Effects Of Si Ni Decoction On Sepsis Induced Myocardial Depressionclinical Intervention Observation

ObjectiveTo observe the clinical effect of si ni decoction on patiens with YQKX(insufficiency of yang-qi type) of sepsis induced myocardial depression(SIMD), by comparing the APACHE Ⅱscore, TCM syndrome integral, the efficiency efficacy of TCM symptoms, the peripheral blood cTnI and BNP concentrations, ejection fraction, E/A,28 day mortality of the treatment group and the control group, to study the effect of si ni decoction in the treatment of sepsis induced myocardial depression.MethodsIn the ShenZhen Hospital of TCM, in 2013 February to 2015 year in May, 1CU treated with Severe sepsis induced myocardial depression included 60 patients were randomly divided into 2 groups:the control group (n=30) and the treatment group (n=30). The two groups were given conventional treatment according to the Surviving Sepsis Campaign:International Guidelines for Management of Severe Sepsis and Septic Shock:treatment groups treated with si ni decoction (treatment for 7consecutive days). On the first and the eighth day in the clinical study, recorded the APACHE II score and TCM syndrome integral of the patients, and statistical the efficiency efficacy of TCM symptoms, at the same time,5ml peripheral blood samples were obtained from Patients, cTn1、BNP、were measured. and we examined ejection fraction, E/A of all the patients by echocardiography technique at the two time point. Record the 28 day mortality of all the patients. Analysis the data by statistical software (SPSS 13.0).Results1. The 2 groups of patients with age, gender, APACHE Ⅱ score, TCM syndrome integral peripheral blood cTnI and BNP concentrations, had no significant difference before treatment(P>0.05).2. After treatment, Both can decrease APACHE Ⅱscore and TCM syndrome integral significantly (P<0.05), and the treatment group were significantly decreased than the control group(P<0.05). Comparison of efficacy of TCM symptoms:The total effective rate between treatment group and control group were 66.67% and 40%, the two groups had significant difference (P<0.05).3. The 2 groups after treatment, peripheral blood cTnI and BNP concentrations were significantly decreased, with statistical significance (P<0.05), while the treatment group decreased more significantly (P<0.05).4. Both can improve ejection fraction and E/A significantly after the treatment (P<0.05), while the treatment group improved more significantly (P<0.05).5. The 28 day mortality between the 2 group was not statistically significant (P>0.05).ConclusionCombination treatment with conventional western medicine and si ni decoction, compared to pure western medicine treatment, can not only decreased APACHE Ⅱ score and TCM syndrome, improved efficacy of TCM symptoms, but also can decreased the peripheral blood cTnI and BNP concentrations, improved ejection fraction and E/A significantly of the patients with sepsis induced myocardial depression. Si Ni Decoction maybe able to improve the cardiac diastolic and systolic function of the patients with SIMD, and improve the clinical symptoms.