| Objective:This study used a prospective,randomized controlled research method to observe the clinical efficacy of shenling baizhu powder on gastrointestinal dysfunction in patients with severe pneumonia-induced sepsis from multiple perspectives,including gastrointestinal dysfunction score,gastrointestinal symptoms,nutritional status and internal environment improvement,sepsis condition improvement degree and prognosis.And further explore its therapeutic mechanism.To explore a new way of treating sepsis related gastrointestinal dysfunction by traditional Chinese medicine and provide clinical evidence support.Method:According to the corresponding admission and exclusion standards set in this study,a total of 60 patients with severe pneumonic-induced sepsis gastrointestinal dysfunction were enrolled from the intensive care unit(ICU)of the first affiliated hospital of tianjin university of traditional Chinese medicine from January 2019 to December 2019,and these patients were divided into 30 cases in the treatment group and 30 cases in the control group by random number table method.The control group received conventional treatment in the ICU for sepsis.The treatment group received nasal feeding with shenling baizhu powder decoction on the basis of the treatment.The observation period was 14 days,of which the treatment course was7 days,and continue observation for 7 days after the end of treatment.The basic information of the two patients including gender,age,basic diseases and source of cases were recorded before the formal enrollment.Within 14 days of enrollment,gastrointestinal tract status,gastrointestinal function score and gastrointestinal discomfort symptoms of the two groups of patients were recorded in detail.And on the treatment 1 day,the treatment 72 h and after the end of treatment for 1 day monitoring patients of blood routine,urine routine,and stool routine,liver function,renal function,c-reactie protein(CRP),procalcitonin(PCT)and APACHE Ⅱ score,SOFA score and clinical pulmonary infection score(CPIS),and other data.After data collection,SPSS22.0 software was used for statistics and analysis,and the test level was defined as 0.05,that is,P<0.05 was considered statistically significant.Result:1.Baseline comparison The two groups of patients at general cases(gender,age,cases of sources,etc.), gastrointestinal status(gastrointestinal function score,clinical symptoms,physical and chemical indicators,etc.)and basic illness conditions(APACHE II score,SOFA score,CRP,PCT,hemogram and liver,Kidney function,etc.)and other baseline comparisons were not significantly different(P> 0.05),so the data of the two groups of patients were comparable.2.Improvement of gastrointestinal function2.1 score of gastrointestinal dysfunction After treatment,the score of gastrointestinal dysfunction in both groups decreased compared with that before treatment(P<0.05).The decrease of gastrointestinal dysfunction score in the treatment group was better than that in the control group(P<0.05).Moreover,the scores of gastrointestinal dysfunction in the two groups were further compared on the first,third and fifth days after the end of treatment,and it was found that the scores of patients in the treatment group were still better than those in the control group(P<0.05).2.2 gastrointestinal symptoms After treatment,the incidence of gastrointestinal discomfort symptoms such as abdominal distension,reduced bowel sounds and diarrhea in both groups decreased compared with that before treatment:The comparison between groups showed that the data on the treatment 72h、the day 1after the treatment and day 3 after the treatment showed that the incidence of diarrhea in the treatment group was significantly lower than that in the control group(P<0.05).However,there was no statistical significance in the comparison of abdominal distension and reduced bowel sounds between the groups(P>0.05).2.3 nutritional status and internal environment2.3.1 nutritional status After treatment,the total protein,albumin and pre-albumin of the patients in the treatment group were increased compared with those before treatment,while the three datas of the control group were slightly decreased compared with those before treatment,and the improvement degree of the nutritional status level of the treatment group was better than that of the control group(P<0.05).2.3.2 internal environment status After treatment,the Ph value in the treatment group was better than that in the control group(P<0.05).However,there was no statistical significance in the improvement degree of other physical and chemical indicators of internal environment,such as serum potassium,serum sodium and serum chlorine(P>0.05).3.Inflammatory and prognostic indicators(1)After treatment,the body temperature of patients in both groups was significantly improved compared with that before treatment(P<0.05).The improvement of body temperature in the treatment group was better than that in the control group(P<0.05).(2)After treatment,the improvement of leucocyte in the treatment group was better than that in the control group(P<0.05).(3)After treatment,the improvement of lactic acid in the treatment group was better than that in the control group(P<0.05).(4)After treatment,the results of CRP in both groups were significantly improved compared with those before treatment(P<0.05).The improvement of CRP in the treatment group was better than that in the control group(P<0.05).(5)After treatment,the PCT results in the treatment group were better than those in the control group(P<0.05).(6)After treatment,two groups of patients with APACHE Ⅱ score than before treatment significantly improved(P < 0.05).The improvement of APACHE Ⅱ score in the treatment group was better than that in the control group(P<0.05).(7)After treatment,SOFA scores of patients in both groups were significantly improved compared with those before treatment(P<0.05).The improvement of SOFA score in the treatment group was better than that in the control group(P<0.05).(8)After treatment,CPIS scores in both groups were significantly improved compared with those before treatment(P<0.05).The improvement of CPIS score in the treatment group was better than that in the control group(P<0.05).Conclusion:1.Both of the Shenling baizhu powder combined with routine treatment in ICU and the routine treatment in ICU alone can improve the score of gastrointestinal dysfunction in severe pneumonia-induced sepsis patients and reduce the incidence of gastrointestinal discomfort symptoms,but the group of shenling baizhu powder has a more obvious and lasting effect on the improvement of diarrhea symptoms and the overall gastrointestinal function.2.Shenling baizhu powder combined with routine treatment in ICU can significantly improve the levels of nutritional indicators such as total protein,albumin and prealbumin in severe pneumonia-induced sepsis patients,and further promote the recovery of nutritional status and immune function in patients.3.Both of the Shenling baizhu powder combined with routine treatment in ICU and the routine treatment in ICU alone can significantly improve the inflammation and prognosis indicators such as body temperature,hemogram,lactate,CRP,PCT,APACHE II score,SOFA score and CPIS score in patients with sepsis caused by severe pneumonia The improvement in Shenling baizhu powder group was more obvious,and the prognosis was better. |
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