The Influence Of Integrated Traditional Chinese Medicine With Western Medicine On High Mobility Group Box Chromosomal Protein1(HMGB1),Treg,Th1/Th2,HLA-DR In The Patients Of Sepsis Withacute Lung Injury/Acute Respiratory Distress Syndrome(ALI/ARDS)

Objective To observe the effects of Qingfeichengqi decoction on thelevels of high mobility group box chromosomal protein1(HMGB1), Regulatory Tcells(Treg) ratio,Th1/Th2and human leukocyte antigen DR（HLA-DR）in patients withsepsis-associated lung injury． To investigate the relationship between HMGB1andsepsis, Discussion on biological basis of"The lung and the large intestine being interior-exteriorly related" induced acute lunginjury and acute respiratory distress syndrome (ALI/ARDS), to provide the basis ofscientific essence for "lung and large intestine photograph the outside and the inside".Methods A total of62patients with sepsis-associated lung injury who were admittedconsecutively between2010March—2013June were recruited in No.1Hospital ofDalian Medical University, emergency ICU and general surgery，them were randomizedto the western medicine group(n=31,routine treatment of Western medicine plus placebo,placebo is similar character granules without efficacy) and the integrated Chinese andWestern medicine group(n=31， routine treatment of Western medicine plusQingfeichengqi decoction， Qingfeichengqi decoction oral/tube injection/enema,2times/d, continuous administration for14days).Select the same age, sex matched15normal subjects as control group. To observe and compare the expression rate ofHMGB1,Treg，Th1/Th2,HLA-DR among three groups on admission (D1) and thirddays(D3),seventh days (D7) and14days (D14) after treatment. Results C reactionprotein (CRP) and APACHE II score were statistically significant difference betweenthe integrated Chinese and Western medicine group and the western medicine group（P＜0.05）,the integrated Chinese and Western medicine group CRP and APACHE II scorehigher, more serious illness. Estimated marginal means shows:(1) the integratedChinese and Western medicine group and Western medicine group had no difference inD3,but significant difference in D7and D14and the integrated Chinese and Western medicine group was higher. Compared with the control group, the expression rate ofHLA-DR in D14time is similar, the difference was statistically significan（tP＜0.01）.(2)The expression rate of Treg shows the integrated Chinese and Western medicine grouponly higher than the western medicine group in D7, the difference was statisticallysignificant（P＜0.01）.(3) The expression rate of Th1/Th2of the integrated Chinese andWestern medicine group in D3, D14was lower than western medicine therapy group,D7was higher than the western medicine group, the difference was statisticallysignificant（P＜0.01）.(4)The integrated Chinese and Western medicine group HMGB1in D7, D14lower than western medicine group, the difference was statisticallysignificant（P＜0.01）. Conclusion Purgative method had a better effect than westernmedicine treatment in patients with sepsis-associated lung injury on HMGB1,Treg,Th1/Th2,HLA-DR.Reduce the level of HMGB1can improve the prognosis of sepsis,these improved indexes supports the theory of ‘lung and large intestine photograph theoutside and the inside’.