The Clinical Study On Treatment Of Sepsis Gastrointestinal Dysfunction With Comprehensive Therapy Of Traditional Chinese Medicine

ObjectivesAt present,the treatment of gastrointestinal dysfunction in sepsis is dominated by symptomatic support.However,the treatment is single,and the curative effect is little.Traditional medicine has unique advantages for sepsis gastrointestinal dysfunction on the basis of the concept of wholism and the therapy with syndrome differentiation,Which has been verified by massive research.But most of the research merely explore some kind of therapy,not the optimization combination on the scheme of traditional Chinese medicine(TCM).This study aimed to explore the clinical curative effect of the TCM comprehensive therapy for sepsis gastrointestinal dysfunction,worked out a comprehensive diagnosis and treatment of TCM which combined internal treatment with external treatment,and acupuncture with Chinese medicine.The goal was to entirely exert the function of TCM in the treatment of sepsis.MethodsThe research for prospective randomized controlled design method incorporated 60 patients with sepsis gastrointestinal dysfunction at the university city hospital Intensive Care Unit of Guangdong Provincial Hospital of TCM from May 2016 to March 2017.It was divided into treatment group and control group 30 cases each via a random number table grouping method.Both groups were cured with conventional western medicine treatment based on the 2012 international sepsis consensus.Of which on the basis the treatment group added up comprehensive treatment of TCM(including Xuebi jing injection dripped into veins,electroacupuncture Zusanli point,and external application of Wuzhuyu on Shenque point),course of treatment for 7 days.To observe two groups of ICU hospitalization days and 28 days mortality.It was respectively observed on the before treatment,and the seventh day that inclued APACHE-II score,gastrointestinal diseases in TCM syndrome score,blood white blood cell,procalcitonin,C-reactive protein,plasma sedimentation rate,gastrointestinal dysfunction score,function of gastrointestinal motility(motilin,gastrin,vasoactive intestinal peptide),gastrointestinal immune barrier function(immune globulin,T-lymphocyte subset),gastrointestinal mucous membrane barrier function(diamine oxidase,d-lactate).Results1.Comparing the disease severity and prognosis:After the treatment,compared 28 days mortality of the two groups,there was no statistically significant difference(P>0.05).Compared with the control group,the treatment group ICU hospitalization days was obviously reduced(P<0.05),on the 7th the treatment group APACHE-II score decreased obviously(P<0.05).2.Comparing inflammatory biomarkers:On the seventh day,compared with the control group,the treatment group WBC,PCT,CRP all decreased obviously(P<0.05);the treatment group compared with control group of ESR,there was no statistically significant difference(P>0.05).3.Comparing gastrointestinal diseases in TCM syndrome score:On the seventh day,compared with the control group,the treatment group score decreased obviously(P<0.05).4.Comparing gastrointestinal dysfunction score:On the seventh day,compared with the control group,the treatment group score decreased obviously(P<0.05).5.Comparing function of gastrointestinal motility:On the seventh day,compared with the control group,the treatment group MTL increased obviously(P<0.05),the treatment group GAS decreased obviously(P<0.05);the treatment group compared with control group of VIP,there was no statistically significant difference(P>0.05).6.Comparing gastrointestinal immune barrier function:On the seventh day,compared with the control group,the treatment group IgG,IgA,IgM,CD3+increased obviously(P<0.05);the treatment group compared with control group of CD4+/CD8+,there was no statistically significant difference(P>0.05).7.Comparing gastrointestinal mucous membrane barrier function:On the seventh day,compared with the control group,the treatment group DAO,D-LAC decreased obviously(P<0.05).ConclusionsOn the foundation of conventional western medicine treatment,application of TCM comprehensive therapy treatment sepsis gastrointestinal dysfunction,which can improve disease severity and shorten ICU hospitalization days,but can not reduce 28 days mortality,reduce inflammatory reaction,improve TCM syndrome,improve gastrointestinal function including gastrointestinal motility function,immune barrier and mucous membrane barrier function.