The Study Of GuBa Decoction's Treatment On The Stagnated Heat Syndrome And Its Influence On Inflammatory Mediators In The Femoral Shaft Fractures

Objective To observe the clinic effect of Gu Ba decoction in treating the Stagnated Heat syndrome on the early stage of closed femoral shaft fractures and its impact on IL-1, IL-6, TNF-a. Furthermore, explore the machanism of Gu Ba decoction in treating the Stagnated Heat syndrome.Methods From August 2009 to February 2010,60 patients with closed femoral shaft fracture were employed to made study in Foshan hospital of traditional Chinese medicine, according to the inclusion criteria and exclusion criteria.Male 46 cases,14 female, aged 20-50 years, mean age 36.8±2.6 years; injured parts:the left legs of 30 cases,30 cases of right; the mean time from injury to treatment was 6.5±1.5 hours.60 patients were randomized into Gu Ba decoction group, TaoHongSiWu decoction group, conventional therapy group in accordance with the method of stratified randomization. The patients of GuBa decoction group were treated with GuBa decoction one day at a time, combined with basic therapy from the first day, and the course of treatment was 7 days; Tao Hong Si Wu decoction group were treated with Tao Hong Si Wu decoction; and similar with GuBa decoction group. Conventional treatment group were only given basic treatment for 7 days. The symptom scores of the Stagnated Heat syndrome were collected and the IL-1, IL-6, TNF-a serum levels were tested on the first day after admission (before administration), the third day, the fifth day and the seventh day in each patient, compared the clinical symptom scores and IL-1, IL-6, TNF-a serum levels, and further analysed the correlation between the Clinical symptom scores and the IL-1, IL-6, TNF-a serum level.Results The clinical symptom scores were of no significant difference and comparable between three group on the first day; but the scores in the GuBa decoction group was lowest, the TaoHongSiWu decoction was the second, the conventional treatment group was the highest on the third day, the fifth day, the seventh day. the difference was of significant (P＜0.05), but the Taohongsiwu decoction group compared with the conventional group showed no significant difference (P> 0.05). The constipation and swelling scores in GuBa decoction showed the lowest points, and the result was significant in comparing conventional group and the TaoHongSiWu decoction group (P<0.05). The inflammatory cytokines of IL-1, IL-6, TNF-a levels in threen group was of no significant difference on first day. On the third, the fifth and the seventh day, GuBa decoction group compared with Taohongsiwu decoction group and the conventional group showed significant difference(P<0.05). The multiple linear regression and multiple correlation analysis showed positive correlation between IL-6, TNF-a serum levels and Stagnated Heat syndrome scores of GuBa decoction group and TaoHongSiWu decoction group. The correlation coefficient r in GuBa decoction were (0.548,0.7650) respectively, the coefficient in the conventional group were(0.5170,0.2510)respectively, and the results were statistically significant in two group (P<0.05), However, IL-1 in the two groups were not statistically significant, was deleted.Conclusion The study suggests that GuBa decoction, with appropriate drug selection, reasonable compatibility, can significantly improve the clinical symptom of the Stagnated Heat syndrome in the early stage of the femoral shaft fractures, regulate IL-1, IL-6, TNF-a serum levels to some extend. Furthermore, this study finds a positive correlation between IL-6, TNF-a serum levels and Stagnated Heat syndrome scores, and infers that theIL-6, TNF-a may be the microscopic pathology material basis of Stagnated Heat syndrome, concludes that the mechanism of Gu Ba Fang's effect may relate with the regulation of IL-6, TNF-a serum levels.