Clinical Research Of Clearing Heat And Resolving Phlegm Method In Treating With Acute Tracheobronchitis Patients With SIRS And Related Meta-analysis

Objective: 1. This study was designed to investigate and explore the clinical efficacy of tanreqing injection in treating acute tracheobronchitis patients with systemic inflammatory response syndrome(the syndrome of phlegm-heat obstructing lung).2. Application of Meta –analysis to explore the clinical efficacy and safety of clearing heat and resolving phlegm drug Tanreqing injection in patients with SIRS.Methods: 1. 60 patients with acute tracheobronchitis combined with systemic inflammatory response syndrome(the syndrome of phlegm-heat obstructing lung)were selected in Department of Respiratory Medicine and Emergency in Tianjin Nankai Hospital from November 2014 to November 2015, they were divided into 30 cases in the control group, treated with symptomatic treatment and conventional anti-SIRS therapy, and 30 in the treatment group which therapy on the basis of the contol, added Tanreqing injection. Observing the total clinical efficiency of the two group of patients before and after treatment and the following indicators: the symptom scores, temperature(T), heart rate(HR), respiratory rate(RR), white blood cell count(WBC), procalcitonin(PCT), C- reactive protein(CRP), activated partial thromboplastin time(APTT), thrombin time(TT), prothrombin time(PT), the total clinical efficacy, and then these indicators were statistically analyzed. At the same time, observing complications and death.in the two groups of patients.2. Application of the computer and manual retrieval, to find the Chinnese How Net medical database(CNKI), Chongqing VIP periodical resource integration services platform(VIP), Chinese Biomedical Literature Database, Wanfang medical database,Ovid/Pubmed, Embase databases and other large domestic and foreigner databases.With the “tanreqing injection”, ” systemic inflammatory response syndrome./SIRS”,“Meta-analysis”,” clinical research” as the search term, the retrieval time from January of 2000 to May of 2015, published about the efficacy of Tanreqing injection cure the patients with SIRS, collecting randomized controlled trials( RCT) in treatment of Tanreqing injection, language Chinese or English, the Jadad quality evaluation method evaluating the quality of the literatures, and using the Rev Man5.3software analyzing the literatures.Results: 1.The symptom scores,HR, T, WBC, CRP,PCT, APTT and PT before and after treatment improved more significantly than the control group,the incidence of gastrointestinal bleeding and paralytic ileus was lower than that of the control group,the total efficiency of the treatment group was higher than the control group;and the above comparable items had statistically significant difference(P<0.05). 2. Finally,11 papers, a total of 811 patients were included, in the control group contained 396 which therapy was conventional anti-SIRS; and 415 in the treatment group which therapy on the basis of the control group combined with Tanreqing injection.Meta-analysis of the final results showed that: in the treatment group the clinical total efficiency was higher than that of the control group, the level of WBC, CRP, PCT,TNF-a, IL-6 and T decreased significantly, the difference was statistically significant(P<0.05); and all included studies were not reporting adverse reactions.Conclusion:1.The clinical efficacy of application of heat-clearing and phlegm-resolving method treatment in patients with acute tracheobronchitis combined with systemic inflammatory response syndrome is obvious, not only to reduced the symptom score, improve clinical total efficiency, stabilize the patient's vital signs,improve the patient's inflammation and blood clotting index, still be able to reduce the incidence of complications in patients with acute tracheobronchitis combined with systemic inflammatory response syndrome. 2.The Meta-analysis showed that application of Tanreqing injection treatment of the patients with systemic inflammatory response syndrome, the infectious reaction decreased, the clinical efficacy was reliable and good, and had no clinical adverse reactions, had high security.3.Tanreqing injection is the typical representative of heat-clearing and phlegm-resolving drug in Proprietary Chinese medicines, which can cure a variety of diseases with systemic inflammatory state, is not only convenient, but also safe and effective.