Study On Immune Function Of Ginseng Decoction In Patients With Acute Respiratory Distress Syndrome Induced By Sepsis

BackgroundSepsis(sepsis)is a systemic inflammatory reaction caused by infection,which may lead to the respiratory dysfunction or other organs’ dysfunction.Patients with ARDS induced by Sepsis always have an acute and rapid progress condition,and high mortality rates.At present,there is a broad consensus in the application of mechanical ventilation and infection control in the treatment of ARDS.Also the immune regulation of nutrition and antibiotics gradually get attention.However,the curative effect is not clear due to the complex pathogenesis.ObjectiveTo observe the effect of Ginseng Decoction on immune function of ARDS patients induces by sepsis;The effect on respiratory function,economic index and survival rate were observed,as well.To explore the immunomodulatory effects of traditional Chinese medicine(TCM)in the treatment of sepsis caused by ARDS,to provide ideas for clinical treatment,and to play the potential and advantages of traditional Chinese Medicine.MethodThis study was a prospective randomized controlled clinical trial,We selected patients with ARDS induces by sepsis who accord to the inclusion criteria,during 2015.5-2016.10,the 66 patients with sepsis induces by ARDS were grouped according to the order of treatment,ans randomly divided into treatment group and control group,each group with thirty-three people.The treatment group was treated with Ginseng Decoction on the basis of classic intensive care;the control group was treated with classic intensive care,we observe the change of the immune index,respiratory index and survival rate.The curative effect was analyzed and evaluated from the aspects of safety,clinical curative effect,APACH Ⅱ score,health economics index and so on.ResultsThere was no lost to follow-up in the study.there was no significant difference between the treatment group and the control group,or between the aforementioned groups in the moderate ARDS subgroup(P>0.05).APACHE II scores,respiratory frequencies,body temperature and heart rates on Day five(D5)were significant improved than before treatment.The advantages still existed when it came to the moderate ARDS subgroup(P<0.01,P<0.05).The APACH II score and Respiratory frequency are Significantly improved than Corresponding control group,but the body temperature and heart rate have no significant difference.1 immune function indicators:(1)Moderate ARDS subgroup:After treatment,T lymphocyte CD4 of the control group was significant higher than that before(P<0.05),other remaining indexes were higher than before with no significance(P>0.05).Moderate ARDS treatment group about Immunoglobulin IgG,IgA,IgM,Complement C3,CH50,LymphocyteCD3 and CD4 in treatment group were higher than before(P<0.01,P<0.05).The improvement of IgG、C3 and CD3 after treatment were significant greater in the treatment group than the control group(P<0.05,P<0.01).(2)within all group:After treatment,IgM,C3 ans CD3 of the control group were higher than before(P<0.05).The Immunoglobulin IgG,IgM,IgA,complement C3,CH50,and T lymphocyte CD3,CD4,CD4/CD8 of total treatment group were higher than before(P<0.01,P<0.05),the IgG,CH50 and CD3 level were higher in the treatment group than in the control group(P<0.05).At the same time,the differences of IgG,CD3 and C3 after treatment in the treatment group was higher than those in the control group(P<0.01,P<0.05).2.Respiratory function index:The ventilation on fifth days’ oxygen partial pressure,arterial oxygen saturation,and oxygenation index on D5 of treatment group were significantly after treatment,as the same in the ARDS subgroup(P<0.01,P<0.05).3.mechanical ventilation and health economics:(1)moderate ARDS subgroup:Ginseng decoction increased the rate of Success weaning and decreased ventilation time and average daily ICU hospitalization expense,there was no statistical difference in other indicators(P>0.05).(2)Within all groups:Treatment group was higher in the rate of Success weaning and lower in the ventilation time,average daily ICU hospitalization expense and total ICU hospitalization expenses(P<0.05).But there was no statistical difference in mechanical ventilation time,length of hospitalization,total cost of hospitalization and average hospitalization expenses.4.survival rate:There was no significant difference in survival rate between the total treatment group and total control group,so was within the moderate ARDS subgroup,which maybe related with the small sample size.ConclusionThis study suggests for ARDS patients induced by sepsis,especially moderate ARDS,Ginseng decoction can improve immune function,respiratory parameters,relief the clinical symptoms,and reduce ventilation time,improve the success rate of ventilator weaning,decrease the daily ICU hospitalization expenses.So,it may Have clinical Pragmatic value.However,this study had no significant effect on the survival rate,which maybe related to the sample size,length of Observation time and Severity of illness.Meanwhile,the number of mild ARDS patients and severe ARDS patients was no big enough for this study,it may need to expand the sample size to further study.