The Syndrome Factor And The Syndrome Distribution Rule And The Clinical Exploration Of TCM Treatment On The Critical Illness Patients With Heart Failure In Sepsis (Heart Failure In Sepsis)

Objective:To study the syndrome elements and distribution rules of manifestations of heart failure in sepsis and the treatment of clinical exploration of shen-fu injection..Methods:The study adopted two-step procedure, which were based on appropriate diagnostic criteria, inclusion criteria and exclusion criteria in cases collection Experiment I:According retrospective study included98patients, and in accordance with "measurement differentiation of common symptoms" identifying each syndrome elements and the diagnosis of syndrome name, we can derive the syndrome elements and the distribution regularity of syndrome of heart failure in sepsis, and gain/obtain the advantages syndromes. Experiment II:By using randomized controlled exploratory research methods, we included36patients, which were randomly assigned to control group and treatment group (both were18cases). We recorded their age, gender and other general information. Observed and recorded the white blood cell count, serum C-reactive protein (CRP), APACHE II score, B-type natriuretic peptide, non-invasive cardiac function tests relevant results (CI, CO, SV), left ventricular ejection fraction (EF%) before and after treatment, and to evaluate the clinical efficacy, TCM syndrome before and after the experiment. The resulting data were statistically analyzed.Results:To introduced in two steps:Experiment I-results:In sepsis patients with heart failure, the trend of symptom factors of disease nature were yang deficiency> excessive fluid> heat excess> qi deficiency> yin deficiency> blood stasis> qi stagnation> blood deficiency; the trend of symptom factor of disease location were heart> kidney>> spleen> lung> liver; the trend of disease nature were group insufficiency and excess syndrome>deficiency syndrome>empirical syndrome; TCM syndrome Distribution: the trend of group insufficiency and excess syndrome:heart and kidney yang deficiency syndrome, excessive fluid arrest syndrome> insufficiency of yang syndrome, turbid phlegm and blood stasis syndrome> spleen yang deficiency syndrome, phlegm and fluid block syndrome> evil heat flourishing syndrome, deficiency of both qi and yin syndrome> sputum thermal intrinsic syndrome, deficiency of qi and blood syndrome;the trend of deficiency syndrome:deficiency of both heart and spleen syndrome> qi and yin of lung injury syndrome> yin of kidney deficinency syndrome, liver-blood deficiency syndrome; the trend of empirical syndrome: sputum and thermal trouble mind syndrome> spleen-stomach damp-heat syndrome, qi stagnation and blood stasis syndrome.Experiment Ⅱ-results:(1) In terms of clinical efficacy, the total efficiency of the treatment group (88.89%) than the control group (55.56%), the difference was statistically significant (P<0.05); In terms of the total effective rate, the syndromes treatment group (94.44%) was significantly higher than the control group (66.67%), the difference was statistically significant (P<0.05);(2) Compared the control group with the treatment group after treatment, as for the white blood cell count, serum C-reactive protein, APACHE II score, B-type natriuretic peptide (BNP), non-invasive cardiac function tests relevant results (CI, CO, SV), cardiac ejection fraction (EF%), the difference was statistically significant (P<0.05);(3) Compared before treatment with after treatment in the treatment group, as for white blood cell count, serum C-reactive protein (CRP), APACHE Ⅱ score, B-type natriuretic peptide (BNP), non-invasive cardiac function tests relevant results (CI, CO, SV), cardiac ejection fraction (EF%), the difference was statistically significance (P<0.05).(4) Compared before treatment with after treatment in the control group, as for white blood cell count, serum C-reactive protein (CRP), APACHE II score, B-type natriuretic peptide (BNP), non-invasive cardiac function tests relevant results (CI, CO, SV), cardiac ejection fraction (EF%), the difference was statistically significant (P<0.05).Conclusion:1The symptom factors of disease of heart failure in sepsis syndrome was yang deficiency, excessive fluid, qi deficiency, blood deficiency, heat excess, yin deficiency, blood stasis, qi stagnation; the symptom factors of disease location were heart, kidney, mind, spleen, lung, liver; The syndrome Distribution were heart and kidney yang deficiency syndrome, excessive fluid arrest syndrome, insufficiency of yang syndrome, turbid phlegm and blood stasis syndrome, spleen yang deficiency syndrome, phlegm and fluid block syndrome, evil heat flourishing syndrome, deficiency of both qi and yin syndrome, sputum thermal intrinsic syndrome, deficiency of qi and blood syndrome, ect.2In treatment of sepsis heart failure, shenfu has significantly clinical efficacy.