Effect Of Jiawei Huanglian Jiedu Decoction On Pulmonary Protection Of Multiple Organ Dysfunction Syndrome

ObjectiveMultiple Organ Dysfunction Sysndrome(MODS),a common clinical severe case,is one of major death causes with fatality of 40%-100%.Its pathogenesy is so complicated that many experts research it constantly all of the word.The theorise of inflammatory reaction lossing of control and displacement of enter-microbial population and endotoxin are accepted generally.Discovery of cytokine is breakthrough on recognition of lossing of control on inflammatory reaction.Recently some results of reseaching achievement of NOS,NO and NF-κB in MODS had gain.Monitoring organ-function,treating protopathy and supportive treatment are cardinal treatments.Now some therapeutic effect had gain in combination of TCM with Western medicine on clinic.MODS was indicated to be "organs failure syndrome" of TCM among modern research of TCM on MODS.Its pathogenesis is abundance on heat-toxin and damagement of splanchnic organs.Thus the heat-clearing and detoxicating method is one of the major treatments.This type Chinese materia medica possesses effects of antibiosis,anti-virus,anti-endotoxin,regulating immunity,removing ressradicle and so on.This reseach adopts Jiawei Huanglian Jiedu Decoction combinating western medince to treate MODS.This reseach includes two parts:First,clinical observation:evaluate organ function of pretherapy and post-treatment using APACHEâ…¢;statistics mortality of function disturbance in lung,bowel,lung&bowel both and total;statistics mechanical ventilation and its mortality time between two gropes;compare pretherapy with post-treatment on PaO₂/FiO₂ and PaO₂;Second,experimental study:Jiawei Huanglian Jiedu Decoction regulates NOS,NO,NF-K b and pathematological change on lung and bowel.In order to appraisal the effect of Jiawei Huanglian Jiedu Decoction on lung protection.Method1.64 patients,hospitalized in ICU of Guangzhou pafractionate university of TCM from july,2002 to aprol,2008,are fractionated into combination of TCM with We- stern medicine grope(Jiawei Huanglian Jiedu Decoction combinating routine Western medicine)and Western medicine grope(routine western medicine only).Evaluate or- gan function of pretherapy and post-treatment using APACHEâ…¢;Statistics mortality y of function disturbance in lung,bowel,lung&bowel both and total;Statistics mechanical ventilation time and its mortality between two gropes;Compare pretherapy with post-treatment on PaO₂ /FiO₂ and PaO₂.;Summarize effect of Jiawei Huang lian Jiedu Decoction on preven- tion and cure of MODS.2.Experimental study:big rat model of MODS,manufactured by intraperitoneal in- jection of zymosan- liquid paraffin suspl,are fraction ated into three groups:blank group p,model group and Chinese materia medica group.Detecting NOS,NO,NF-K b and pathematological change on lung and bowel to evaluate clinical therapeutic effect of Jiawei Huanglian Jiedu Decoction.3.The results of all data were showed in the form(?)±SD and were dealed with using SPSS11.5 programs of statistics.The relation of data between two groups were compared using standard t-test.Meanwhile the relation of data among several groups were compared using least significant differential method test(LSD).The numeration data were ananlyzed X² test.Nonnumeration data were ananlyzed Chi-Square Test.Results1.Clinical case retrospective analysis1.1 APACHEâ…¢of organs is significant difference between pretherapy and post-tre- atment of combination of TCM with Western medicine grope(P＜0.05);APACHEâ…¢of organs is nonsignificant difference between pretherapy and post-treatment of Western medicine grope(P＞0.05);APACHEâ…¢of organs is significant difference between post-treatmen of two groups;APACHEâ…¢diference of pretherapy and post-treatment is significant difference between two group(P＜0.05).1.2 Mortality of combination of TCM with Western medicine groupe is more less than Western medicine group.1.3 Mortality of function disturbance both lung and bowel is higher than only of lung or bowel.1.4 Mechanical ventilation time is nonsignificant difference between two gropes,but the mortality of patients with mechanical ventilation in Jiawei Huanglian Jiedu Decoction combinating routine western medicine group is lower than western medicine group.1.SPaO₂ and PaO₂/FiO₂ between pretherapy and post-treatmen are all significant difference in two groups.PaO₂/FiO₂ of post-treatment is significant difference between two groupes(P＜0.05),but PaO₂ of post-treatment is nonsignificant difference between two groupes(P＞0.05).2.Experimental study of MODS2.1 The big rat model of MODS by intraperitoneal injection of zymosanliquid paraffin suspl were successful,and showed systemic inflammatory response syndrome(SIRS),also it showed the pathogenesis of abundance on heat-toxin and damagement of splanchnic organs in TCM.2.2 The NO,iNOS of lung and bowel in Chinese materia medica group are significant different from model group at different period(P＜0.05),are higher than blank group.2.3 The cNOS of lung in Chinese materia medica group is nonsignificant different from model group at different period(P＞0.05),but is less than blank group.The cNOS of bowel in Chinese materia medica group is significant different from model group at different period(P＞0.05),but is less than blank group.2.4 NF-κB of lung in three groups are significant different(P＜0.05).NF-κB of bowel in Chinese materia medica group is significant different from model group(P＞0.05),but is nonsignificant different from blank group.Conclusion1.Jiawei Huanglian Jiedu Decoction combinating routine western medicine could relieve state,reduce the mortality of MODS,degrade APACHEâ…¢of MODS,its therapeutic effect surpass Western medicine.2.Jiawei Huanglian Jiedu Decoction combinating routine western medicine could reduce mortality of patients with pulmonary dysfunction,bowel dysfunction and pulmonary&bowel dysfunction both.3.Jiawei Huanglian Jiedu Decoction combinating routine western medicine could not shorten Mechanical ventilation time,but it could reduce the mortality of patients with mechanical ventilation obviously.4.Jiawei Huanglian Jiedu Decoction combinating routine western medicine could improve PaO₂/FiO₂ and PaO₂ of lung,its therapeutic effect surpass Western medicine.5.Jiawei Huanglian Jiedu Decoction could improve pathematological change of pulmonary and bowel tissue,thus it could protect the function of lung and bowel.6.Jiawei Huanglian Jiedu Decoction could reduce NF-κB expression, thus it could relieve the damage to protect the function of lung and bowel.