Observation On The Clinical Efficacy Of Modified Taohong Siwu Decoction In The Treatment Of Septic Coagulopathy (blood Stasis Syndrome

Objective: To observe the clinical efficacy of Jia Wei Tao Hong Si Wu Decoction in the treatment of septic coagulopathy(syndrome of blood stasis),evaluate the coagulation indexes,tissue perfusion indexes,APACHEⅡscore,SOFA score of sepsis patients,and conduct a preliminary evaluation of its clinical safety and effectiveness,so as to provide a basis for the clinical application of integrated traditional Chinese and western medicine to treat septic coagulopathy.Methods: A total of 40 patients with sepsis and coagulation dysfunction were selected from December 2021 to December 2022 in the ICU of Provincial Direct Hospital of Traditional Chinese Medicine Affiliated to Hunan University of Chinese Medicine.They were randomly divided into control group and treatment group according to random number table method.The control group was given routine interventions according to the Spesis3.0 international guidelines,and the treatment group was treated with nasal feeding Jia Wei Taohong Siwu Decoction on the basis of the control group.The effects of coagulation index,tissue perfusion index,inflammation index,SOFA score,acute physiological and chronic health status score(APACHE II score),TCM syndrome score and clinical efficacy of the two groups were observed before and after treatment.Results: After intervention,coagulation function,tissue perfusion and other indexes of experimental groups were statistically different from that of control group(P < 0.05),and the degree of platelet increase after treatment(145.41 vs.90.25,P < 0.05)was significantly higher than that of control group.After treatment,PT and APTT of experimental group were shortened(13.28 vs.16.87,P < 0.05)and(32.45 vs.41.0,P < 0.05),while D-dimer was decreased(15.29 vs.28.91,P>0.05).Lactic acid level before and after treatment was significantly different(3.05 vs.0.39,P < 0.05).The capillary filling time(CRT)of experimental group was significantly shorter than that of control group after treatment(3.22 vs.5.40,P < 0.05).The change rate of capillary filling time(CRT)was significantly different(-18.5 vs.29.4,P < 0.05).Inflammatory markers were decreased after treatment.CRP(97.99 vs.163.76,P < 0.05),PCT(3.14 vs.12.53,P < 0.05),The difference after treatment was statistically significant,and the experimental group was significantly lower than the control group.TCM syndrome score(5.7 vs.9.40,P > 0.05),but the difference of TCM syndrome score before and after treatment was significant(3.70 vs.-0.05,P < 0.05);SOFA score(6.35 vs.8.95,P > 0.05),APACHE II score(12.70 vs.15.90,P > 0.05),and 28-day fatality rate(30% vs.40%,P > 0.05)were decreased in different degrees compared with the control group.But there was no statistical difference between them.Conclusion:(1)The combination of Jia Wei Tao Hong Si Wu Decoction with conventional Western medicine interventions can shorten PT and APTT,reduce D-Dimer level and increase PLT level compared with single conventional interventions,which is presumed to improve systemic microcirculation,reduce microthrombosis;(2)The combined application of Jia Wei Tao Hong Si Wu Decoction can reduce blood lactate level(LAC),shorten capillary refill(CRT)and reduce the rate of change of capillary filling time(CRT),which is conducive to restoring microcirculatory perfusion and delaying the progress of organ dysfunction in patients with septic shock;(3)The combination of Jia Wei Tao Hong Si Wu Decoction has reduced the APACHE II score,SOFA score and 28-day morbidity and mortality rate,and there is no significant difference in morbidity and mortality rate compared with conventional interventions in Western medicine;(4)The use of Jia Wei Tao Hong Si Wu Decoction can alleviate and improve clinical symptoms and the integral of Chinese medical evidence;(5)The combination of Jia Wei Tao Hong Si Wu Decoction with Western medical treatment,to a certain extent,reduced inflammatory indexes such as CRP,PCT,and alleviated the inflammatory stress response of the organism.