ABSTRACT
ObjectiveTo study the anti-inflammatory effect of traditional Chinese medicine (TCM) Changweishu on sepsis patients with gastrointestinal dysfunction and its protective effect on intestinal mechanical barrier.Methods A prospective research method was conducted. Fifty sepsis patients with gastrointestinal dysfunction admitted into Department of Emergency Intensive Care Unit (EICU) of Hebei Provincial TCM Hospital from October 2013 to June 2015 were enrolled, and they were divided into a conventional treatment of western medicine control group and a TCM Changweishu group according to the random number table method, 25 cases in each group. The conventional western medicine treatment was given to both groups, and in TCM Changweishu group, additionally Changweishu 1 dose per day, a mixture of following ingredients constituting one dose without decoction, was applied, including: rhubarb 9 g, dandelion 20 g, green tangerine peel 15 g, angelica sinensis radix 15 g, red and white peony each 12 g, rhizome ligusticum 9 g, agrimony 20 g, coptidis rhizoma 6 g, rhizoma pinelliae 6 g, fructus trichosanthis 15 g, garden burnet root 20 g, poria 20 g, and taken once 1/2 dose in the morning and once 1/2 dose in the evening by oral or nasal feeding. After treatment for 7 days, the level changes of inflammatory factors of tumor necrosis factor-α(TNF-α), interleukin-6 (IL-6), high mobility group protein B1 (HMGB1) and gastrointestinal dysfunction indexes of diamine oxidase (DAO), D-lactic acid in the two groups were observed.Results After treatment, the levels of TNF-α, IL-6, HMGB-1, DAO, D-lactic acid in the two groups were significantly lower than those before treatment [the western medicine control group: TNF-α (A value) 10.89±1.65 vs. 50.30± 1.58, IL-6 (A value) 7.35±1.85 vs. 12.66 ± 1.43, HMGB1 (A value) 5.28 ±1.64 vs. 6.23±0.95, DAO (A value) 5.87±0.59 vs. 6.67±0.49, D-lactic acid (A value) was 2.63±0.17 vs. 4.58±0.16; TCM changweishu group: TNF -α (A value) 5.38±1.19 vs. 51.23±2.34, IL-6 (A value) 5.54±1.26 vs. 13.24±1.78, HMGB1 (A value) 3.69±1.09 vs. 6.14±1.42, DAO (A value) was 3.39± 0.40 vs. 6.70±0.34, D-lactic acid (A value) 1.95±0.13 vs. 4.63±0.11, allP < 0.05]. After treatment, the degrees of decline in indexes of TCM Changweishu group were more obvious than those in western medicine control group [TNF-α(A value) 5.38±1.19 vs. 10.89±1.65, IL-6 (A value) 5.54±1.26 vs. 7.35±1.85, HMGB1 (A value) 3.69 ±1.09 vs.5.28±1.64, DAO (A value) 3.93±0.40 vs. 5.87±0.59, D-lactic acid (A value) 1.95±0.13 vs. 2.63±0.17, allP <0.05].Conclusions TCM Changweishu has protective effect on sepsis patients with gastrointestinal dysfunction, and its mechanisms are the amelioration of damage in intestinal tract mechanical barrier, decrease of permeability of intestinal mucosa and inhibition of levels of inflammatory factors.