The Effects Of Xiaotan Tongfu Decoction On Gastrointestinal Dysfunction And Inflammatory Factors Of Septic Patients

BackgroundThe treatment of sepsis although after antiinfection, critical care have achievedbig progress, but is still one of the highest rates of the disease inICU，with theresearch progress of pathogenesis, gastrointestinal was confirmed has played animportant role in its physiological pathology process. In recent years, Chinesemedicine in sepsis patients get more and more wide application, this study selectedcontrolled drugs rhubarb has set up a file in a broad application in critical disease, theclinical curative effect and pathophysiological roles in recent years also widelyconfirmed, and research shows that, combining traditional Chinese and westernmedicine treatment improved sepsis the curative effect, reduce the mortality. ProfessorWeiPinKang use the principle “eliminate sputum and dredge bowel path”and creatXiaotan Tongfu Decoction, this decoction has obtained good clinical effect ingastrointestinal dysfunction and critically ill patients, improve the symptoms andreduce the ratio of septic patients developed to MODS. Therefore, this test throughcomparison with rhubarb to improve its effect for the patients gastrointestinaldysfunction, systemic inflammation (SIRS) score and inflammatory factors for septicpatients, further proved the clinical effect of Xiaotan Tongfu Decoction, and it’s effectfor SIRS, and explore the its mechanism in control of the inflammatory response.ObjectiveBy contrasting with the control group, using gastrointestinal dysfunction scoresystem for septic patients with gastrointestinal function disorder symptoms to observethe function of XiaoTanTongFu granule for gastrointestinal function disorder of septicpatients. And use serum test to clear and definite the influence of XiaoTanTongFudecoction on inflammatory reaction index such as: CRP, PCT, LPS. Objectivelyevaluate the curative effect of XiaoTanTongFu Granule on septic patients.MethodsThe trial is divided into three parts, the first, the influence of Xiaotan TongfuDecoction for septic patientswith gastrointestinal dysfunction; Second, the influenceof Xiaotan Tongfu Decoction for SIRS score of septic patients; Third, the influence ofXiaotan Tongfu Decoction for inflammatory factors of septic patients. The wholeprocedure is as follows:Patients were informed in the premise of this study, Using a RCT method,screening60septic patients from march2011to December2011in ICU department of our hospital, they are divide into two groups:30patients in XiaoTanTongFuDecoction group and30patients in Chinese rhubarb group. Fall off2cases during thetrial, finally bring into29patients in each group, XiaoTanTongFu Decoction groupand Chinese rhubarb group all accept the foundation treatment such as fight infection,nutrition support, the conventional treatment according to the SSC sepsis treatmentguidelines[1], gastrointestinal function damage use: folic acid mossa+OmeprazoleSodium for injection+famotidine+Triple Viable Capsules Dissolving at Intestines.XiaoTanTongFu Decoction group take XiaoTanTongFu From decoction per dayorally(or give medicine through stomach tube)。Chinese rhubarb group providerhubarb powder,3g each time, BID；the day when patient get into the hospitalevaluate patients’ APACHE Ⅱ score and gastrointestinal function score. TheAPACHE Ⅱ score≤16points or>16points make into layered group.Part1,evaluate the grade of gastrointestinal function obstacle of the patients intothe group according to the scoresheet and record the data.Part2, evaluate the grade of SIRS score according to the scoresheet of thepatients into the group according to the scoresheet and record the data.Part3, collect blood5ml of the group of patients day1,7respectively, andcentrifugal unified save after, send to Shanghai circular and biological science andtechnology limited company unity measure CRP on admission, PCT, LPS, HMGB1.All data has special staff to collect and input, finally data statistics analysis.Results1. Xiaotan Tongfu Decoction can effectively improve clinical symptoms ofthe sepsis patients with gastrointestinal dysfunction, and can effectively reduce theseptic patients gastrointestinal dysfunction score.2. Xiaotan Tongfu Decoction can obviously improve the septic patients SIRS,effectively reduce the septic patients SIRS score.3. Xiaotan Tongfu Decoction could decrease the CRP and PCT、HMGB1inflammatory factor,the effect is significantly for the patients whose illness is lighter(APACHE Ⅱ score than16). Two groups of patients to LPS improving function wasnot statistically significant, it’s mechanism perhaps not through reduce LPS.