Evaluation Of The Efficacy Of Sepsis-induced ARDS Treated By Combined Treatment Of Traditional Chinese Medicine And Western Medicine

ObjectiveTo observe traditional Chinese and Western medicine combined with complex treatment project clinical curative effect to sepsis induced ARDS patients by prospective randomized controlled clinical trial research, explore reduce capillary leakage, inflammatory reaction and etc. possible mechanisms, develop new treatment ideas for Traditional Chinese medicine in the treatment of sepsis induced ARDS.MethodsSelected in-patients who were treated in affiliated hospital of Chengdu Traditional Chinese Medicine University from Feb.2013to Feb.2014, took met the inclusion criteria60cases sepsis induced ARDS patients as research object, according to clinical prospective research principle randomly divided patients into traditional Chinese and Western medicine combination treatment group (short for treatment group) and pure Western medicine treatment group (short for control group), control group were adopted sepsis related treatment measures and ARDS treatment (mainly include of actively control primary disease, respiratory support therapy and medication), on basis of control group treatment group added resuscitation mixture (the composition were radix aconite lateralis preparata, amomum fruit, tortoise plastron, Chinese ephedra, rhizoma zingiberis, liquorice), nasogastric feeding or take orally Q6h. Took base line and after treatment3,7,14day as the evaluation time point, got through observe Chinese traditional medicine symptoms score, APACHE Ⅱ score, cell factor, blood gas analysis, oxygenation index, extravascular lung water index, hospital day and14day case fatality rate condition, expound and prove treated ARDS curative effect value and clinical significance by Warming kidney and subsiding Yang method.Results1. Base line analysis:①Compared two group patients’sexualities and age: When they joined each group, sexualities and age all hadn’t statistical significances (P >0.05), had comparability;②Compared two group patients’laboratory related test results:Before treatment compared two group patients’oxygenation index, C-reactive protein, white blood cell count, neutrophile granulocyte percentage, glutamic-pyruvic transaminase, Urea nitrogen and creatinine, the differences hadn’t statistical significances (P>0.05), had comparability;③Compared two group patients’related score:Before and under treatment compared two group patients’ traditional Chinese medicine symptoms score, APACHE II score, Murray lung injury score, the differences hadn’t statistical significances (P>0.05), had comparability.2. Curative effect analysis:①Compared after treatment48d total curative effect and lapse:After treatment, although treatment group’s result better than control group, but the differences hadn’t statistical significances (P>0.05); although treatment group’s14d case fatality rate lower than control group, the differences hadn’t statistical significances (P>0.05).②Compared Traditional Chinese medicine curative effect: Although treatment group’s result better than control group, the differences hadn’t statistical significances (P>0.05).Compared after treatment7day,14day traditional Chinese medicine symptoms score, the differences had statistical significances (P<0.05).③Compared two group patients’laboratory related indexes before and after treatment:A. Compared before and after treatment total white blood cells classification different constants, the differences all hadn’t statistical significances (P>0.05); B. Compared before treatment observation group and control group’s oxygenation index values, the differences hadn’t statistical significances (P>0.05), after treatment14day,compared again, the differences had statistical significances (P <0.05); C. Compared with before treatment observation group and control group’s after treatment3day,7day and14day extravascular lung water all decreased, compared with control group, observation group patients’7day,14day extravascular lung water obviously decreased, the differences had statistical significances (P<0.05); D. Compared with before treatment, observation group and control group’s after treatment3day,7day and14day CRP content all decreased, compared with control group, observation group patients’14day CRP content obviously decreased, the differences had statistical significances (P<0.05), compared with before treatment, compared survival and death patients’CRP content, the differences hadn’t statistical significances (P>0.05),but after treatment, survival patients’CRP content lower than death patients, the differences had obvious statistical significances (P<0.01); E. Compared with before treatment, observation group and control group’s after treatment3day,7day and14day IL-6、IL-8and TNF-α content all decreased, the differences had statistical significances (P<0.05). Compared with control group, observation group patients’14day IL-6content obviously decreased, the differences had statistical significances (P<0.05), but two group patients’IL-8and TNF-α content all hadn’t any statistical differences (P>0.05) in each after treatment periods.④Compared with before treatment, observation group and control group’s after treatment3day,7day and14day APACHE Ⅱ, SOFA and LIS score all obviously decreased, the differences had statistical significances (P<0.05); Compared with before treatment, compared survival and death patients’APACHE Ⅱ score, the differences hadn’t statistical significances (P>0.05), after treatment, survival patients’ APACHE score lower than death patients, the differences had obvious statistical significances (P<0.01).⑤Survival patients’in two groups, compared their invasive mechanical ventilation andICU hospital days and expenses, the differences all hadn’t statistical significances (P>0.05).⑥Treatment group’s death rate than control group, but the difference hadn’t statistical significances (P>0.05).3. Security analysis:In treatment progress, treatment group’s adverse effects rate was10.00%, control group’s was13.80%, all hadn’t special handling, symptoms relieved by patients themselves, and patients could adhere treatment by themselves. Compared two group’s adverse effects rate, the difference hadn’t statistical significances (P>0.05). Two groups adverse events all didn’t occur.Conclusion1. Compared with pure Western medicine treatment, assisted with resuscitation mixture traditional Chinese and Western medicine treatment can decrease ARDS patients’14d case fatality rate trend, and can shorten ARDS patients’invasive mechanical ventilation time, its mechanism maybe have relation with reduction in pulmonary vascular leakage, lighten pulmonary edema, so then improve patients’ condition.2. Compared with pure Western medicine base treatment, assisted with resuscitation mixture traditional Chinese and Western medicine treatment project have some advantage in improve ARDS patients’condition prognosis.