Clinical Study Of Shenling Baizhu Powder In Patients With MODSE And Malnutrition In Spleen And Stomach Deficiency Type

OBJECTIVE:This study adopts a randomized controlled method to observe the clinical efficacy of Shenling Baizhu Powder in patients with Multiple Organ Dysfunction in the Elderly(MODSE)combined with malnutrition in spleen and stomach deficiency type from multiple perspectives,including the improvement of APACHE Ⅱ score,syndrome score,nutritional status indicators,inflammation factor levels,and prognosis,and to explore the possible mechanisms of its action from a combination of Chinese and Western medicine,providing certain evidence and support for the treatment of MODSE combined with malnutrition from a combination of Chinese and Western medicine perspectives.METHODS:According to the inclusion and exclusion criteria formulated in this study,a total of 60 MODSE patients with combined malnutrition in spleen and stomach deficiency type were selected for hospitalization in the Cardiovascular Division Ⅲ department at QingDao Traditional Chinese Medicine Hospital between November 2020 and September 2022,and the 60 patients who met the criteria were randomly divided into 30 patients in the treatment group and 30 patients in the control group using the random number table method.Both groups were recorded in detail before enrollment;and given symptomatic support from Western medicine after enrollment.The treatment group was given Shenling Baizhu Powder orally or nasally on the basis of the above,with 21 days as the treatment cycle.At the end of the treatment,the laboratory indexes and the APACHE Ⅱ and spleen and stomach weakness evidence type scores were recorded in detail.The APACHE Ⅱ score,related laboratory indexes,and mortality rate before and after treatment were statistically analyzed using SPSS22.0,and P<0.05 was considered statistically significant.RESULTS:1.Baseline comparisonThere were no significant differences between the two groups in the data comparison of general information,nutritional status(ALB,PA,etc.),clinical inflammatory factor levels(TNF-α,IL-6,IL-8)and basic conditions(APACHE Ⅱ,spleen and stomach weakness evidence score,blood routine,liver and kidney function,etc.)before enrollment,and the data were comparable.2.Comparison of clinical efficacy2.1 APACHE Ⅱ scoreThe APACHE Ⅱ scores of both groups exhibited a significant decrease post-treatment in comparison to their pre-treatment values(P<0.001).Notably,the treatment group showed superior effectiveness in comparison to the control group,with a statistically significant difference in scores(P<0.05).2.2 Spleen and stomach weakness syndrome type scoreFollowing treatment,both groups demonstrated a reduction in the spleen and stomach weakness type score,with statistical significance observed in both cases(P<0.05,P<0.001).Moreover,the treatment group exhibited a more notable decrease in the type score when compared to the control group,with a statistically significant difference in scores between the two groups(P<0.05).2.3 Nutritional statusPost-treatment,both groups demonstrated an improvement in albumin(ALB)and prealbumin(PA)values,with statistical significance observed in both cases(P<0.05,P<0.001).Notably,the treatment group displayed a more remarkable increase in the values compared to the control group,with a statistically significant difference between the groups(P<0.05).2.4 Levels of inflammatory factorsFollowing treatment,there was a decrease in the levels of Tumor necrosis factor-α(TNF-α),Interleukin-6(IL-6),and Interleukin-8(IL-8)in both groups,with statistical significance observed in both cases(P<0.05,P<0.001).Notably,the treatment group exhibited a more substantial decrease in the values following treatment,and there was a statistically significant difference between the two groups(P<0.05).2.5 Mortality comparisonThe mortality rate for the treatment group was found to be 13.33%,while that of the control group was 30%.However,there was no significant difference observed in the comparison of mortality rates between the two groups of patients(p>0.05).CONCLUSION:The Shenling Baizhu Powder has the effect of reducing inflammation factors,improving nutritional levels,protecting organ function,and relieving clinical symptoms in MODSE patients with combined malnutrition and spleen and stomach weakness.The level of inflammation factors can well reflect the severity of the condition in MODSE patients and serve as a reference for the assessment of the condition of MODSE patients with combined malnutrition.