidence,11 cases with mixed deficiency and excess syndrome,and 1 case with deficiency syndrome.2.Experimental research2.1 Survival rate Within 72 hours after the establishment of the model,the survival rate of rats in the sepsis group(C),prevention group(P),treatment group(T)each group showed a downward trend as a whole,with the passage of time.At the 72-hour node,the survival rate was the highest in the prevention group,followed by the treatment group,and the lowest in the sepsis group.P<0.05,the difference was statistically significant.2.2 Inflammatory reaction After 12 hours of modeling,there were significant differences in serum IL-6 and TNF-α among the three groups.Compared with sham operation group,the levels of IL-6 and TNF-α in prevention group,treatment group and sepsis group were significantly higher.Among them,the prevention group was the lowest,followed by the treatment group,and the sepsis group was the highest.P<0.05,the difference was statistically significant.2.3 Oxidation reaction Compared with the sham operation group,the concentration of MDA in the lung tissue of the sepsis group increased significantly.After treatment with ginkgo biloba extract,the concentration of MDA decreased significantly,and the concentration of the prevention group was significantly lower than that of the treatment group.The activity of SOD in sepsis group was significantly lower than that in sham operation group,and that in prevention group and treatment group was significantly higher than that in sepsis group,and that in prevention group was significantly higher than that in treatment group.P<0.05,the difference was statistically significant.Conclusions1.Age factor is an important factor in the prognosis of patients,the condition is dangerous,elderly patients suffer from the disease,physical deficiency,coupled with more basic diseases,treatment is particularly difficult,the prognosis is poor.2.The basic pathogenesis of acute lung injury in sepsis is the deficiency of healthy trend and excess of pathogenic factors,and the loss of lung.The pathological nature always belongs to standard reality and deficiency.The pathological factors of the disease include heat toxin,phlegm and blood stasis.Heat toxin,phlegm and blood stasis are pathogenic factors,while deficiency of qi,yang and yin.3.Septic acute lung injury is more common with compound syndrome,such as heat toxin,turbid phlegm,blood stasis,viscera and so on.Deficiency and excess syndrome,especially deficiency syndrome,has a poor prognosis.4.Experimental studies have shown that ginkgo biloba extract injection has a certain protective effect on acute lung injury in septic rats,and the preventive application of ginkgo biloba extract has a significant protective effect and a significant effect on the long-term survival and prognosis of rats.5.Ginkgo biloba extract injection can reduce the levels of IL-6 and TNF-αand the concentration of MDA in septic rats with acute lung injury,and increase the activity of SOD. |
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