| Background:Nowadays,stroke,with its' high morbidity,mortality and disability,brings about heavy economic and mental burdens to both the society and families.While,the stroke-associated infection(SAI)happens in stroke patients will make the outcome worse,even cause the patients to death.Therefore,it is noticeable and necessary for us to make efforts to do early prevention and prompt treatment for SAI.Objective:In order to explore the changing features of inflammatory response on acute cerebral infarction patients and phlegm-heat and bowel-qi-obstructed syndrome,we take the IL-6 as the target and analysize by different subgroups.Explore the IL-6 dynamic change of SAI group and no SAI group;explore the IL-6 dynamic change of SAI patients with Chinese herb group and western laxative treatment group.From the perspective of the inflammatory responses,we aim at the possible relationship of the brain,fu organ,lung and the urinary system.Methods:62 patients with acute cerebral infarction and phlegm-heat and bowel-qi-obstructed syndrome who met the inclusion criteria were divided randomly into two groups with the ratio of 2:1.During the clinical observation,there is one shedding-case in study group and one eliminated case in control group.The study group was prescribed with Xinglouchengqi decoction while the control group routine western laxative treatment.Besides,all the patients were under the basic medical treatment.During the observation,the patients who sufferd from the SAI should meet the diagnosis criteria of the stroke-associated infection.The treatment course was usually 5±2 days,which can be flexibly adjusted in line with the relief of fu organ.We adjusted every enrolled patients by a series of stroke-related scales and detected IL-6 levels at the exact time when we enrolled them and fu organ was relieved.We visited the patient and observed the symptom changes every day during the study course until the patient's bowl qi was unobstructed.The SAI patients would be adjusted by the SAI scale and collected extra IL-6 levels in the infection point.Security indicators will be detected again at the end of the observation.Results:1.After the treatment,we found the significant improvement of the traditional Chinese medicine(TCM)signs and symptoms,the NIHSS scores,the scores of scale for phlegm-heat and bowel-qi-obstructed syndrome in both study group and control group(P<0.05).Besides,the scores of inner wind,inner fire,phlegm-dampness,blood stasis and yin-deficiency lowered after the treatment in both groups(P<0.05).Pitifully,we didn't find any significant difference between the two groups in above-mentioned scales(P>0.05).2.The scores of SAI scale were better after treatment in SAI patients in two groups(P<0.05),but there was no significant difference between the two groups(P>0.05).3.Among the patients with the SAI(n=14)and without the SAI(n=46),the changing IL-6 levels showed the opposite tendency.The average IL-6 levels sharply declined in SAI subgroup while slowly rised in no SAI subgroup.Surprisingly,they were both close to a certain level.4.Among the patients with the SAI,after the treatment,the average IL-6 levels dropped in both Chinese herb group(n=7)and western laxative treatment group(n=7)and there was no significant difference before or after the treatment between the two groups(P>0.05).However,the dropping range of average IL-6 levels was more obvious in the Chinese herb group from the trend chart.The dropping range of IL-6 levels didn't match the changing range of white blood cell count.5.Among the patients without the SAI,the average IL-6 levels increased in both Chinese herb group(n=33)and western laxative treatment group(n=13)and there was no significant difference before or after the treatment between the two groups(P>0.05).However,there was a rising trend in average IL-6 levels in both subgroups but the rising range was more obvious in the Chinese herb group from the trend chart.Conclusion:1.As the opposite trends in the patients with the SAI(n=14)and without the SAI(n=46),we hypothesize that the therapy of relaxing bowel and resolving phlegm owns the dual effects in changing the IL-6 levels between the infected and uninfected patients,making the abnormal well-balanced and eazing the inflammatory response.lt remains further studies to confirm.2.Among the SAI patients in Chinese herb group and western laxative treatment group,the trend of IL-6 levels is dropping and it is more obvious in the Chinese herb group.The dropping range of IL-6 levels in both subgroups don't match the changing range of white blood cell count,which indicates that the IL-6 owns sensitivity in predicating the variation of inflammatory response.3.Among the no SAI patients in Chinese herb group and western laxative treatment group,the trend of IL-6 levels is rising and it is more obvious in the Chinese herb group.We wonder if the therapy of relaxing bowel and resolving phlegm can advance the peak of IL-6 levels or shorten the time from the abnormal to the normal,which remains further study.4.With the gradually smoothy trend of IL-6 levels,improvement of stroke conditions,phlegm-heat and bowel-qi-obstructed syndrome and symptoms of neurological impairment turns out.5.The therapy of relaxing bowel and resolving phlegm can relieve the infected signs and symptoms via adjusting the QI-ji and the inner fire factors and fu organ constipation of the middle-jiao possibly. |
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