The Study Of The Expert Opinion Survey And The Syndromes Distribution Rules Of Sepsis

ObjectiveThe study is aimed at exploring the distribution rule of the septic patients’syndromes and preventing the development of sepsis in the early time by summarizing the experts’clinical experiences and the retrospect-tive study.MethodsThe experts are asked to fill the form indepengdently according to their experience in septic treatment. By collecting and statistical experts’opinions on TCM treatment of sepsis, we are trying to analyse and summarize the experiences of the experts.We selected51patients from the Emergency Unit and Intense Care Unit of Guangdong Hospital of Traditional Chinese Medicine who have been in-patient from Jan2013to Nov2013. All of them have been diagnosed sepsis or MODS. We Collect the characters of the syndromes through looking into the cases of those patients from day1, day2-3, day4-7and find the connections between the scores of APACHE II, MODS score, PCT level, Lactic aid level and the syndromes distribution rule.ResultMost experts agree with the dignose standard and the definition of sepsis. Most experts often choose Wei qi ying blood syndrome differentia-tion. Most of them think lung involves in sepsis. The main pathological factors include virtual, poison, blood stasis and heat, is virtual reality is the basic pathogenesis of sepsis. Most experts agree with the importance of the filling of the deficiency syndrome; they think it should be carried out through the treatment of sepsis. Experts Commonly use thess medicine. Qi deficiency syndrome, most experts often use the Buzhongyiqi decoction, astragalus injection, astragalus root, ginseng, atractylodes and other drugs; Yin deficiency syndrome, the Shengmai decoction and Shengmai injection, commonly used drugs such as radix ophiopogonis, radix rehmanniae, fructus schisandrae; Yang deficiency syndrome, commonly used Sini decoction, Shenfu injection, aconite, dried ginger, asarum; Heat syndrome, commonly used Baihu decoc-tion, Xuebijing injection, radix scutellariae, gypsum, rhizoma coptidis drugs; Blood stasis syndrome, the commonly used Xuefuzhuyu decoction, salvia miltiorrhiza injection, peach kernel, salvia miltiorrhiza, and safflower medicines; Relieving syndrome, commonly used Dachengqi decoti-on, rhubarb and magnolia bark and glauber and other drugs.There are60.78%of male and39.22%of female in this research; the average age is71years old. There are30patients stay in the ICU while the other21in the general ward. The average length of the hospital stay is11days. Most patients share the past history as hypertension, diabe-tes, cerebral infarction sequela. About the infection, most patients were infected with respiratory system. We can see there are17cases of sepsis and the rest are MODS. In the MODS cases, patients have higher APACHE II score, Lactic acid level then the others. They also have the longer hospital stay. About the motarity, there are16cases of death, and the patients with the MODS have the higher motarity than the sepsis ones. Patients with higher APACHE II score, MODS score, and lactic acid level have more possibility of death than the other.About the endogenous injury foundation,64.71%of the patients have deficiency mixed syndrome as the foundation,21.57%of the patients have the empirical syndrome, and the rest of them don’t have any injury founda-tion. Cases with deficiency mixed syndrome or relieving syndrome have the higher motarity than the other.Among the cases, there are two kinds of syndromes, one is deficiency mixed syndrome, the other is empirical syndrome. Most of the patients are in the former group, there is no single one case is deficiency syndrome. There are more cases with relieving syndrome, Qi deficiency, and Yin defici-ency, Yang deficiency in MODS than in sepsis. And cases with relieving syndrome, Qi deficiency, and Yang deficiency have higher motarity than the other cases. Patients with deficiency mixed syndrome have higher APACHE II score, MODS score and Latic aid level than the patients with empirical syndromes.ConclusionThe experts all agree the importance of the filling of the deficiency syndrome; think it should carry out all the way in the treatment of sepsis. We can evaluate the patient with the APACHE II score, MODS score, and latic aid level. So we should strengthen the body resistance while drive out the evil spirit syndrome...