The Curative Effect Of Method Of Supplementing Qi And Activating Blood Circulation On Optimizing The Early Goal-Directed Therapy Of Sepsis

ObjectivesThis research is mainly based on the pathogenesis of anomaly of coagulation system of sepsis, combines with the modern pharmacological effects of Chinese traditional medicine, and uses the method of supplementing Qi and activating blood circulation by Chinese medicine injection in EGDT to explore the therapeutic effect, the demonstrating compliance of EGDT and 28-day mortality rate of the sepsis bundle of intervention of traditional Chinese medicine and western medicine. Meanwhile, this research also explores the effect of blood lactate clearance rate and Sequential Organ Failure Assessment(SOFA) score by sepsis bundle of intervention of traditional Chinese medicine and western medicine, which can provides basis and train of thought in treatment of sepsis by the intervention of traditional Chinese medicine and western medicine.MethodsThe research object is 68 patients treating in the emergency department and ICU in Guangdong Provincial Hospital of Chinese Medicine. It is a simple, random and control study, which the patients were divided into two groups, the treatment group and the control group. The two groups will be treated with the same standard by international guidelines of severe sepsis and sepsis shock of SSC in 2012, but the treatment group will add using 60ml injection of shenmai and 10ml injection of salviaemiltiorrhizae and ligustrazine in liquid recovery treatment. The observation items are clinical symptoms, signs, blood lactate clearance rate, APACHEⅡ score, SOFA score and 28-day mortality rate before, the 6th hour, the 24th hour and the 72th hour of treatment. SPSS18.0 software package is adopted to establish the database. The measurement data is calculated the mean and standard deviation. Comparison between group is tested by t test when accorded with normal distribution, and is tested by t’ test when variance is not neat. Comparison between groups uses independent sample t test, Comparison between before and after treatment uses paired samples t test. Comparison between groups is tested by rank sum test when does not accord with normal distribution, comparison between groups uses independent sample the Mann-Whitney rank sum test. Comparison between before and after treatment is tested by Wilcoxon signed rank sum test. The enumeration data is calculated the index composition and distribution. The comparison of total effective rate between groups is tested by the four table chi-square test, and the form comparison made between group is tested by R * C table chi-square test. Difference is statistically significant when P<0.05.Results1. The rate of reaching the standard of treatment group in 6 hour is higher than the control group(P<0.05).2. The lactic acid clearances of treatment group in 6 h,24 h and 72 h are higher than the control group(P<0.05).3. After treatment, the SOFA scores of treatment group and control group are decreased than before(P<0.01), but after treatment, the SOFA scores of treatment group and control group are the difference of the posttreatment SOFA scores of treatment group and control group is no statistically significant(P>0.05).4. The death toll and 28-day mortality rate of treatment group is slightly lower than control group, but the difference is no statistically significant (P>0.05).5. The hospital stay of ICU of treatment group is significantly lower than control group(P<0.05), and the total hospital stay of treatment group is slightly decreased than control group, but the difference is no statistically significant(P>0.05).Conclusion1. Comparing with the simple therapy of EGDT, combining with the method of supplementing Qi and activating blood circulation by injection of shenmai and injection of salviae miltiorrhizae and ligustrazine can improve the rate of reaching the standard.2. Comparing with the simple therapy of EGDT, combining with the method of supplementing Qi and activating blood circulation by injection of shenmai and injection of salviae miltiorrhizae and ligustrazine can improve the clearance rate of lactate, and be more conducive to improve hypoperfusion of tissue and microcirculation dysfunction.3. Comparing with the simple therapy of EGDT, combining with the method of supplementing Qi and activating blood circulation by injection of shenmai and injection of salviae miltiorrhizae and ligustrazine can reduce the hospital stay of ICU.4. Comparing with the simple therapy of EGDT, combining with the method of supplementing Qi and activating blood circulation by injection of shenmai and injection of salviae miltiorrhizae and ligustrazine can not reduce the the posttreatment SOFA scores and 28-day mortality rate.