| ObjectiveIn the study,using randomized controlled methods,all patients were randomly divided into treatment group and control group.All patients were treated with conventional western medicine,on the basis of Western medicine treatment of symptomatic branches,Shenfu injection combined with Yiqi Huoxue Mixture were used to systematically compare the clinical effect of the treatment group and the control group after treatment,the Apache?scale score before and after treatment,the Yang deficiency and blood stasis syndrome score,and the mortality of inflammatory factors after treatment before and after treatment.To explore the therapeutic value of Shenfu injection combined with Yiqihuoxue mixture on MODSE.MethodsFrom January 2015 to December 2018,190 patients in the Department of geriatrics and emergency department of QingDao Hospital of Traditional Chinese Medicine were selected,who were in accordance with the MODSE diagnosis of Western medicine and identified as Yang deficiency and blood stasis syndrome according to the syndrome differentiation of traditional Chinese medicine.They were randomly divided into treatment group and control group with 95 cases in each group.After admission,the patients in the two groups were treated according to the western medicine routine symptomatic support,such as anti infection,expansion,maintenance of acid-base and electrolyte balance,mechanical ventilation,correction of hypoxia and other measures,and actively treat the primary disease and eliminate the induced factors.On the basis of the above,the treatment group was given60 ml ivdrip QD plus Yiqi Huoxue Mixture(prepared by the preparation department of QingDao Hospital of Traditional Chinese Medicine)orally or nasally,150 ml each time,twice a day.Take 14 days as a course of treatment,observe and compare after one course of treatment.(1)Clinical efficacy comparison:Based on the indexes in the diagnosis standard of MODSE,the judgment standard of efficacy is established;significant effect:the symptoms basically disappear,and the abnormal organ function basically returns to normal;effective:the symptoms obviously improve,the number of organs with incomplete function decreases or changes from the failure stage to the early stage of failure are regarded as effective;ineffective:no improvement in symptoms,no change in the indexes of organ function or Deterioration is considered invalid;(2)Apache?score comparison:the parameters of acute physiological function and chronic health condition were compared before and after treatment;(3)The score of Yang deficiency and blood stasis syndrome refers to the guiding principles for clinical research of new Chinese medicine.The symptoms are divided into four grades:none,light,medium and heavy,the main symptoms are recorded as 0,2,4,6,the secondary symptoms are recorded as 0,1,2,3,and evaluated once before and after treatment;(4)Mortality comparison:the two groups of patients were invalid by default.The number of deaths and mortality after treatment were compared between the two groups;(5)Comparison of tumor necrosis factor(TNF-?):the fasting venous blood of patients before and after treatment was collected,the plasma TNF-?level was detected by enzyme-linked immunosorbent assay(ELISA),and the comparison was made before and after treatment;(6)the ratio of hs CRP:the fasting venous blood of patients before and after treatment was collected,and the serum hs-CRP was measured by immunoturbidimetry White(hs-CRP)levels were compared.SPSS v11.0 statistical analysis software was used for statistical analysis,and the counting data was expressed in%;the measurement data was expressed in x±s,the counting data was tested by X ~2 test,and the comparison between the measurement data groups was made by non paired t test,P<0.05 was considered statistically significant.Results1 The effective rate and total effective rate were 71.74%and 86.95%in the treatment group,36.47%and 75%in the control group,respectively.2 There was no statistical significance between the two groups before treatment(P>0.05).After treatment,the score of Apache?in the two groups was significantly lower than that before treatment(P<0.05,P<0.01).After treatment,the score in the treatment group was significantly lower than that in the control group,and the difference was statistically significant(P<0.05).Before and after treatment,the score of Yang deficiency and blood stasis syndrome was statistically significant(P<0.05)There was no statistical significance(P>0.05),the scores after treatment were significantly lower than before treatment,the difference was statistically lower(P<0.01),and the scores in the treatment group after treatment were significantly lower than that in the control group,the difference was statistically significant(P<0.01).3 There was no significant difference in the levels of hsCRP and TNF-?between the two groups before treatment(P>0.05);after treatment,the levels of hsCRP and TNF-?in the two groups were significantly lower than that in the control group(P<0.05),and the level of NF-A in the control group was not significantly lower than that before treatment(P<0.05).4 The mortality of the treatment group was significantly lower than that of the control group(P<0.05).Conclusions1 Shenfu injection combined with Yiqihuoxue mixture can effectively improve the clinical symptoms of MODSE patients,and reduce Apache?scale score and yang deficiency,can improve organ perfusion,have a good protective effect on a variety of organs,and have a good effect on reducing the mortality of MODSE;2 Shenfu injection combined with Yiqihuoxue mixture can the expression of inflammatory factors in the pathogenesis of MODSE,so as to alleviate the clinical symptoms and delay the progress of the disease,and further explore the role of inflammatory mediators in the development of MODSE. |
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