Clinical Observation On Treatment Of Gastrointestinal Dysfunction In Sepsis Based On Collateral Disease Theory

Objective : To evaluate the clinical efficacy of traditional Chinese medicine self-made prescriptions based on collateral disease theory combined with conventional western medicine in the treatment of gastrointestinal dysfunction in sepsis and effect on inflammatory and coagulation indexes.Methods : Prospective cohort study method,the selection in October2016 to October 2018 in Hebei Province Hospital of Chinese Medicine intensive medicine(ICU),emergency department and emergency severe strengthen ward(EICU)closed type 57 cases of gastrointestinal dysfunction in sepsis in hospital patients as research object,according to patients' wishes,29 patients treated with conventional western medicine were included in the non-exposure group,and 28 patients treated with traditional Chinese medicine self-made prescription combined with conventional western medicine were included in the exposure group.The clinical efficacy,acute physiological and chronic health status evaluation II(APACHEII)score,gastrointestinal dysfunction score,plasma procalcitonin(PCT),plasma d-dimer,and plasma platelet count(PLT)were compared between the two groups before and after treatment.Results:1.Comparison of general data: There were 29 patients in the non-exposure group,including 18 males and 11 females,with a mean age of(72.47±13.24).There were 28 patients in the exposure group,including 15 males and13 females,with a mean age of(69.13 ± 15.58).There was no significant difference in general data between the two groups(P>0.05),which was comparable.2.Comparison of clinical efficacy: after treatment,the total clinicaleffective rate of the exposure group was 92.86%,higher than that of the non-exposure group(79.31%),and the difference was statistically significant(Z=2.408,P<0.05).3.Comparison of APACHEII score and gastrointestinal dysfunction score before and after treatment: APACHEII score of patients in the two groups after treatment was significantly lower than that before treatment,while APACHEII score of patients in the exposure group was significantly lower(t=2.16,P<0.05).The gastrointestinal dysfunction score of the two groups after treatment was significantly lower than that before treatment,while the gastrointestinal dysfunction score of the exposure group was significantly lower,with statistically significant difference(t=3.58,P<0.01).4.Comparison of plasma PCT,D-dimer and PLT levels before and after treatment: PCT levels of the two groups of patients after treatment were significantly lower than before treatment,while PCT levels of the exposure group were significantly lower(t=2.12,P<0.05).After treatment,the D-dimer level of patients in both groups decreased significantly compared with that before treatment,while the d-dimer level of patients in the exposure group decreased significantly(t=2.26,P<0.05).After treatment,PLT level in the exposure group increased compared with that before treatment,and the difference was statistically significant(t=2.14,P<0.05),while PLT level in the non-exposure group decreased compared with that before treatment,and the difference was not statistically significant(t=1.07,P>0.05).PLT level increased more significantly in the exposure group,and the difference was statistically significant(t=3.07,P<0.01).Conclusion:This study result shows that traditional Chinese medicine self-made prescriptions based on collateral disease theory combined with conventional western medicine in the treatment of gastrointestinal dysfunction in sepsis can obviously decrease the plasma PCT,D-dimer level,and increase the PLT level,to improve the function of inflammation and blood coagulation,reduce gastrointestinal dysfunction score,improve gastrointestinal function,reduce the APACHEII scores,reduce disease severity,improve the prognosis.