| When the body is suffered from the serious blow, such as severe infection, trauma, burns, acute pancreatitis, shock, surgery, postoperative cardiopulmonary resuscitation, etc, It will be resulting in multiple organ dysfunction syndrome (multiple organ dysfunction syndrome, MODS). It is critical condition, if you have Less effective control, may progress to irreversible multiple organ failure (multiple organ failure, MOF) phase. The mortality is high and the prognosis is poor. Some studies have shown, the occurrence of the two organ failure mortality was 6.67%, three organ failure, mortality was 81.82%, four organ failure, mortality was 100%. The occurrence of multiple organ dysfunction mechanism is that when the body was badly hit, the body will produce defensive reactions, release of inflammatory mediators, but it release of too much proinflammatory, will be resulting in a systemic inflammatory response syndrome (systemic inflammatory response syndrome, SIRS) SIRS has caused systemic multiple organ system damage, resulted in the occurrence of MODS. The common path that the occurrence of MODS due to various factors from SIRS has been most common approach in the academic recognition. From the time that the body has been the emergence of a serious blow to the MODS, SIRS is the most critical link. Therefore, it has great significance that researching the occurrence and development of SIRS and preventting the occurrence of MODS, even the incidence of MOF.In the development of SIRS, the tumor necrosis factor (TNF-a), interleukin-6 (IL-6) are two important inflammatory mediators. TNF-αand IL-6 can activate the vascular endothelial cells, mononuclear cells to produce chemokines, activation of neutrophil cells to produce inflammatory mediators, activation of B cells, T cells, NK cells, and enhance its activity and function. It's particularly important that TNF-αplays an important role on the inflammatory response. It was produced by the monocytes and macrophages as the inflammatory response in the initial factor. Therefore, it may be an effective way for the treatment of SIRS and to prevent the occurrence of MODS that the reduction or inhibition of TNF-αand IL-6 expression.But also the occurrence and development of SIRS are closely related with the intestinal. When the body was a major blow, the intestinal is ischemia and hypoxia, intestinal mucosal barrier damage, shifting of intestinal flora, it will be resulting in SIRS The intestinal fatty acid binding protein (iFABP) is a sensitive indicator when the intestinal mucosal barrier is impaired. Therefore, it is an important aspect of their treatment in the treatment of SIRS and restore bowel function to protect the intestinal mucosal barrier.In clinical, it was used to treat SIRS that the drug could reduce application of cytokine synthesis and release, such as increasing the concentration of intracellular cAMP and glucocorticoid and other drugs, but its clinical efficacy remains to be affirmed. The studies have reported that Dachengqitang prescriptions achieved good effect. such as severe acute pancreatitis, acute lung injury, acute respiratory distress syndrome. Whether they are pro-inflammatory by decreasing the media, Therefore, these studies are important which show the direction of researching and treatmenting SIRS for our. The damagement of the intestinal mucosal barrier, and the shift intestinal flora and increase is a way to produce or aggravate SIRS, but whether their protection through the intestinal mucosal barrier to reduce the systemic inflammatory syndrome, currently few reports related to the research.Dachengqitang isthe prescription which mainly takes over, and its role in blood circulation is weak. The SIRS occurs, intestinal are ischemia and hypoxia, it is necessary to increase blood circulation drugs that Dachengqi decoction is of treating systemic inflammatory response syndrome. The project intends to study effects of Dachengqi decoction in the treatment of SIRS on TNF-α, IL-6, and the relationship between the intestinal mucosal barrier and TNF-α,IL-6.Objective:First, research the effects on TNF-αand IL-6 for Dachengqi decoction in the systemic inflammatory response syndrome (SIRS). Second, research the relationship between the inflammatory factors and intestinal function in the occurrence ofsystemic inflammatory response syndrome (SIRS).Materials and methods:Put 30 cases patients with systemic inflammatory response syndrome of The Undergraduate Office (2010,10-2011,3) to sort by admission in chronological order who has suffered a severe blow:1-30, They were randomly divided into two groups:A group (control group,15) And B (experimental group,15). Give drugs in a clear diagnosis within 24 hours, B group is will be given drugs by stomach tube or oral Dachengqi Decoction, A group is will be given water of the 5% brown sugar (placebo). Respectively, puming blood After the initial assessment of patients admitted to hospital and at 7:00 of the second,third,fourth and fifth day after admission, and centrifuging into the-80℃refrigerator. Recording the duration of systemic inflammatory response syndrome and intestinal function recovery time, measuring the value of TNF-α, IL-6 and iFABP with enzyme-linked immunosorbent assay were used (ELISA), creating dynamic.curves to compare.Results:First, The comparison of the duration of systemic inflammatory response syndrome:The comparison of the duration of systemic inflammatory response syndrome for B group (experimental group) and the A group (control group) were significantly different ((?)P<0.05), The time of sustained systemic inflammatory response syndrome B group was significantly shorter than the A group.Second, Comparison of intestinal function recovery time:The recovery time of bowel function for B group (experimental group) and A (control group) were significantly different (P<0.05), intestinal function recovery time of B group was shorter in group AThird, the dynamic changes for TNF-α:The plasma TNF-αlevels for B group (23.3493±7.7363) pg/ml compared with A group (25.2600±9.9063) pg/ml no significant difference (Pall>0.05), within 24h in the hospital for SIRS patients; the third day, B group (26.9780 ±7.5978·) pg/ml was significantly lower than the A group (42.6273±17.7431) pg/ml (Pal<0.05); the fourth day, B group (18.1493±5.4142·) pg/ml was significantly lower than the A group (30.5647±11.1026) pg/ml (Pal<0.05); the fifth day, B group (13.6653±3.5621·) pg/ml was significantly lower than the A group (21.7840±6.1643) pg/ml (Pall<0.05); B group (13.6653±3.5621·) pg/ml after five days of hospitalization were significantly different (Pall<0.05) from admission within 24h (23.3493±7.7363) pg/ml.Fourth, the dynamic changes of IL-6:SIRS patients, on admission, The levels of IL-6 in plasma for B group (12.9693±6.2826) pg/ml witch compared with the A group (13.7247±7.3188) pg/ml is no significant difference (Pall> 0.05); B group (13.6087±5.6475) pg/ml on the third day of hospital was significantly lower than the A group (28.8000±18.6828) pg/ml (Pall<0.05); B group (10.4747±4.2599) pg/ml on the fifth day of hospitalization was significantly lower than A group (19.0380±10.2374) pg/ml (Pall <0.05); B group (7.6967±3.5569) pg/ml on the fifth day of hospitalization was significantly lower than A group (12.8000±6.5457) pg/ml (Pall<0.05); B group of patients admitted to hospital the fifth day (7.6967±3.5569(?)) pg/ml compared with the admission within 24h (12.9693±6.2826) pg/ml significantly Lower (Pall<0.05).Fifth, the dynamic changes of iFABP:the plasma in the intestinal fatty acid binding protein (iFABP) content (5.5687±4.2487) ng/ml for B group on admission compared with the A group (5.4800±3.8965) ng/ml is no significant difference (Pall> 0.05)for SIRS patients; On the fifth day of hospitalization, the group B (2.7600±1.1862(?)) ng/ml was significantly lower than the A group (5.1100±3.2290) ng/ml (Pal<0.05); The B group (2.7600±1.1862(?)) ng/ml on the fifth day of hospitalization compared with the admission (5.5687±4.2487) ng/ml within 24h was significantly lower (Pal<0.05).Sixth, the plasma concentration versus time curve of iFABP, TNF-α, IL-6:Comparing A group and B group, the plasma concentrations began to decrease time of iFABP, TNF-αand IL-6 for B group is earlier than A group.Seventh, The relationship between iFABP and TNF-a, IL-6:in the B group, plasma concentration of TNF-αand iFABP was positive correlation,R2=0.979, P<0.05, and the regression equation is statistically significant; the plasma concentration of IL-6 and iFABP was positive correlation,R2=0.9731,P=<0.05, the regression equation is statistically significant, in the A group, plasma concentration of TNF-αand iFABP was positive correlation, R2=0.9731, P<0.05, and the regression equation is statistically significant; the plasma concentration of IL-6 and iFABP was positive correlation, R2=0.9918, P<0.05, the regression equation is statistically significant.Conclusion:First, Da Cheng Qi decoction can reduce the systemic inflammatory response syndrome duration, the recovery time of bowel function.Second, In the systemic inflammatory response syndrome (SIRS), Da Cheng Qi decoction can decrease the plaasma concentration of tumor necrosis factor-α(TNF-α), interleukin-6 (IL-6) and intestinal fatty acid binding protein (iFABP). Third, Impaired intestinal barrier function are closely related with the tumor necrosis factor-α(TNF-α), interleukin-6 (IL-6). |
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