Effect Of Xuebijing On Inflammatory Response And Prognosis In Patients With Septic Shock

ObjectiveIn order to analyze the clinical effect of Xuebijing on septic shock patients,the effects of Xuebijing on inflammatory reaction and prognosis of septic shock patients were discussed to seek more effective clinical treatments and improve the prognosis and survival rate of septic shock patients.MethodsIn this study,80 patients diagnosed as septic shock admitted to intensive care unit(ICU)of the first affiliated hospital of Zhengzhou university from January 2019 to December 2019 were selected as the study objects,and they were randomly divided into Xuebijing group(n=40)and control group(n=40).Patients in both groups were treated in strict accordance with the 2016 international guidelines for the diagnosis and treatment of septic shock.On the basis of the treatment in the control group,the Xuebijing group added 100ml Xuebijing injection,intravenous drip twice a day for 7 days.Baseline data of all patients were recorded in detail,such as:gender,age,infection site,APACHE ? score,SOFA score,blood routine,liver and kidney function,coagulation function,etc.Before(t0)and after treatment 3 days(t3),7 days(t7),10 days(t10)of interleukin 6(IL 6)and C-reactive protein(CRP),procalcitonin(PCT)and heparin binding protein(HBP)and APACHE ? score were recorded,compared two groups of patients with different time points of difference between the various indicators.The 28-day fatality rate was calculated based on the prognosis of the patients,and the differences in mechanical ventilation time,ICU length of stay,total length of stay,and total cost of stay were compared between the two groups.Finally,according to the survival of the patients,the patients were divided into the death group and the survival group.Logistic regression analysis was used to analyze the risk factors affecting the prognosis of the patients,analyze the therapeutic effect of Xuebijing on septic shock,and guide the selection of the best treatment plan.Results(1)Among the 80 included cases,55 were males(68.75%)and 25 were females(31.25%),of which 29 died with a mortality rate of 36.25%and 51 survived with a survival rate of 63.75%.The sources of infection were lung in 29 cases(36.25%),abdomen in 24 cases(30%),blood in 15 cases(18.75%),urinary system in 7 cases(8.75%)and other 5 cases(6.25%).Among the 40 patients in the Xuebijing group,the age was 20-71 years old,with an average age of 59.38±12.12 years old.The 40 patients in the control group were 21-74 years old,with an average age of 57.95±13.64 years.(2)There were no statistically significant differences in the general clinical data between the two groups,such as age,gender,APACHE ? score,SOFA score(all P>0.05).(3)Patients in the ICU first laboratory results white blood cell(WBC),hemoglobin(HB)and platelets(PLT),neutrophils ratio(NEU%),alanine aminotransferase(ALT),aspertate aminotransferase(AST),albumin(propagated),total bilirubin(STB),creatinine(Cr),activated partial clotting enzyme live time(APTT),prothrombin time(PT),PCT,CRP,IL-6,HBP,lactic acid(Lac)had no statistical significance(P>0.05).With the beginning of treatment,the inflammatory factors(PCT,CRP,IL-6,HBP)and APACHE ? score all gradually decreased.On t0,PCT?CRP?IL-6?HBP?APACHE ? score were[PCT(ng/ml):3.03(0.55;18.22)vs.2.74(0.94,10.93)?CRP(mg/L):146.67(56.43,261.90)vs.193.33(35.87,273.15)?IL-6(pg/ml):98.39(27.33,400.20)vs.65.00(28.47,228.65)?HBP(pg/ml):181.05(81.55,309.50)vs.146.35(83.33,242.35)?APACHE ???:17.53±6.47 vs.18.08±7.18]respectively.Compared with the control group,IL-6,HBP and APACHE ? score in the study group were significantly decreased on t7:[IL-6(pg/ml):66.20(16.34,163.71)vs.79.81(23.95,178.64),HBP(pg/ml):95.59(45.23,157.37)vs.132.98(73.90,162.05),APACHE ? score:11.06±5.12 vs.15.99±6.78,all P<0.05];on t10,PCT,CRP,IL-6,HBP and APACHE ? score were significantly decreased:[PCT(ng/ml):1.14(0.20,3.39)? 1.31(0.68,4.21),CRP(mg/L):66.32(19.46,1±5.81)?89.16(20.52,143.76),IL-6(pg/ml):31.90(13.23,138.74)? 166.30(42.75,288.10),HBP(pg/ml):62.45(29.17,96.51)? 112.33(58.70,143.96),APACHE ? score:8.34±3.18 vs.13.29±5.90,all P<0.05].(4)According to the prognosis of the patients,there was no statistically significant difference in the case fatality rate and total length of stay between the two groups(P>0.05).The P values of mechanical ventilation time,length of stay in ICU and total cost of hospitalization were 0.003,0.000 and 0.049,respectively,with statistically significant differences.Regrouping,all patients can be divided into death and survival groups,the patients with baseline data and into the ICU first laboratory indexes single factor variance analysis found that the factors affecting the prognosis of patients with the WBC,NEU%,CRP,Lac,APACHE ? score,IL-6,HBP(all P<0.05),the above indicators further lines of Logistic regression analysis in IL-6,CRP,APACHE ? score for the independent risk factors affecting prognosis of patients with(all P<0.05).Conclusions(1)Combined with Xuebijing in the treatment of septic shock can reduce the level of inflammatory factors and reduce the inflammatory response of the body to a certain extent,thus reducing the time of mechanical ventilation,shortening the length of stay in ICU and reducing the total cost of hospitalization.However,it did not reduce the mortality of patients with septic shock.(2)The IL-6,CRP,APACHE ? score for the independent risk factors affecting the prognosis of patients with septic shock.