Clinical Observation Of Huoxue Qingjie Decoction In Treating Patients With Sepsis Type Acute Severe Cholangitis After Decompression And Drainage

Objective: Through randomized contrasted clinical trials,the clinical efficacy and safety of Huoxue Qingjie Decoction in the treatment of patients with acute cholangitis of severe type after decompression and drainage were observed,in order to provide reference for clinical application.Methods: 40 patients with acute severe cholangitis after biliary decompression and drainage who were admitted to the department of General Surgery,Hepatobiliary Spleen and Stomach and Emergency Department of Henan Provincial Hospital of Traditional Chinese Medicine from December 2019 to December 2020 were randomly selected.They were subdivided randomly into the observation and the control group of 20 cases each.The control group was treated basic treatments such as anti-shock,anti-infection,organ support,and systemic support.On the basic treatment of the control group,Huoxue Qingjie Decoction was given to the observation group.They were observed for 7 days.The two groups were recordedon before operation、the third and seventh day after operation,white blood cell count(WBC),neutrophil ratio(NEUT%),procalcitonin(PCT),alanine transaminase(ALT),aspartate transaminase(AST),total bilirubin(T-Bil)and direct bilirubin(D-Bil)levels,and compare the TCM syndrome scores,complication rates and mortality between the two groups before and on the 7th day after operation.Through statistical analysis of data,the clinical efficacy and safety of Huoxue Qingjie Decoction in the treatment of septic acute severe cholangitis patients after decompression and drainage were evaluated.Results: A total of 40 subjects were included in this study,and 37 cases were recorded and analyzed.(1)General data: The general data of the two groups of patients,such as age,gender,time from onset to consultation,previous diseases and surgical methods,were compared between the two groups.There was no statistical difference between the two groups(P>0.05).(2)Inflammation indicators: There was no significant difference in WBC,NEUT% and PCT between the two groups before operation,but there was no significant difference in WBC between the control group and the control group on the 3rd day after operation,but on the 7th day after operation,there was significant difference between the two groups,and there was significant difference between the observation group on the 3rd day and the 7th day after operation,and there was significant difference between the two groups(P < 0.05).There were significant differences in the levels of WBC,NEUT% and PCT between the two groups on the 3rd day and the 7th day after operation,and the levels in the observation group were lower than those in the control group.(3)Liver function indicators: There was no statistical difference in ALT,AST,T-Bil and D-Bil between the two groups of patients before operation(P>0.05).On the 3rd and7 th day after operation,the levels of ALT,AST,T-Bil and D-Bil were lower than before operation,and the observation group was significantly lower than the control group(P<0.05).(4)TCM syndrome scores and syndrome curative effect: After the test,the TCM syndrome scores of the two groups were both significantly reduced(P < 0.05),and the observation group was significantly lower than the control group(P < 0.05),and the effective rate of the treatment group was 88.89% The effective rate of the control group was 52.63%,and the curative effect of the observation group was significantly better than that of the control group(P<0.05).(5)Safety index: After the test,Local complication rate and mortality rate between the two groups were barely noticeable different(P>0.05).Conclusion:(1)On the basis of sufficient biliary decompression and drainage by ERCP,Huoxue Qingjie Decoction can effectively reduce many infection indexes and liver function indexes in patients with septic acute severe cholangitis,and has a good effect on reducing inflammatory reaction and promoting the recovery of liver function.(2)The decoction can significantly reduce the TCM syndrome score and improve the clinical symptoms,improve the effectiveness of clinical syndromes,and has good security.