| Objective The aim of this study was to investigate whether adjuvant treatment of ozoned water enema can improve long-term prognosis by regulating inflammatory response and improving microcirculation in patients with sepsis.was beneficial for the treatment of patients with sepsis,and to observe the safety of this therapy in these patients.Methods This is a prospective,single-center randomized controlled study.A total of 50 patients with sepsis admitted to the Intensive Care Unit(ICU)of Shanghai East Hospital South Hospital from December 2020 to June 2022 were included in the study.Four patients refused enema treatment and 2 patients were excluded from the cohort due to lack of primary test results on subsequent examinations.The remaining 4 4 patients were randomized into two groups: Control group(Group A,n = 22,treated with routine therapy and deionized water enema),a total of 22 cases(14 males,8 females),and Ozonated water enema group(group B.n = 2 2,treated with routine therapy and ozonated water enema),a total of 22 cases(13 males,9 females).Based on routine ICU treatment,the patients in the two groups were treated with deionized water or ozonated water enema respectively on the 1 st,2 nd,3 rd,4 th,and 5 th days.The plasma concentrations of white blood cell count(WBC),C-reactive protein(CRP),procalcitonin(PCT),IL-1 β,IL-2,IL-6,and TNF-α were recorded before enema(T0),on the first day(T1),the third day(T2),the fifth day(T3),and the seventh day(T4)after enema,serum biochemical indicators(albumin,total bilirubin,direct bilirubin,ALT,AST,LDH,creatinine,etc.)and coagulation function at every time point,lactate levels were measured at T0,T3,and T4 time points,the types of infectious pathogens and antibiotics used were recored on the third day of ICU admission,and the ICU length of stay,total length of hospital stay,complications,and mortality were recorded in both groups.Results There were no significant differences between the two groups in terms of age,gender,underlying diseases,ICU length of stay,total length of stay,etc.(P>0.05).Within each group of patients,compared with the T0 time point,the plasma concentrations of WBC,CRP,PCT,IL-2,IL-6,and TNF-α at the T4 time point were significantly decreased after treatment respectively(P< 0.0 5),total bilirubin and ALT,AST were significantly reduced(P < 0.0 5),and serum total protein was significantly increased(P < 0.05),urea nitrogen and uric acid levels in both groups were also significantly decreased(P<0.05).Compared with the control group,the ozonated water enema group had significantly lower plasma concentrations of CRP,IL-1 β,IL-2,IL-6,and TNF-α at the T4 time point,there were statistical significances(P< 0.0 5).Furthermore,compared with the control group,the lactate level in the ozonated water enema group was significantly reduced at the T3 time point(P< 0.0 5).There were no significant differences in SOFA scores and APACHE II scores at various time points between the two groups (P>0.0 5).After five days of adjuvant therapy with ozonated water enema,no adverse events related to ozonated water enema were observed in all patients in the experimental group.The 7-day mortality rate in the control group was 18.2%,and that in the ozonated water enema group was 13.6%.After statistical analysis,there was no significant difference between the two groups(P> 0.0 5).The Kaplan-Meier survival curve analysis performed during the 6 0-day follow-up of the two groups also showed no statistical significance(P>0.05).Conclusion: This study confirmed that the use of ozonated water enema as an adjuvant treatment during routine treatment of sepsis can effectively reduce the degree of inflammation in sepsis patients,and this treatment has a high level of safety. |
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