Evaluation The Efficacy Of TCM Intervention For Sepsis Shock Patient Based On PiCCO

ObjectiveThe main purpose of this study is to observe patients with sepsis shock,on the PiCCO monitoring and conventional anti-septic treatment,the Xuebijing injection and Xinmailong injection combined with syndrome differentiation analysis of traditional Chinese medicine,the changes of relevant indicators has been observed and the clinical efficacy has been evaluated,in order to further explore the clinical curative effect of TCM injections Xuebijing and Xinmailong.MethodThis study is a prospective randomized controlled study.From September 2016 to December 2018,70 septic shock patients admitted to ICU of Guangdong provincial hospital of traditional Chinese medicine were divided into treatment and control group according to the order of admission and random number table method.Patients in both groups were treated with standard treatment and PiCCO monitor.Patients in the treatment group were mainly divided into two types based on TCM syndrome differentiation,combine with the syndrome differentiation was guided by PiCCO parameters.For patients with heat poisoning and blood stasis syndrome,treatment of qinrehuoxue:Xuebijing injection 50ml BID,intravenous infusion,with a course of 5 days.For patients with Yang deficiency and blood stasis syndrome,treatment of wenyanghuoxue:Xinmaolong injection,5mg/kg body weight BID,was intravenous drip for a course of 5 days.Collected the data of MAP,hemodynamic changes,tissue perfusion(Scv02,Lac and arteriovenous pco2 gradient),serum myocardial injury markers(BNP and cTnI,),inflammation index(CRP and PCT),security index(liver function,and renal function index)and end event case fatality rate(28 days),and other clinical data.The experimental data were analyzed using Prism 8.0 statistical software package combined with relevant majors.Results1.No significant difference of MAP between two group before treatment(P>0.05),both groups' s MAP are better after treatment,there was a significant difference(P<0.05).In addition,the MAP of treatment group rise superior to control group,the MAP difference value between two groups show statistical significance(P<0.05).2.No significant difference of CO,CI,SVI,SVRI,EVLWI and CVP before treatment(P>0.05),there was significant difference in CI between the two groups after treatment,(P<0.05);the difference value of CI and CVP between two groups show statistical significance(P<0.05).3.No significant difference of Scv02,Lac,pco2 difference between arteries and veins,BNP,cTnI,CRP and PCT before treatment(P>0.05).However,pco2 difference between arteries and veins and BNP showed significant difference between the two groups after treatment,(P<0.05);the difference value of Lac and BNP showed significant difference between the two groups(P<0.05).4.No significant difference in mortality between the two groups on day 5,7 and 28(P>0.05).ConclusionMAP and CI in both groups were improved,indicating that PiCCO can guiding the fluid resuscitation in patients with septic shock.However,compared with the control group,the improvement of MAP and CI in the treatment group was better than control group,indicating that Xuebijing and Xinmailong injection could improve the cardiac function to some extent,thereby increasing the MAP of patients.