| Objective This article used the method of combining clinical obse-rvation with experimental research to explore the Xuebijing inject-tion with antibiotic therapy to treat acute pelvic peritonitis1feasibility and advantage. Clinically, we used Xuebijing injection combine with Cefathiamidine to treat acute pelvic peritonitis, and we compared the curative effect with using antibiotic therapy only, we also compared the TCM symptoms curative effect and the clinical comprehensive efficacy. In the experiment aspect, by studying the effect of the Xuebijing injection to procalcitonin (PCT), inter-leukin-6(IL-6) mRNA in the in the whole blood of rats, we discussed what was the possible mechanism for the Xuebijing injection trea-ting acute pelvic peritonitis, and if single using the Xuebijing injection treating acute pelvic peritonitis feasibility, and pro-vide theoretical basis for clinical Xuebijing using to treat acute pelvic peritonitis.Methods In clinical research aspect, we select70cases with acute pelvic peritonitis by western medicine diagnostic criteria and traditional medicine diagnostic criteria in patients as the res-earch objects, the research subjects were randomly divided into treatment group and the control group (n=35). The control group (35cases) only was gived antibiotic treatment, i. e., cefathiamidine1.5g added into250ml static drops of0.9%sodium chloride solution,1times a day. In treatment group(35cases), on the basis of anti-biotic treatment in control group, we also used Xuebijing50ml diluted into100ml saline, dropped out in30min,2times a day. The two groups’treating course were all3days, followed-up for1month. Other similar function medicine could not be used. Compared two groups before and after medication curative effect in TCM symptoms and clinical curative effect and adverse reactions, we proceed statistical analysis.In clinical research aspect, we chose40adult SD rats, and divided into Xuebijing group (Xuebijing8ml/kg+0.9%normal saline8ml/kg), antibiotics group(Cefathiamidine200mg/kg+0.9%normal saline8ml/kg), combination group (Cefa-thiamidine200mg/kg+Xuebijing8ml/kg) and control group(0.9%normal saline16ml/kg),10each group. Using cecum ligation perforation to built sepsis rat model, we collected500μ1rats blood in angular vein, sublingual vein and abdominal aorta at preoperative and postoperative1hour,2,6,10,16,28hours, and used fluorescent quantitation PCR(RT-PCR) method to detect rats blood PCT and IL-6mRNA expression.Results Clinical research:The33cases in treatment group had followed-up visits, and34cases in the control group received followed-up visits.1. TCM symptoms curative effect:The treatment group and the control group used two therapeutic regimen in treating acute pelvic peritonitis, and the TCM symptoms total points are improved. The symptoms were significantly improved in the treatment group after treatment (P<0.05). In the control group, headache, nausea, reduced appetite, abdominal pains, abdominal distension, and diarrhea were significantly improved after treatment compared with those before treatment (P<0.05). The traditional Chinese medicine (TCM) symptom scores including fever, aversion to cold, cough, menorrhagia, menostaxis, and increased leucorrhea were decreased compared with those before treatment; but the differences were not statistically significant (P>0.05). The improvements of headache, nausea, reduced appetite, abdominal distension, abdominal pains, and diarrhea symptoms were not statistically significant after treatment compared between two groups (P>0.05); but the improvements of the remaining symptoms in the treatment group were better than the control group (P<0.05). For the total integral TCM symptoms, total effectiveness of TCM symptoms in treatment group was also much better than in the control group.2. Clinical comprehensive curative effect:Compared the treatment group with the control group after treatment in the clinical comprehensive efficacy, the treatment group cure rate was48.48%, significantly higher than the control group cure rate23.53%, by comparing, the differences between the two groups have statistical significance (P<0.05), but there were no statistically differences in total effective rate between the two groups (P>0.05).3. Inflammation index:After treatment the two groups’total number of white blood cells, creactive protein, calcitonin original and interleukin-6difference has statistically significance (P<0.05).4. Safety evaluation:During the period of treatment and followed-up visits, the treatment group and the control group has no obvious adverse reaction occurred in the investigation, and the security is high.Experimental study:1. The expression level of IL-6mRNA in the blood of rats with sepsis was significantly higher than the normal rats. If given Xuebi jing injection combined with antibiotic therapy, the expression level could be rapidly returned to normal in a short time; if given Xuebijing injection or antibiotics therapy alone, the expression level of IL-6mRNA in the blood might also be gradually restored, but the recovery time was longer than the combined treatment.2. The expression level of PCT mRNA in the blood of rats with sepsis was significantly higher than the normal rats. If given Xuebijing injection combined with antibiotic therapy, the expression level could be rapidly returned to normal in a short time; if given Xuebijing injection or antibiotics therapy alone, the expression level of PCT mRNA in the blood might also be gradually restored, but the recovery time was longer than the combined treatment.Conclusion1. Patients with acute pelvic peritonitis treated with Xuebijing injection and antibiotic therapy, compared with the traditional simple use of antibiotic treatment, it has an obvious advantage in TCM symptoms curative effect, the clinical curative effect is affirmed, and had better recovery effects in patients with inflammatory indicators, it is worth for further promotion in clinical use.2. In terms of the few cases now, using the Xuebijing injection to treat acute pelvic peritonitis, during the period of drugs using and after drug using all had not found adverse reactions, it has higher security.3. Using the Xuebijing injection to treat acute pelvic peritonitis, the mechanism may be related to reduce the serum PCT, IL-6mRNA expression, and inhibiting the body’s inflammatory response.4. For the current animal experiments, Xuebijing injection alone was feasible in the treatment of acute abdominal infection, which could be verified by clinical trials with large sample sizes. |
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