ABSTRACT
Objective To observe the role of Zhenqi Fuzheng granules in the treatment of patients with severe pneumonia respiratory failure. Methods A retrospective research was conducted, 96 patients with severe pneumonia admitted to the Department of Critical Care Medicine of the First People Hospital of Baiyin were enrolled, and they were divided into a western medical conventional treatment group (47 cases) and a combined traditional Chinese and western medicine treatment group (49 cases) according to the different treatment methods. A variety of conventional rescue treatments were carried out in the western medicine routine treatment group (conventional group); while in the combined traditional Chinese and western medicine conventional treatment group (combined group), based on the western medical therapies in the conventional group, at the same time, additionally Zhenqi Fuzheng granules 5 g dissolved in 20 mL warm boiled water were given by nasal feeding to the patients, 2 times daily, 7-10 days constituting a therapeutic course, and after 3 courses, the clinical therapeutic effects were evaluated. The mortality and changes of pre- and post-treatment levels of immunoglobulin, procalcitonin (PCT), C-reactive protein (CRP), course of disease, times of using antibacterial drug and ventilator, and changes in lung exudation before and after treatment, and incidence of pulmonary fibrosis were observed in the two groups. Results The mortality of combined group was significantly lower than that of the conventional group [14.29% (7/49) vs. 36.17% (17/47), P < 0.05]. After treatment, the levels of immunoglobulins were significantly higher than those before treatment, while the levels of PCT and CRP were significantly lower than those before treatment in both groups, and the changes after treatment in the combined group were more obvious than those in conventional group [IgG (g/L): 12.48±2.36 vs. 10.35±3.01, IgA (g/L): 4.16±1.08 vs. 3.18±1.13, IgM (g/L): 5.01±1.15 vs. 3.62±1.02, PCT (mg/L): 1.48±1.36 vs. 2.35±1.01, CRP (mg/L): 8.48±2.36 vs. 10.35±2.01, all P <0.05]. Compared with those in conventional group, the patient's disease course, times of using antibacterial drug and ventilator were significantly shorter in combined group [the course of disease (days): 10.86±2.64 vs. 14.38±3.02, time of using antibacterial drug (days): 11.29±3.54 vs. 13.96±4.21, time of using ventilator (days): 8.26±2.64 vs. 10.25±3.08, all P <0.05]; Compared with those in the conventional group, the cases with significant reduction of pulmonary exudation and the cases with complete absorption of pulmonary exudation were markedly increased, while the cases of pulmonary fibrosis were obviously decreased in the combined group (cases of reduction of pulmonary exudation:15 cases vs. 10 cases, complete absorption of pulmonary exudation: 16 cases vs. 9 cases; cases of pulmonary fibrosis:8 cases vs. 10 cases, all P < 0.05). Conclusion Zhenqi Fuzheng granules can significantly reduce the mortality and inflammatory factor levels, raise immunoglobulin, shorten the course of disease and times of using antimicrobial drugs and ventilator, reduce pulmonary exudation and incidence of pulmonary fibrosis obviously in patients with severe pneumonia.
ABSTRACT
Objective@#To explore the effects of different mild hypothermia therapy time on the efficacy and complications of patients with severe traumatic brain injury (STBI).@*Methods@#A retrospective research method was used. 132 patients with STBI given mild hypothermia therapy admitted to the Third Affiliated Hospital of Gansu University of Traditional Chinese Medicine from January 2010 to December 2018 were enrolled. According to the days of mild hypothermia therapy, the patients were divided into 2-day mild hypothermia treatment group, 5-day mild hypothermia treatment group and 14-day mild hypothermia treatment group. Glasgow coma score (GCS) after treatment of 10 days and 30 days, 30-day disability rate and mortality, coma time, prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (Fib), D-dimer, and the incidence of complications such as decreased blood pressure, decreased gastrointestinal motility, infection, nonunion of scalp, cerebrospinal fluid leakage, etc. were compared among three groups.@*Results@#Among the 132 patients with STBI, there were 44 cases in the 2-day mild hypothermia treatment group, 45 cases in 5-day mild hypothermia treatment group, and 43 cases in 14-day mild hypothermia treatment group. There was no significant difference in gender, age, GCS score before treatment or time from injury to admission among three groups. Compared with 2-day mild hypothermia treatment group, the GCS score 10 days and 30 days after treatment in 5-day mild hypothermia treatment group and 14-day mild hypothermia treatment group were significantly higher (11.61±2.23, 10.17±2.03 vs. 6.79±1.49; 13.15±2.53, 11.24±2.24 vs. 8.79±1.59), the coma time were shorten (days: 5.79±1.89, 5.45±1.72 vs. 13.65±2.73), and 30-day disability rate and mortality were significantly decreased [13.33% (6/45), 11.63% (5/43) vs. 22.73% (10/44); 17.78% (8/45), 16.28% (7/43) vs. 31.82% (14/44)], PT and APTT were reduced obviously (s: 20.14±4.12, 22.54±3.56 vs. 30.67±5.19; 35.14±12.41, 38.59±13.54 vs. 56.67±10.62), Fib rose obviously (g/L: 1.84±0.25, 1.98±0.27 vs. 0.67±0.12), and D-dimer reduced obviously (mg/L: 53.10±19.84, 49.20±20.13 vs. 102.60±20.13), with statistically significant differences (all P < 0.05). But there was no significant difference in above indicators between the 5-day mild hypothermia treatment group and 14-day mild hypothermia treatment group (all P > 0.05). The incidence of complications in 14-day mild hypothermia group was significantly higher than those in 2-day mild hypothermia group and 5-day mild hypothermia group [decrease of blood pressure: 55.56% (20/36) vs. 36.67% (11/30), 35.14% (13/37); weakening of stomach intestinemotive power: 72.22% (26/36) vs. 46.67% (14/30), 45.95% (17/37); urethral infection: 52.78% (19/36) vs. 36.67% (11/30), 35.14% (13/37); lungs infection: 47.22% (17/36) vs. 36.67% (11/30), 37.84% (14/37); disunion of scalp: 5.56% (2/36) vs. 0% (0/30), 0% (0/37); leak of cerebrospinal fluid: 5.56% (2/36) vs. 0% (0/30), 0% (0/37), all P < 0.05], but there was no significant difference between the 2-day mild hypothermia treatment group and 5-day mild hypothermia treatment group (all P > 0.05).@*Conclusions@#The optimal time frame for mild hypothermia treatment in patients with STBI is 5-day, which shortens the coma time, and reduces the mortality and the disability rate. The shorter mild temperature time cannot effectively prevent secondary brain injury. However, the prolonged period of mild temperature will affect the repair of the patient's injury tissue, which is not conducive to the recovery of patient's mechanical function and is prone to complications.
ABSTRACT
Objective To explore the effects of different mild hypothermia therapy time on the efficacy and complications of patients with severe traumatic brain injury (STBI). Methods A retrospective research method was used. 132 patients with STBI given mild hypothermia therapy admitted to the Third Affiliated Hospital of Gansu University of Traditional Chinese Medicine from January 2010 to December 2018 were enrolled. According to the days of mild hypothermia therapy, the patients were divided into 2-day mild hypothermia treatment group, 5-day mild hypothermia treatment group and 14-day mild hypothermia treatment group. Glasgow coma score (GCS) after treatment of 10 days and 30 days, 30-day disability rate and mortality, coma time, prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (Fib), D-dimer, and the incidence of complications such as decreased blood pressure, decreased gastrointestinal motility, infection, nonunion of scalp, cerebrospinal fluid leakage, etc. were compared among three groups. Results Among the 132 patients with STBI, there were 44 cases in the 2-day mild hypothermia treatment group, 45 cases in 5-day mild hypothermia treatment group, and 43 cases in 14-day mild hypothermia treatment group. There was no significant difference in gender, age, GCS score before treatment or time from injury to admission among three groups. Compared with 2-day mild hypothermia treatment group, the GCS score 10 days and 30 days after treatment in 5-day mild hypothermia treatment group and 14-day mild hypothermia treatment group were significantlyhigher (11.61±2.23, 10.17±2.03 vs. 6.79±1.49; 13.15±2.53, 11.24±2.24 vs. 8.79±1.59), the coma time were shorten (days: 5.79±1.89, 5.45±1.72 vs. 13.65±2.73), and 30-day disability rate and mortality were significantly decreased [13.33％ (6/45), 11.63％ (5/43) vs. 22.73％ (10/44); 17.78％ (8/45), 16.28％ (7/43) vs. 31.82％ (14/44)], PT and APTT were reduced obviously (s: 20.14±4.12, 22.54±3.56 vs. 30.67±5.19; 35.14±12.41, 38.59±13.54 vs. 56.67±10.62), Fib rose obviously (g/L: 1.84±0.25, 1.98±0.27 vs. 0.67±0.12), and D-dimer reduced obviously (mg/L:53.10±19.84, 49.20±20.13 vs. 102.60±20.13), with statistically significant differences (all P < 0.05). But there was no significant difference in above indicators between the 5-day mild hypothermia treatment group and 14-day mild hypothermia treatment group (all P > 0.05). The incidence of complications in 14-day mild hypothermia group was significantly higher than those in 2-day mild hypothermia group and 5-day mild hypothermia group [decrease of blood pressure: 55.56％ (20/36) vs. 36.67％ (11/30), 35.14％ (13/37); weakening of stomach intestinemotive power: 72.22％(26/36) vs. 46.67％ (14/30), 45.95％ (17/37); urethral infection: 52.78％ (19/36) vs. 36.67％ (11/30), 35.14％ (13/37); lungs infection: 47.22％ (17/36) vs. 36.67％ (11/30), 37.84％ (14/37); disunion of scalp: 5.56％ (2/36) vs. 0％ (0/30), 0％ (0/37);leak of cerebrospinal fluid: 5.56％ (2/36) vs. 0％ (0/30), 0％ (0/37), all P < 0.05], but there was no significant difference between the 2-day mild hypothermia treatment group and 5-day mild hypothermia treatment group (all P > 0.05). Conclusions The optimal time frame for mild hypothermia treatment in patients with STBI is 5-day, which shortens the coma time, and reduces the mortality and the disability rate. The shorter mild temperature time cannot effectively prevent secondary brain injury. However, the prolonged period of mild temperature will affect the repair of the patient's injury tissue, which is not conducive to the recovery of patient's mechanical function and is prone to complications.
ABSTRACT
Objective To observe the clinical therapeutic effect of Astragalus injection combined with sub-hibernation therapy for treatment of patients with severe craniocerebral injury.Methods A retrospective research method was conducted, and 89 cases with severe craniocerebral injury admitted to the Department of Critical Care Medicine of the First People Hospital of Baiyin in Gansu Province from January 2010 to December 2016 were enrolled. Astragalus injection combined with sub-hibernation was applied for treatment of 45 patients in the observation group, and for another 44 cases assigned in the control group, simply conventional treatment was used. The Glasgow coma score (GCS), coma time, ratio of cripple, mortality, incidences of pulmonary infection and urinary tract infection were compared between the two groups.Results After treatment, GCS scores were significantly higher than those before treatment in both groups, but the degree of increase was more marked on the 30 days after treatment in the observation group than that in the control group (13.15±2.53 vs. 8.79±1.59,P 0.05).Conclusions The treatment of Astragalus injection combined with sub-hibernation treatment can significantly improve the coma degree, shorten the time of coma, reduce the mortality and disability rate of patients with severe craniocerebral injury.