Clinical Observation On Treatment Of Toxic And Heat Type Sepsis With Yiqi Huoxue Jiedu Method

Objective:By using Yiqi Huoxue Jiedu decoction in the treatment of toxic and heat type sepsis and monitoring the related indicators,to evaluate the effectiveness of Yiqi Huoxue Jiedu decoction in the treatment of toxic and heat type sepsis and the prognostic value of NLR,CRP/PA and other indicators on sepsis patients.Methods:A total of 64 patients were enrolled from the Department of Intensive Care,the First Affiliated Hospital of Heilongjiang University of Chinese Medicine on January 2021.A total of 72 patients with toxic-heat sepsis were randomly divided into a control group and an experimental group(3 6 cases in each group)by coin toss method.Patients in the control group were treated with conventional western medicine therapies such as anti-infection,liquid resuscitation and symptomatic treatment according to the sepsis guidelines.The experimental group was treated with Yiqi Huoxue Jiedu decoction combined with conventional western medicine treatment,with a treatment cycle of seven days in each group.Demographic characteristics,inflammatory indexes(CRP,PCT,NEUT),and safety indexes(AST,ALT,and Cr)were collected on days 1,3,and 7,and the neutrophil/lymphocyte ratio(NLR)and C-reactive protein/prealbumin(CRP/PA)values were calculated.SOFA score,APACHE Ⅱ score,hospitalization time,TCM syndrome score and curative effect were also recorded.The mortality was followed up for 28 days.Result:1.On days 3 and 7 of treatment,the inflammatory indexes such as CRP,PCT and NEUT of patients in the two groups are lower than those before treatment and the differences are statistically significant(P<0.05).Besides,the CRP of day 3 and day 7 of treatment in the experimental group are better than those of the control group(P<0.05).2.On days 3 and 7 of treatment,the safety indexes of AST,ALT and SCr of patients in the two groups were lower than those before treatment and the differences were statistically significant(P<0.05).Besides,AST and ALT on days 3 and AST,ALT and SCr on days 7 of treatment in the treatment group were better than those of the control group(P<0.05).3.On days 3 and 7 of treatment,the SOFA score,APACHE Ⅱscore,TCM syndrome score and curative effect of patients in the two groups were improved compared with those before treatment(P<0.05).Besides,the APACHE Ⅱ score on day 3,TCM syndrome score on day 7,as well as the SOFA score,APACHE II score,TCM syndrome score and curative effect on day 7 in the treatment group were better than those in the control group(P<0.05).4.The hospitalization time in the experimental group was shorter than that in the control group(P<0.05);5.AUC of NLR is 0.901,optimal threshold is 12.53,sensitivity and specificity are 95%and 71.2%,respectively;The AUC of CRP/PA was 0.760,the optimal threshold was 2.00,and the sensitivity and specificity were 4 5%and 9 8.1%,respectively,both of which had diagnostic value for toxic-heat sepsis(P<0.05).Conclusion:1.Yiqi Huoxue Jiedu decoction can reduce the inflammatory response in patients with toxic-heat type sepsis.2.Yiqi Huoxue Jiedu decoction can alleviate the clinical symptoms of patients with toxic-heat type sepsis and improve the SOFA score,APACHE-Ⅱ score and TCM symptom scores.3.Yiqi Huoxue Jiedu decoction can shorten the ICU stay of patients with toxic-heat sepsis.4.NLR and CRP/PA were the independent risk factors for 28-day death in patients with toxic-heat sepsis.