Discussion On The Clinical Effect Of Xuebijing Injection In Treatment Of Severe Pneumonia Based On Lung Collateral Theory

Objective:Severe pneumonia is a kind of refractory infectious disease which puzzles clinical treatment because of its complicated pathogens,high incidence,high mortality and limited treatment methods.It is often complicated with multiple organ dysfunction and difficult to prolong.Based on the theory of lung collaterals and the principle of "dredging collaterals",this experiment explored the effect of Xuebijing injection on early improvement of infection control and pulmonary microcirculation in patients with severe pneumonia by observing the changes of infection index,inflammatory factors,coagulation function and vascular endothelial function,so as to provide references for the adjuvant treatment of critically ill patients with traditional Chinese medicine.Method:From January 2017 to January 2019,64 patients in ICU of Suzhou Hospital Of Traditional Chinese Medicine,Affiliated Hospital of Nanjing University of Chinese Medicine,who met the diagnostic criteria of severe pneumonia(lung heat collateral stasis syndrome),were divided into treatment group(29 cases)and control group(35 cases)randomly.In the treatment group,50 ml Xuebijing injection was added on the basis of the control group,twice a day,continuous intravenous drip for 7 days as a course of treatment.APACHE ? score,CPIS score,WBC,PCT,PLT,D-Dimer,Lac,IL-6,sE-selectin,sP-selectin and vascular endothelial growth factor levels were measured before and 7 days after treatment,and the changes of symptoms and indicators were compared before and after treatment.Result:1.Comparing the baseline data(including gender,age,APACHE ? score,CPIS score,WBC,PCT,PLT,D-Dimer,Lac,IL-6,sE-selectin,sP-selectin and vascular endothelial growth factor)before treatment,there was found no significant difference between the two groups(P>0.05),that is,the two groups were evenly distributed before treatment and the grouping was comparable.2.Comparing the curative effect of TCM symptoms between the two groups before and after treatment,the total curative effect of the treatment group was 82.75%,which was better than that of the control group 60.00%.The difference between the two groups was statistically significant(P<0.05).There was no difference in the final mortality rate between the two groups(P>0.05).3.After treatment,except WBC,PCT,Lac of the control group and Lac of the treatment group had no difference(P>0.05),the data of the two groups decreased significantly(P<0.05),and the APACHE ? score and CPIS score of the treatment group had significant difference before and after treatment(P<0.01).Compared with the control group after treatment,the decrease levels of IL-6,TNF-a,sE-selectin in the treatment group were significantly different(P<0.01).The decrease levels of CPIS score,WBC,PLT,D-Dimer,sP-selectin and VEGF were also in difference(P<0.05).In the inter-group comparison,the APACHE ? score,PCT and Lac after treatment were found not different(P>0.05).Conclusion:Based on the pathogenesis of febrile diseases and the law of transmission in lung collateral theory,the pathogenic factors of exogenous febrile toxins invade the human body,the process of transmission from Yang collateral to Yin collateral and from Qi collateral to Xue collateral and the characteristics of pathogenesis,with the principle of "using collateral to dredge collaterals" as the treatment principle,the theoretical study of blood purification and detoxification,clearing heat and activating collaterals,and removing obstruction of lung collaterals and blood stasis can be concluded from this experiment,compared with the single use.Western medicine standard treatment means,combined use of Xuebijing injection in the treatment of severe pneumonia(lung heat collateral stasis syndrome)can improve pulmonary microcirculation,improve vascular endothelial function,reduce the formation of pulmonary microthrombosis,reduce the level of inflammatory factors,assist in controlling the progress of infection,to a certain extent,improve the effectiveness of treatment of severe pneumonia.However,the improvement of the final mortality rate remains to be verified.