| Background: Sepsis is a common and severe complication among the patients who are seriously infected, suffered from shock or injury as well as critically ill patients with internal medicine or surgery problems.At present, sepsis has become the main causes of the death of ICU and it is also a primary problem in the medical field. Septic coagulation disorder runs through the whole process of its pathological development and plays an important role in it. It is also an essential part in the development of DIC、MODS.In recent years, there are still some confusions in the modern medical field about the treatment of sepsis in each stage and there is no obvious effect in the treatment of antibacterial agents, anti-CD, the external toxin antibody and anti-TNF-alpha. What’s more, little effect is found in anticoagulant therapy, immunization therapy, expansion of microcirculation and neuroendocrine system regulating, on the contrary, they accelerate the progress of the disease and at last cause DIC which leads to the rising fatality rate each year. Except for APC in the treatment of sepsis, there’s no other clear evidence-based medicine in western medicine. Due to the fact that the western treatment is poor, more and more people have been motivated to explore the treatment of Chinese medicine. The application of traditional Chinese medicine to improve the coagulation function of patients with sepsis has become the focus of our study. According to these conditions, this study carries out the work based on clinical experiments.Objective:The paper rely on researching the improvement of coagulopathy on the use of shengmai injection and decoction for invigorating the spleen in septic patients with coagulopathy aims to provides a new way to treat septic blood syndrome with combination therapy.Methods:Observe the46ICU patients with sepsis coagulopathy satisfied the inclusion criteria during the period from2011December to2013June in Xiyuan Hospital. Divide them into two groups randomly, the treatment group (24cases) for Shengmai injection combined with Guipi Decoction and routine western medicine,the matched group(22cases)for the conventional Western medicine. Observe the two groups separately and record their temperature, respiratoryrate, blood platelet count, blood coagulation(APTT, PT, TT), occult blood test, C-reactive protein, APACHE score, TCM symptom score before they are texted and at the fifth and tenth day in the process. Then judge the TCM influence on coagulationdisorders. Furthermore, record the fatality rate during the28days and study the relationship between TCM and prognosis.Results:(1)Compare the treatment group and the matched group on the fifth day, there is no statisticalsignif icance in the difference of temperature, respiratoryrate, soterocyte, blood coagulation, C-reactive protein,turn rate of occult blood test and APACHE II (P>0.05). However, there is statisticalsignificance in the difference of TCM symptom score (P<0.05).On the tenth day, there is no statisticalsignif icance in the difference of temperature, respiratoryrate, soterocyte and APACHE (P>0.05). There is statisticalsignificance in the difference of blood coagulation, C-reactive protein, turn rate of occult blood test and TCM symptom score (P<0.05).(2)In the treatment group, compare the situation separately on the fifth day and the tenth day with that before the treatment and we can find that there is statisticalsignificance in the difference of temperature, respiratoryrate, blood coagulation, TCM symptom score and APACHE Ⅱ (P<0.05).However, as for soterocyte, C-reactive protein and turn rate of occult blood test, there is no statisticalsignificance on the fifth day (P>0.05), but there is statisticalsignificance on the tenth day.(3) In the matched group, compare the situation separately on the fifth day and the tenth day with that before the treatment and we can find that there is statisticalsignificance in the difference ofsoterocyte, TCM symptom score (P<0.05). As for temperature, blood coagulation, C-reactive protein and APACHE II score, there is no statisticalsignificance in the difference both on the fifth day and tenth day (P>0.05). When it comes to the treatment of respiratoryrate, there is no statisticalsignificance on the fifth day (P>0.05),but there is on the tenth day (P<0.05).(4)Compare the mortality rate of the two groups during the28days, there is statisticalsignificance due to the fact that the rate of the treatment group(25%) is far lower than the other group.Conclusions:1.The treatment effect to cure the septic patients with septic blood syndrome who are characterized by Qidys function in bloodcontrol using shengmai injection and decoction for invigo-rating the spleen is obvious.2.According to the difference among laboratory related indexes, the treatment group compared to four items of blood coagulation, occult blood test and control group,It proves that there has certain advantages to correct the disorder of blood coagulation and increase the number of positive cases of occult blood test by using shengmai injection and decoction,besides,it can also prevent the development of septic hyperlipidemia.3. The comparison about two groups of patients28day mortality were statistically significant, it indicates that Shengmai injection and decoction has some effect on the prognosis of the patients, because it can reduce mortality.4. The change of C reactive protein in patients in treatment group is more important than the control group on statistical aspect, it proves that Shengmai injection and decoction has certain effect on reducing the inflammatory response in patients. |
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