Clinical Study Of JiaWeiJieDuShengMai Powder In The Treatment Of Septic Cardiomyopathy

Objective:Through clinical study,to observe the clinical effect of Jiawei jiedu Shengmai powder on septic cardiomyopathy,and to explore the possible mechanism of Jiawei jiedu Shengmai powder on septic cardiomyopathy.Method:Patients with septic cardiomyopathy who were admitted to the EICU of Jiangsu Province Hospital on Intergartion of Chinese and Western Medicine during the period of 2019.05-2020.02 were selected.70 patients with septic cardiomyopathy who met the enrollment criteria were divided into two groups according to the random number table method(n=35).Patients in both groups received indistinguishable treatment for sepsis,including:early limited fluid resuscitation;empirical antibiotics to cover possible pathogens;norepinephrine is preferred to maintain blood pressure,if it was difficult to maintain blood pressure due to decreased cardiac contractility,try combined with dobutamine therapy;take anticoagulant therapy according to the needs;early enteral nutrition support therapy;organ function support therapy and so on.The experimental group was treated with Modified Jiedu Shengmai Powder on the basis of routine treatment.To observe the effect of Modified Jiedu Shengmai Powder on myocardial damage index,inflammatory index,lymphocyte subsets,TCM syndrome score,TCM syndrome curative effect and ICU stay time,number of cases stopped using vasoactive drugs within 5 days and the fatality rate of 28 days in patients with septic cardiomyopathy,etc.Result:1.Baseline comparison:there was no significant difference in gender,age,height,weight,basic disease,site of infection and APACHE II score between the two groups(P>0.05).2.Intra-group comparison:after treatment,the levels of E' on the 3rd and 7th day in the two groups were significantly higher than when they were enrolled(P<0.05),and the levels of LUEF,LVEDD and cTnI on the 7th day were significantly better than when they were enrolled(P<0.05).Compared with they were enrolled,The LVEF of patients in the experimental group on the 3rd day was also significantly higher and the NT-proBNP on the 7th day decreased significantly(P<0.05).Comparison between the two groups:after treatment,compared with the control group,the LVEF of the experimental group on the 3rd and 7th day increased significantly([P=0.044,P=0.044),and the NT-proBNP on the 7th day decreased significantly(P=0.045).3.Comparison within the group:after treatment,the levels of WBC,hs-CRP and PCT of the two groups of patients decreased to normal levels on the 7th day,which were statistically significant compared with the time of enrollment(P<0.05).The WBC level of patients in the experimental group was also significantly reduced on the 3rd day compared with the time of enrollment(P<0.05).Comparison between groups:after treatment,the WBC level of patients in the experimental group on the 7th day was statistically different from that in the control group(P=0.038).4.Intra-group comparison:after treatment,the levels of CD4+T cells and total T lymphocytes on the 7th day in the control group were significantly higher than when they were enrolled(P<0.05),and the levels of CD8+T cells on the 3rd and 7th day were also significantly higher(P<0.05).The levels of CD4+T,CD8+T cells and total T lymphocytes in the experimental group on the 3rd and 7th day were significantly different from those before the enrollment(P<0.05).After entering the group,the CD4+T/CD8+T of the two groups of patients both showed a downward trend,and the CD4+T/CD8+T of the control group on the 3rd and 7th days was significantly lower than that of the group(P<0.05).Comparison between groups:on the 3rd day,the levels of CD4+T and CD8+T cells in the experimental group were significantly higher than those in the control group(P=0.01,P-0.06).On the 7th day,the levels of CD4+T and CD8+T cells in the experimental group were also significantly different from those in the control group(P=0.03,P<0.001).5.Intra-group comparison:after treatment,the TCM syndrome scores of patients in the control group on the 3rd day were significantly lower than when they were enrolled(P=0.001).And those in the experimental group on the 3rd and 7th day were also significantly lower than when they were enrolled(P All Value<0.001).Comparison between groups:after treatment,the TCM syndrome scores of patients in the experimental group on the 3rd day and the 7th day were significantly different from those in the control group(P=0.038,P=0.013).6.After treatment,the total effective rate of the experimental group was significantly higher than that of the control group(P=0.035),the number of patients who stopped using vasoactive drugs within 5 days was significantly higher than that of the control group(P=0.026),and the time of staying in ICU was significantly shorter than that of the control group(P=0.04),but there was no significant difference in hospital stay and 28-day mortality between the two groups(P>0.05).Conclusion:1.Modified Jiedu Shengmai Powder can significantly improve NT-proBNP and LVEF in patients with septic cardiomyopathy(syndrome type of ReRuYingXue and QiYinLiangShang).2.Modified Jiedu Shengmai Powder can effectively improve the TCM syndrome scores of patients with septic cardiomyopathy(syndrome type of ReRuYingXue and QiYinLiangShang),raise the treatment effect of TCM syndromes,reduce the number of vasoactive drugs used within 5 days,and shorten the time of staying in ICU.3.Modified Jiedu Shengmai Powder can significantly improve the WBC level in patients with septic cardiomyopathy(syndrome type of ReRuYingXue and QiYinLiangShang),adjust the level of CD4+T and CD8+T lymphocytes,and have a tendency to improve cellular immune function.