Studies On The Characteristics Of Traditional Chinese Medical Syndrome And The Role Of Nuclear Factor-kappaB Activation In Critically Patients With Systemic Inflammatory Response Syndrome

Background: Multiple organ dysfunction syndrome (MODS) is a major cause of death in intensive care unit patients .At present, it is well known that systemic inflammatory response syndrome (SIRS) may play a very important role in the development of MODS. SIRS was a conception first brought forward in America in 1991 referring to the uncontrolled systemic inflammatory cascade induced by infectious or noninfectious factors. It always leads to pyaemic shock and multiple organ dysfunction syndrome. Up to now, the cause and pathogenesis are still unknown, and there isn' t any effective therapeutic methods. Detecting and diagnosis of SIRS in early stage is significant to interrupt the pathophysiologic process. Though previously studies showed that a variety of treatments in traditional Chinese medicine may be valuable for the disease, those studies are still in the primary stage as a whole. There is a lack of systematic research and relatively accordant understanding in the aetiology, pathogenesis, distribution of syndromes, characteristics of progress, and treatment with syndrome differentiation. As a starting point of the systematic research of SIRS, this study aims at finding out the elementary syndrome indifferent stages, probing into the possible tendency in the regularity of evolvement and some sensitive indicator of SIRS.Methods: According to standard diagnosis put forward by ACCP and SCCM, the 48 patients who met SIRS criteria were studied after they were hospitalized in ICU of the first affiliated hospital of Guang Zhou university of TCM from April, 2003 to December, 2004. The APACHEII was detected in 48 patients admitted at ICU at the first day. At the same time, the traditional Chinese medical(TCM) features of the different symptom types of SIRS were investigated. And the information of inspection, the listening and smelling examination, inquiry and palpation four examinations. Blood was drown from elbow vein in each patient respectively at the second day morning after their admission. ELISA methods were used to determine NF-κB activation in peripheral Blood Mononuclear cell from SIRS patients, and RIA methods were used to determine plasm TNF-a and IL—1β levels. 20 healthy individuals were used as controls. Results:1. In the SIRS patients, the mostly TCM syndromes are phlegm heat syndrome(27.1%), phlegm moist syndrome(22.9%), and stagnant blood syndrome (22. 9%).The patients with exterior syndromes and blood deficiency syndrome are quit a few.2. The tongues of the SIRS patients show that these tongues are often dull (52.1%) , and have greasy coatings (72.9%) . The rapid pulses are the majorpulses (70.9%) in the SIRS patients,,3. In the SIRS patients, the percentage of the excess syndrome is 41. 6%, which of the excess & deficiency syndrome is 52.1% and deficiency syndrome is 6. 3%. compared with the normal control group (p<0.01) .4. The level of TNF- a and IL—1β in the group ofA, B and C are significantly increased, compared with the normal control group (p<0. 01) .5. The level of NF- κ B in the group of A, B and C are significantly increased, compared with the normal control group (p<0. 01) .