Study Of The Distribution Of TCM Syndrome Of Sepsis Complicated With Gastrointestinal Dysfunction And The Curative Effect Of Acupuncture

Background:Sepsis is a systemic inflammatory response syndrome caused by a host reaction disorder which with serious infection.Gastrointestinal dysfunction is one of the common organ injuries in sepsis,which not only seriously affects the prognosis of patients with sepsis,but also greatly increases the economy of patients.With the development of medical technology,the understanding of gastrointestinal dysfunction of sepsis is deepening,and the advantages of the Traditional Chinese Medicine(TCM)in its diagnosis and treatment are prominent.But the TCM syndrome,efficacy and safety are still urgent problems to be solved in current clinical work.Objective:1.Explore the TCM syndrome differentiation of sepsis with gastrointestinal dysfunction,to understand the disease characteristics and the laws of TCM syndrome differentiation.2.By observing the effects of acupuncture on TP,ALB,WBC,PCT,bowel sounds,and AGI grade,evaluating the efficacy and safety of acupuncture in the treatment of gastrointestinal dysfunction in sepsis,and provide clinical basis for the application of acupuncture treatment in the field of critical illness.Methods:1.Collecting the information of four diagnosis of TCM of 80 patients with sepsis gastrointestinal dysfunction,and describing the symptom signs,tongue mass,tongue moss and pulse image by frequently describing methods.Exploring the laws of TCM syndrome differentiation of sepsis with gastrointestinal dysfunction by cluster analysis.2.The further 40 patients were randomly divided into two groups,of which 20 were in observation group and 20 were in control group.Both groups were given basic treatment,and the observation group was given acupuncture treatment once a day.Recording patient’s information(including registration number,age,gender,APACHE-II score,and SOFA score)at the first day.The TP,ALB,WBC,PCT,bowel sounds,and AGI grade were observed at the first day and the seventh day.And recording 14-day death rates.The data were analyzed statistically using SPSS 21.0 to evaluate the efficacy and safety of acupuncture to sepsis gastrointestinal dysfunction.Results:1.Study of the TCM Syndrome of Sepsis Complicated with Gastrointestinal Dysfunction(1)Baseline statistics: a total of 80 cases were included,of which 46 were male,accounting for 57.5%,34 were women,accounting for 42.5%,with an average age of74.50±11.95,with an average SOFA score of 6.73±2.79 and an average APACHE-II score of21.21±6.83.(2)The statistics of four diagnosis of TCM: symptoms of a total of 58 items,fever,constipation,abdominal pain,thirsty and abdominal distension were appeared more frequently,accounting for more than 40% of the total sample.Red tongue,dry tongue with little saliva,pale tongue,purple tongue and tongue with petechiae have the higher frequency.Yellow moss,thin moss,thick moss,dry moss have the higher frequency.Rapid pulse,sink pulse,stringy pulse,unsmooth pulse,forceful pulse and weak pulse have the higher frequency.The total frequency of tongue mass was 135 times,the total frequency of tongue moss was 96 times,and the total frequency of pulse image was 168 times.(3)Cluster analysis results: After clustering analysis,the types of evidence included in the case are divided into 5 categories: solid-fu due to intestine-heat syndrome(42.5%)>blood stagnation of gastrointestinal syndrome(27.5%)> pi wei qi asthenia syndrome(15%)>accumulation of phlegm and dampness in the spleen syndrome(7.5%)and stomach heat syndrome(7.5%).2.Study of the Acupuncture in The Treatment of Sepsis Complicated with Gastrointestinal Dysfunction(1)Baseline statistics: No significant statistical differences(P>0.05)were found in the two groups of sex,age and pre-treatment SOFA score,APACHE-II score comparison.(2)Observational indicators: A comparison in the observation group found that,TP,ALB and bowel sounds in the seventh day of treatment were higher than those in the first day of treatment.WBC,PCT,AGI grade in the seventh day of treatment were lower than those in the first day of treatment.And those differences were statistically significant(P<0.05).In the control group,TP,ALB and WBC in the seventh day of treatment were higher than those in the first day of treatment,with statistically significant differences(P<0.05).And there were no statistical difference(P>0.05)in PCT、AGI grade and bowel sounds between the first and the seventh day of treatment.The comparison of two groups found that the differences of PCT and bowel sounds between the first day of treatment and the seventh day of treatment were not statistically significant(P>0.05).TP,ALB,WBC and AGI grade in two groups had no differences(P>0.05)on the first day,and had significant differences(P<0.05)on the seventh day.(3)Safety and Prognosis: No adverse reactions associated with acupuncture during the study in the observation group.Of the 40 patients,15 died,with a total mortality rate of37.5%.Among them,6 patients died in the control group with a mortality rate of 30%,and 9patients died in the observation group with a mortality rate of 45%.There was no significant difference in mortality between the observation groups and the control group(P>0.05).Conclusion:1.The frequency of TCM syndrome of sepsis complicated with gastrointestinal dysfunction from high to low: solid-fu due to intestine-heat syndrome,blood stagnation of gastrointestinal syndrome,pi wei qi asthenia syndrome,accumulation of phlegm and dampness in the spleen syndrome,and stomach heat syndrome.2.Acupuncture in the treatment of sepsis gastrointestinal dysfunction helps to regulate gastrointestinal function,thus helping to control infection,and it is possible to play a positive role in improving the nutritional status of patients.3.Acupuncture in the treatment of sepsis gastrointestinal dysfunction is safe,but there is no significant effect on the prognosis of patients.