The Clinical Observation Of Xuebijing Injection On Septic Shock

Introduction: Septic shock are clinical symdrom which conduce organic function damage, and they are the major reason lead to death of paticent in ICU. The complications of septic shock are more than other shock,and induce clinical procedures'complication,and the patients'progn are different. Recently, anti-infection and organic function support technique have developed rapidly, but the occur rate and the case fatality of septic shock still remain high level, so finding out effect prevention and cure methods,is problem not stoved yet.Correlate research indicate Xuebijing injection could inhibit the release of cellar factor and antagonize inflammation media, could protect organic function, which prove valuable in animal experimentation, but clinical report about treatment to septic shock with Xuebijing has never been heard before..Objective: estimated Xuebijing'sclinical value to the preventive and therapeutic effects of septic shock, and hopely provided a new strategy for septic shock.Methods: Analyzing 41septic shock patients retrospectively, conventional therapy group was treated by the principle of early-aim treatment strategy, while the Xuebijing group was infused Xuebiijing injection with the former strategy. Observing the dynamic changes of early-aim treatment success momengt and 24h,72h after that, and the chang of HR,T,liver and renal functiion and PaO2, PaCO2,PaO2 /FiO2,Lac,APACHE II ;the final survial rate in both groups, to find whether there were differences between the two groups.Results: After treatment,Hrand T of Xuebijing therapy group were better than the conventional therapy group remarkablely,therre are no difference in importante organ damage index,APACHE Iibetween two groups. After treatment, Xuebijing therapy group are obviously surpass the conventional therapy group .the oxgen metabolize target of therapy group were better than contral group, and presented a tendency of changing better gradually; while final survial rate of the two groups did not differ from eath other.Discussion: Recently,Septic shock's occur rate is increasing gradually,still sit the first place in the world of non-cardiac disease intensive care.The whole tissue hypoperfusion induce anaerobic metabolism product in septic shock cause cellular damage , oxygen free radical and endotheliocyte function damage,many cytokine and inflammation media release ,this is SIRS.inducing MODS finally.MODS inducing by infect can cause SIRS too, if the two are not effect containment ,will lead to MOF finally.AT present, most specialist cunsider that the treated key is block and control septic and MODS patho- cascade reaction,SIRS is the foundation.Xuebijing's essential component are paeoniae radix,rhizoma,danshen root,flos carthami and angelice. Long-term large basic and clical show that Xuebijing coule antagonize ET and morbility related multitude inflammation mediator,could rivalry TNF-α,IL-1 and IL-6,protected vascular endothelial cell,enhance HLA-DR expression, to promote immune functional restoration.Clear oxygen free radical,improve tissue filling and microcirculation,thereby control systemic inflammatorome,protect organism's function, provided a new strategy for ICU salvage and therapy.In septic shock , multitude inflammation mediator (IL-1β,TNF,IL-6) release interfere hepatocyte energy metabolism,induce other inflammation cells'infiltration cause hepatocyte damage;at the same time,many organs and muscle tissue oxygen deficiency precipitate precipitate step up. multitude inflammation mediator damage vascular endothelial cell and other cell,induce renal Vasomotor function disorder,ndodermis damage and permeability increase ,lead to remal filling,renal blood current abnormal distribution,glomcrulus thromb,direct or indirect damage renal tissue cell,cause acute renal failure.Xuebijing can block and control above patho-reaction development,protect liver and renal function.This study show that Xuebijing group vital sign is stable,liver and renal damagement lessen than conventional therapy group,conformit with literature.At the moment of severe sepsis, tissue function in ingesting and utilizing oxgen changed. Correlated report show that sepsis and septic shock patient's tissue cell existed hypoxia and oxygen utilize disorder.Blood gas analysis can exactly reflect breath and metabolism,object evaluation oxygenate,venting,acid-base balance.Arterial blood Lac possess concordance in judying tissue oxygen deficiency with DO2 and VO2. So Xuebijing group Blood gas analysis index chang and Lac level are better than conventional therapy group,reflect Xuebijing can omprove septic shock tissue filling and oxygenation.Prognosis prognostication is omportant in ICU therapy,can help promptly pathogenetic condition,reflex intervention therapy effect. APACHE II is close correlation with patient's Prognosis and patient's condition Severity degree.Lac can sensitly reflex patient's condition and case fatality.APACHE II can reflex patient's condition Severity degree ,the score is higher,the entity risk quotient is higher.after 72h, APACHE ll score is lower,show that patient condition is improve,and Xuebijing group improve manifest.we can say Xuebijing can improve patient condition.Lac is total body perfusion and oxygen met inportant index,is reconstruction, the advance of Lac reflect below Hypoperfusion condition anaerobic metabolism increase. If Lac level high ,the case fatality increase,if Lac decrease,reflex therapy effect. Lac advance come with tissue oxygenate diorder, This study showed that Xuebijing injection can improve LAC level,the possible mechanism:①Xuebijing improve septic shock hypoperfusion,inhibit anaerobic glycolysis,Lac production decrease.②Xuebijing can protect liver and renal function, ensure clearance of Lac.But Lac in Xuebijing group still is not return, prognosticate progn is bad.This study showed that Xuebijing injection could inhibit the release of cellar factor and antagonize inflammation media, could protect organic function while it couldn't raise the final survial rate, the reasones considered as followed: First, successful rescue is related with many factors, invention therapy merely with ulinastatin couldn't raise the final survial rate obviously; second, many salvage drugs used in resuscitation process also influence organs function and organism internal environment during salvage process the medication and dosage are non-negligible factors; third, the kind of administration modality(initial and maintenance dose),how much dosage and dosing interval, they are all the to be further discussed questions.Conclusion: Aplicating Xuebijng treat septic shock has invariably protection trend to important organs function, and stilize vital sign, can regulate microciculation and oxygen metabolism and so on. But can't raise the final survial rate, there are versatility reasons. But the effect of Xuebijing showing in the study makes us to inspirit, there are also some questations to approch for us.