ABSTRACT
Objective:To investigate the effect of long-term oral administration of β-blocker on septic myocardial injury and prognosis.Methods:A retrospective study was conducted. Patients who were admitted to the emergency intensive care unit (EICU) and intensive care unit (ICU) of Tongde Hospital of Zhejiang Province from January 2015 to June 2020 were enrolled. A total of 289 patients who met the criteria of myocardial injury induced by sepsis were included in the analysis. Among them, 187 patients who had never taken β-blocker within 3 months before diagnosis were divided in the non-β-blocker group, and 102 patients who took β-blocker daily for more than 3 months before diagnosis were in the β-blocker group. The physiological and biochemical characteristics were compared between the two groups, including heart rate, mean arterial pressure (MAP) at the time of diagnosis, cardiac troponin I (cTnI), brain natriuretic peptide (BNP), MB isoenzyme of creatine kinase (CK-MB), blood lactic acid (Lac), central venous oxygen saturation (ScvO 2), sequential organ failure assessment (SOFA) score, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score within 24 hours of diagnosis, left ventricular ejection fraction (LVEF), early and late mitral orifice diastolic peak flow velocity ratio (E/A), utilization rate of vasoactive drugs during hospitalization and 28-day mortality. Results:The heart rate in the β-blocker group at the time of diagnosis was significantly lower than that in the non-β-blocker group (bpm: 107±8 vs. 110±7, P < 0.01), and the levels of cTnI and BNP within 24 hours of diagnosis were significantly lower than those in the non-β-blocker group [cTnI (μg/L): 0.191 (0.220) vs. 0.291 (0.300), BNP (ng/L): 627 (133) vs. 690 (201), both P < 0.05]. However, there were no significant differences in MAP, CK-MB, Lac, ScvO 2, SOFA score, APACHE Ⅱ score, LVEF, E/A, vasoactive drug utilization rate, and 28-day mortality between the β-blocker and non-β-blocker groups [MAP (mmHg, 1 mmHg = 0.133 kPa): 70.6±3.9 vs. 69.9±3.8, CK-MB (μg/L): 4.24 (3.33) vs. 4.32 (3.13), Lac (mmol/L): 3.50 (1.80) vs. 3.50 (1.90), ScvO 2: 0.729±0.032 vs. 0.735±0.041, SOFA score: 7.74±2.34 vs. 7.25±2.23, APACHE Ⅱ score: 17.19±5.13 vs. 18.27±6.12, LVEF: 0.567±0.058 vs. 0.557±0.051, E/A: 0.71 (0.20) vs. 0.69 (0.20), vasoactive drug utilization rate: 60.8% (62/102) vs. 56.7% (106/187), 28-day mortality: 23.5% (24/102) vs. 25.7% (48/187), all P > 0.05]. Conclusion:Long-term oral administration of β-blocker reduce myocardial injury in septic patients, and has no effect on disease severity and prognosis.
ABSTRACT
Objective] To summarize the experiences of Professor Shu Qijin and to introduce his frequently used traditional Chinese medicine(TCM) herbal-pairs for treating lung cancer. [Methods] Professor Shu's experience and the treatment principles on herbal-pairs were summarized by attending the process of his diagnosis and treatment for lung cancer patients and his medical records. [Results] Shu treated that lung cancer by traditional Chinese medicine belongs to the multi-target therapy, drug although short, lung disease is also complex. However, the drug for lung cancer a target in strong, if properly combined, can hold simplification, observant insight. For advanced lung cancer patients with Qi deficiency symptoms, Shu used common heterophylla-Astragalus, Codonopsis-white atractylodes rhizome, Radix Glehniae, Ophiopogon japonicus, medicine of Fuzheng anticancer; sputum is a poison stasis, Shu divided common diffusa-sheliugu, Lobelia chinensis, Scutellaria barbata, Taxus chinensis var. mairei, Polygonum cuspidatum root medicine for detoxification Sanjie; blood stasis, Shu used common trigonous, rhizome, notoginseng, radix paeoniae rubra, etc. drug for promoting blood circulation and removing blood stasis. Anyway, Shu permited the treatment of lung cancer, on the basis of dialectical argumentation, discerning the pathogeny, disease location, disease, illness and mastering five flavors of the four properties of traditional Chinese medicine(TCM), rising and sinking, using the following drugs, clinical addition and subtraction, herbal prescription has better clinical efficacy, and attached with the case of a post-mortem. [Conclusions]Medicine of precise curative effect is determined by Shu and the mechanism of medication has higher clinical value,it is worth in-depth study and application.