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Objective To investigate the clinical effect of Qingrelishi prescription in the treatment of infantile rotavirus enteritis (RE). Methods One hundred and twenty children with RE admitted to the Department of Intestinal Outpatient of Tianjin Children's Hospital from October to November 2018 were enrolled, and they were divided into a Qingrelishi prescription group and a western medicine treatment control group, 60 cases in each group. Qingrelishi prescription addition and/or subtraction was given to the Qingrelishi prescription group (composition of the prescription: pueraria lobata, radix pseudostellariae, poria cocos, fried atractylodes macrocephala, each 6 g, scutellaria baicalensis, coptis chinensis, amomum villosum, argastaches leaves, roasted licorice, each 3 g), 1 dose a day, orally taken 1/2 dose twice a day, in thermogravimetric patients, plaster and rhizoma phragmititis were added, in cases with dampness, rhizoma alismatis and rhizoma atractylodis were added, and in patients with vomiting, bamboo shavings and pinellia were added; the western medicine treatment control group was given Montmorillonite powder. After 7 days of treatment, the clinical symptoms, changes of laboratory indexes and clinical efficacy were observed in both groups. Results After treatment, the number of children with stool soft, cases with fecal times less than 3 times per day and cases with reduction of fecal times ≥ 50% in Qingrelishi prescription group were obviously more than those in the western medicine treatment control group (fecal property soft: 25 cases vs. 21 cases, fecal times less than 3 times per day: 28 cases vs. 22 cases, cases with reduction of fecal times ≥ 50%: 48 cases vs. 41 cases, all P < 0.05). The number of children with laboratory examination index of rotavirus antigen (RV-Ag) transformed into negative, the case number with pH value normal shown by blood gas analysis, cases with residual alkali (BE) normal and cases with urinary ketone body transformed into negative in the Qingrelishi prescription group were significantly higher than those in western medicine treatment control group (RV-Ag transformed into negative cases: 49 cases vs. 42 cases, pH value normal cases:48 cases vs. 42 cases, BE normal cases: 51 cases vs. 43 cases, urinary ketone body transformed into negative cases:52 cases vs. 44 cases, all P < 0.05). The total effective rate of Qingrelishi prescription group was significantly higher than that of the western medicine treatment control group [80.0% (48/60) vs. 68.33% (41/60)], the difference was statistically significantly (P < 0.05). Conclusion Qingrelishi prescription can significantly improve the clinical symptoms and laboratory examination indicators of children with RE, increase the total clinical efficacy, and its therapeutic effect is definite.
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Objective To observe the clinical effect of the quadruple therapy of integrated traditional Chinese and western medicine for treatment of patients with paralytic ileus.Methods A prospective randomized control trial was conducted.Ninty-five patients with paralytic ileus diagnosed by Tianjin First Central Hospital from January 2015 to February 2016 were randomly divided into a control group (47 cases) and a research group (48 cases).Routine western medical treatment was given to the patients in control group;on the basis of western medical routine treatment,quadruple therapy was applied to the patients in the research group,including alprostadil injection 10 μg,intravenous drip,once a day;Xuebijing injection 40 mL,intravenous drip,twice a day;liangge powder with modification (ingredients or their dosages being added and/or subtracted) composed of rhubarb 10 g,mirabilite 10 g,gardenia 15 g,weeping forsythia 20 g,scutellaria 15 g,glycyrrhiza 6 g,mint 6 g,bamboo leaves 10 g,honey 10 g.administered by gastric tube;point selection principle:zusanli (ST36),sanyinjiao (SP6),tianshu (S25),hegu (LI4),yanglingquan (GB34),zhongwan (CV12),xiawan (CV10),dachangshu (C07)etc.No.30 filiform needle was used to be perpendicularly inserted by moderate and equi-librious acupuncture technique,needle retaining being 30 minutes,once a day for 72 hours.The numbers of the patients with abdominal pain,abdominal distension,nausea and vomiting,absence of exhausting and defecation,gurgling sound attenuation or disappearance,abdominal X-ray abnormality,and the first defecation time,gurgling reappearance time,disappearance time of main symptoms were observed.The clinical effects of these two groups were statistically analyzed.Results After treatment in the two groups,the numbers of patients with abdominal pain,abdominal distension,nausea and vomiting,absence of exhausting and defecation,gurgling sound attenuation or disappearance,abdominal X-ray abnormality were all significantly reduced compared with those before treatment,except the nausea and vomiting symptom,the degrees of descent of other indexes were more remarkable in the research group (abdominal pain:7 cases vs.44 cases,abdominal distension:6 cases vs.45 cases,absence of exhausting and defecation:3 cases vs.48 cases,gurgling sound attenuation or disappearance:11 cases vs.43 cases,abdominal X-ray abnormality:12 cases vs.48 cases),the time of first defecation in research group (hours:22.65 ± 6.72 vs.34.35 ± 5.38),gurgling reappearance time (hours:40.36 ± 6.99 vs.51.33 ± 5.80),symptom disappearance time (hours:51.44 ± 9.41 vs.60.10 ± 5.48) in research group were all shorter significantly than those in control group (all P ＜ 0.05).The total effective rate in the research group was obviously higher than that of the control group [93.75％ (45/48) vs.87.37％ (37/47),P ＜ 0.05].Conclusions The therapeutic effects of the quadruple therapy of integrated traditional Chinese and western medicine are remarkable for treatment of paralytic ileus.
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Objective To evaluate the effect of phlegm and blood stasis on atrial fibrillation and the effect of D-dimer on coagulation index. Methods 80 patients with phlegm and blood stasis were randomly divided into control group and treatment group, 40 cases in each group. The control group using a simple Western medicine treatment methods to Western medicine treatment based; and integrated traditional Chinese and Western medicine treatment group is based on Western medicine treatment, according to the traditional Chinese medicine syndrome, plus traditional Chinese medicine treatment, with Gualou Xiebai Banxia Decoction , Huanglian Wendan Decoction, Xuefu Zhuyu Decoction and other main plus or minus treatment, compared the two groups of efficacy, coagulation index (D-dimer). Results The total effective rate (97.5％) in the treatment group was higher than that in the control group (82.5％), the difference was statistically significant (P <0.05). After treatment, the level of D dimer in the treatment group was significantly lower than that in the control group, the difference was statistically significant (P <0.05). Conclusion The combination of traditional Chinese medicine and western medicine in the treatment of phlegm and blood stasis type is effective, and the level of D-dimer can be reduced.
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Objective To investigate the clinical therapeutic effect of Xuebijing injection for treatment of patients with ventilator-associated pneumonia (VAP).Methods A prospective study was conducted. Forty-eight patients with confirmed diagnosis of VAP requiring mechanical ventilation admitted into intensive care unit (ICU) of Hubei Provincial Hospital of Integrated Traditional Chinese and Western Medicine between May 2013 and September 2014 were enrolled. The patients were randomly divided into observation group (26 cases) and control group (22 cases) by random number table. All patients in both groups received western conventional treatment, and the patients in observation group were treated additionally with 50 mL Xuebijing injection intravenous drip twice a day, and control group received only routine western medicine, the therapeutic course in both groups being 7 days. The changes of white blood cell count (WBC), serum procalcitonin (PCT) levels and the clinical pulmonary infection score (CPIS) were observed, and the clinical therapeutic effect and 28-day prognosis were analyzed in both groups.Results After treatment for 7 days, the WBC, PCT levels and CPIS score were decreased compared with those before treatment in the two groups, and the degree of descent in observation group was more significant than that in the control group [WBC (×109/L): 9.16±1.62 vs. 12.03±2.34, PCT (μg/L): 0.17±0.04 vs. 0.28±0.69, CPIS score: 3.31±0.97 vs. 4.23±1.15, allP < 0.05]. The effective rate of observation group was higher than that of the control group [84.6% (22/26) vs. 54.5% (12/22), P < 0.05], while the 28-day fatality rate in the observation group was lower than that of control group [11.5% (3/26) vs. 36.4% (8/22),P < 0.05].Conclusion The clinical therapeutic effect is good when patients with VAP is treated with addition of Xuebijing injection on the basis of conventional western medicine therapy, as the injection can improve the therapeutic efficacy and reduce the fatality rate.
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Objective To explore an optimal scheme for diagnosis and treatment of patients with acute viral myocarditis (AVM) with an experience prescription of professor Zhang Zengying, Junkang oral liquid.Methods A prospective study was conducted. Sixty patients with AVM admitted into the Affiliated Hospital of Tianjin Academy of Traditional Chinese Medicine (TCM) from March 2012 to January 2014 were randomly divided into two groups: a control group and a treatment group (each, 30 cases). The patients in control group were treated with routine western medicine, including antiviral drugs, polarized solution, adenosine disodiu, and oxygen inhalation; while in treatment group, besides the comprehensive treatment in the control group, the patients were given Junkang oral liquid (main ingredients: Codonopsis pilosula, Salvia miltiorrhiza, Polygonatum odoratum, Notopterygii, Paris polyphylla Smith var. chinensis Hera, Forsythia suspensa, rhizome Ligustici Chunxiong, Hedyotis diffusa, Ophiopogonis tuber), 10 mL each time, three times a day; the treatment was consecutively applied for 3 months in both groups, 15 days constituting one therapeutic course. The changes of cardiac function [heart ejection fraction (EF), stroke volume (SV)] and myocardial enzyme [creatine kinase (CK), MB isoenzyme of creatine kinase (CK-MB), aspartate aminotransferase (AST), lactate dehydrogenase (LDH)], and the TCM syndrome integral score, symptoms and signs such as fever with chills, palpitation or severe palpitation, oppressed feeling in chest, deficiency of qi and disinclination to talk, dizziness, weakness and shortness of breath, spontaneous sweating, night sweating, body limb aches, premature beat shown on electrocardiogram (ECG) and curative effect were observed before and after treatment in the two groups.Results Compared with those before treatment, in the two groups after treatment, the EF and SV were significantly elevated, while the CK, CK-MB, AST, LDH, TCM syndrome integral score were obviously decreased, the degree of improvement in the treatment group being more prominent [EF: 0.601±0.088 vs. 0.538±0.084, SV (mL): 67.02±6.78 vs. 61.03±5.88, CK (U/L): 76.25±28.41 vs. 92.54±31.68, CK-MB (U/L): 18.34±8.94 vs. 22.45±9.70, AST (U/L): 31.29±14.28 vs.33.45±11.21, LDH (μmol·s-1·L-1): 2.28±0.51 vs. 2.34±0.68, TCM syndrome integral score: 12.34±1.24 vs. 18.36±1.98, allP 0.05).Conclusion Junkang oral liquid can significantly improve the clinical symptoms in patients with AVM, reverse its acute course and control arrhythmia, showing the advantage in diagnosis and treatment with combination of traditional Chinese and western medicine.
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Objective To study the clinical therapeutic effect of combination of Naodekang capsule and western medicine for treatment of patients with mental disorders after bilateral cerebral frontal lobes contusion and laceration.Methods A prospective study was conducted. Sixty-two patients with mental disorders after bilateral frontal lobes contusion and laceration hospitalized from June 2012 to January 2014 in the Department of Neurosurgery in Liangzhou Hospital, Wuwei City, Gansu Province were enrolled. According to random principle, they were divided into combined traditional Chinese and western medicine treatment group (32 cases) and western medicine treatment control group (30 cases). Conventional symptomatic therapy was given to both groups. In the western medicine control group, based on the above conventional treatment, antipsychotic drug risperdal (risperidone) was given, the beginning dosage was 4 mg daily and gradually reduced to 1 mg daily. In combined traditional Chinese and western medicine group, beside the conventional therapy, oral Naodekang capsules and oral risperdal were given. The ingredients of the capsule included: Astragalus 60 g, Radix Paeoniae Rubra 15 g, Rhizoma Chuanxiong 25 g, Angelica 15 g, Earthworm 10 g, Semen Persicae 10 g, Safflower 15 g, Salvia miltiorrhiza 15 g, Rhizoma Gastrodiae 15 g, Uncaria 10 g, Bupleurum 20 g, Pueraria 15 g, Rhizoma Acori Tatarinowii 15 g; the patients took once 3 capsules, three times a day, and risperdal 2 mg per day at the beginning and gradually reduced to 1 mg daily. Before treatment and after treatment for 2, 6 and 12 weeks, the brief psychiatric rating scale (BPRS) score was applied to evaluate the clinical therapeutic effect on the situation of patients' improvement of symptoms; in the two groups, the clinical curative effects were observed and when the psychiatric symptoms were controlled, the mean dosage of antipsychotic western medicine used daily in each patient was calculated.Results After treatment, the BPRS scores in the two groups were lower than those before treatment, from 6 weeks after treatment, the degree of descent in the BPRS score in the combined treatment group was more significant than that in the western medicine group (38.68±7.81 vs. 54.05±6.75,P < 0.05), and the descent was persistent until 12 weeks after treatment (15.46±8.51 vs. 23.98±8.03,P < 0.05). The cure rate of the combined group was markedly higher than that in western medicine group [84.4% (27/32) vs. 76.6% (23/30),P < 0.05]. When the psychiatric symptoms were controlled, the dosage of antipsychotic western drug used in each patient in the combined group was less than that in western medicine group (mg/d: 1.5±0.1 vs. 2.8±0.2,P < 0.05).Conclusion The westernconventional therapy combined with traditional Chinese medicine Naodekang capsule for treatment of mental disorders after bilateral cerebral frontal lobes contusion and laceration has relatively good therapeutic effect.
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Objective To approach the therapeutic effect of modified Linggui Zhugan decoction for treatment of patients with type Ⅱ cardiorenal syndrome (CRS).Methods Thirty patients with CRS admitted to Affiliated Hospital of Tianjin Institute of Chinese Medicine were selected. By a random number table and double-blind method, they were divided into two groups: treatment and control groups, 15 cases in each group. The patients in both groups were treated with conventional western medicine, and those in the treatment group were additionally given traditional Chinese medicine (TCM) modified Linggui Zhugan decoction (including the following ingredients: Poria 30 g, Cinnamomi Cortex 10 g, Atractylodis Macrocephalae Rhizoma 15 g, Glycyrrhizae Radix et Rhizoma Preparata cum Melle 10 g, Morindae Officinalis Radix 15 g, Arecae Pericarpium 30 g, Astragali Radix 30 g, Zingiberis Rhizoma 10 g, Descurainiae Semen 15 g), one dose daily for consecutive 30 days. Before and after treatment the changes in levels of B-type natriuretic peptide (BNP), serum creatinine (SCr), blood urea nitrogen (BUN), amount of urine, clinical efficacy and TCM syndrome score efficacy were observed in two groups.Results After treatment, the levels of BNP, SCr, and BUN were significantly decreased, while urine volume was obviously increased compared with those before treatment in the two groups, and the degrees of changes in the treatment group were superior to those in control group [BNP (ng/L): 297.3±75.1 vs. 344.2±56.3, SCr (μmol/L): 139.7±62.1 vs. 154.4±39.7, BUN (mmol/L): 10.1±6.4 vs. 13.2±8.7, urine volume (mL/d): 847.2±32.7 vs. 786.4±13.6, allP < 0.05]. The total effective rates of patients and TCM syndrome scores in treatment group were significantly higher than those in control group [both 86.7% (13/15) vs. 66.7% (10/15), bothP < 0.05]. Conclusions Modified Linggui Zhugan decoction can alleviate the symptoms of yang deficiency of heart and kidney and heart failure due to the attack of heart by retained fluid, and can also ameliorate the complicated renal function impairment; the therapeutic effect of integrative traditional Chinese and western medicine for treatment of patients with type Ⅱ CRS is superior to that of conventional western medicine treatment.
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Objective To observe the clinical therapeutic effect of oral solution of Huaixue Shenshu for treatment of patients with IgA nephropathy and explore its mechanism. Methods A prospective study was conducted. Forty patients with IgA nephropathy diagnosed by pathology were selected, and they were randomly divided into treatment group and control group, 20 cases in each group. The two groups were subjected to the routine treatment, and on this base, the control group also received cozaar 50-100 mg, while the treatment group additionally received oral solution of Huaixue Shenshu decoction (drug composition:Centellae herba 15 g, Sophorae Flos 20 g, Ecliptae Herba 20 g, Ligustri Lucidi Fructus 15 g, Cicadae Periostracum 15 g, Pyrolae Herba 20 g, Saposhnikoviae Radix 10 g, Astragali Radix 15 g, the above ingredients were immersed in water and boiled to form 200 mL decoction, as a dose, and then divided into two parts to take orally one of them each time, twice a day). Both groups took two therapeutic courses in total, 3 months constituting one course. After treatment, the integral changes of clinical symptoms and clinical efficacy were observed, and before treatment and 3 months and 6 months after treatment, the 24-hour urine protein, serum creatinine (SCr), and albumin (Alb) were measured in the two groups. Results Before treatment, there was no significant difference in integral of clinical symptoms between treatment group and control group (score: 18.42±5.41 vs. 19.95±6.25, P>0.05);after treatment, the integrals of two groups were significantly lower than those before treatment, and the degree of decrease in treatment group was more obvious (score: 6.35±2.11 vs. 9.45±3.55, P 0.05); with the prolongation of treatment, the 24-hour urinary protein was decreased gradually, and Alb was increased gradually, reaching its peak after 6 months of treatment, and the changes were more obvious in treatment group [24-hour urinary protein (g):0.71±0.58 vs. 1.31±0.55, Alb (g/L):37.8±6.1 vs. 35.5±5.2, both P 0.05). Conclusion The effect of oral solution of Huaixue Shenshu in treatment of IgA nephropathy is good.
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Objective To observe the effect of Shenfu injection on fluid intake volume of resuscitation therapy for patients with septic shock. Methods The clinic data of 36 patients with septic shock admitted to Department of Critical Care Medicine of the Affiliated Hospital of Hangzhou Normal University from June 2010 to June 2013 were retrospectively analyzed. All the patients were treated with western conventional medicine. Twenty cases treated with western medicine combined with Shenfu injection (intravenous drip 100 mL once daily, half of a month was a therapeutic course) were defined as Shenfu group; the rest 16 cases treated with western medicine only were assigned as control group. The following data after treatment for 6, 24, and 72 hours in the two groups were compared:liquid intake and urine volumes, system vascular resistance index (SVRI), mean arterial pressure (MAP), cardiac index (CI), and case fatality rate in 28 days. Results There were no significant differences in the liquid intake volume in 6 hours after treatment (mL:3 101±219 vs. 3 329±295, P>0.05), the urine volumes in 6, 24 and 72 hours after treatment (mL, 6 hours:701±229 vs. 651±292, 24 hours:1 870±566 vs. 1 697±618, 72 hours:7 396±2 546 vs. 5 987±2 497), and the levels of SVRI in 24 hours after treatment between Shenfu group and control group (kPa·s·L-1·m-2:802±158 vs. 741±106, all P>0.05). The total liquid intake volumes (mL) in 24 hours and 72 hours after treatment in Shenfu group were significantly less than those in the control group (24 hours:4 544±425 vs. 4 996±396, 72 hours:10 985±891 vs. 11 612±807, both P<0.05). The SVRI, MAP, and CI in 72 hours of Shenfu group were significantly higher than those of control group [SVRI (kPa·s·L-1·m-2): 1 361±182 vs. 1 163±183, MAP (mmHg, 1 mmHg = 0.133 kPa): 76.2±6.1 vs. 71.8±6.3, CI (mL·s-1·m-2):76.2±7.5 vs. 70.8±7.2, all P<0.05], and the 28-day mortality rate in Shenfu group was significantly lower than that of control group [25.0%(5/20) vs. 62.5%(10/16), P<0.05]. Conclusion The application of Shenfu injection was favorable to the reduction of liquid intake volume in 72 hours after treatment that may be beneficial to the fluid limitation management in the course of treatment for septic shock.
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Objective To observe the clinical effect of Xisui Huangu Formula combined with technetium [99Tc] methylenediphosphonate injection in the treatment of avascular necrosis of femoral head (ANFH). Methods A total of 73 patients were randomly divided into treatment group (37 cases) and control group (36 cases). The control group was given conventional western medicine treatment, while the treatment group was given Xisui Huangu Formula on the basis of conventional western medicine treatment. Clinical symptoms and joint function of the two groups were observed before and after treatment, and the clinical effects were compared. Results In the treatment group, 17 cases were cured, 17 cases improved, 3 cases were unrecovered, and the effective rate was 91.89%. In the control group, 4 cases were cured, 25 cases improved, 7 cases were unrecovered, and the effective rate was 80.56%. The difference was statistically significant between the two groups (P<0.05). Improvement of joint pain, lameness, dysfunction, and joint function in the treatment group were better than those in the control group (P<0.05). Conclusion Xisui Huangu Formula can significantly improve clinical symptoms of ANFH. Integrated traditional Chinese and Western medicine therapy is helpful to alleviate ANFH disease progression.
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Objective To observe the effects of Tongbi Shuxin Granule on life quality of acute coronary syndrome (ACS) patients with anxiety and depression.Methods Ninety patients were randomly divided into the treatment group and control group through random number table method, 45 cases for each group. The control group was given fundamental treatment and emotional intervention, while the treatment group was given Tongbi Shuxin Granule additionally. On admission and 4th and 12th weeks, the scores of HAMA and HAMD were evaluated. On admission and 12th week, SAQ score was observed.Results In the 4th week, scores of HAMD and HAMA of two groups decreased compared with those on admission (P0.05);the treatment group decreased significantly compared with on admission and 4th week (P<0.05), without statistical significance between the two groups (P<0.05). In the 12th week, all dimensions of SAQ score in the two groups increased compared with those on admission (P<0.05);the treatment group was much higher than the control group, especially the scores of physical limitation, angina stability and angina frequency (P<0.05).Conclusion Tongbi Shuxin Granule has the exact treatment effects on ACS patients with anxiety and depression.
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Objective To observe the therapeutic effect of rhubarb combined with Probiotics for treatment of patients with severe acute pancreatitis (SAP) accompanied by acute lung injury (ALI). Methods A prospective randomized controlled trial was conducted. Sixty patients with SAP and ALI were randomly divided into a rhubarb group and a combination of rhubarb and Probiotics group (combined group), 30 cases in each group. Both groups were treated with conventional therapy. On that therapeutic base, the patients in rhubarb group were treated with rhubarb 3 g·kg-1·d-1 (Raw rhubarb in boiling water 200 mL was cooked for 30 minutes, then the decoction was divided into two parts to be infused through nasal jejunal tube, retaining for 1 hour);while in the combined group, beside the above rhubarb therapy, the patients were additionally given Probiotics [Clostridium butyric acid:Chang Lekang capsule, once 1 grain (0.42 g), twice a day] through nasal jejunal tube. The therapeutic course was 14 days in the two groups. The plasma endotoxin levels, oxygenation index, and acute physiology and chronic health evaluationⅡ(APACHEⅡ) score were observed before and after treatment for 7 days and 14 days, respectively. After treatment for 30 days, the time of intestine functional recovery and mechanical ventilation, number of damaged organs, number of infectious sites, number of pancreatic pseudocysts, length of intensive care unit (ICU) stay and 30-day fatality rate were observed in the two groups. Results With the prolongation of treatment, the plasma level of endotoxin and APACHEⅡscore in the two groups were gradually reduced, and the oxygenation index was gradually increased after treatment for 7 days and 14 days in the two groups compared with those before treatment, and there were statistically significant differences in above indexes on the 14th day after treatment between combined group and rhubarb group [endotoxin (μg/L): 19.16±1.90 vs. 21.20±1.05, oxygenation index (mmHg, 1 mmHg = 0.133 kPa): 369.50±5.45 vs. 341.50±7.36, APACHE Ⅱscore:11.84±0.60 vs. 13.00±0.86, P 0.05). The times of mechanical ventilation (days: 13.40±1.76 vs. 15.60±1.28) and the length of ICU stay (days:16.13±1.25 vs. 17.63±1.30) were significantly shorter in combined group than those in rhubarb group (both P<0.05). Conclusion Rhubarb combined with Probiotics for treatment of patients with SAP and ALI can promote their recovery of lung function and shorten their length of ICU stay.
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Objective To explore the therapeutic effect and possible mechanisms of Xuebijing injection for treatment of rabbits with acute pulmonary thromboembolism (APTE). Methods Thirty-two New Zealand rabbits were randomly divided into normal control group, model group, low molecular weight heparin (LMWH) group and Xuebijing group by random number table, 8 rabbits in each group. APTE model was reproduced by re-infusing autologous blood clots, and nothing was done for the normal control group. After the model was established, intravenous injection of Xuebijing 1 mL/kg from ear marginal vein was given to the rabbits in Xuebijing group, the LMWH 100 U/kg was subcutaneously injected in LMWH group, the same amount of normal saline was given intravenously to model group and normal control group, twice daily for 7 days in all the groups. The changes of plasma D-dimer and endothelin-1 (ET-1) levels were detected by enzyme-linked immunosorbent assay (ELISA) after modeling for 8 hours and 1, 3, 5, 7 days;after 7 days the animals were sacrificed and their lung tissues were removed for the examination of ultrastructural changes under an electron microscope. Results With the prolongation of time, the D-dimer level in the model group was gradually increased, and on the 7th day after modeling, the level was significantly higher than that of the normal control, LMWH and Xuebijing groups (g/L:3.98±1.14 vs. 0.43±0.12, 1.05±0.13, 1.04±0.15, all P0.05). Electron microscopic examination of lung tissue ultra-structure showed:in the model group, there were the lung tissue basement membrane rupture, the organelle structure in vascular endothelial cells and alveolar epithelial cells typeⅠandⅡnot clear, disappearance of microvilli on cell surface, cytoplasm concentration, nuclear chromatin condensation, a lot of debris due to nuclear lysis, formation of apoptotic bodies after shedding, and mitochondrial structural damage. In LMWH group, the capillary endothelial cell swelling, a lot of necrotized blood cells oozing, blockage of lumen, the cytoplasm of typeⅡalveolar epithelial cell loose, edematous and multiple lamellar bodies vacuolized were seen. In Xuebijing group, capillary endothelial cell swelling, necrotized blood cells blocking the lumen and seeping, the link basically normal, the type Ⅱ alveolar epithelial cell edematous, mitigation of lamellar bodies emptying were found. Conclusions Xuebijing can significantly reduce the plasma D-dimer and ET-1 levels, adjust the balance of coagulation and fibrinolysis, simultaneously decrease the pulmonary vascular permeability obviously in rabbits with APTE, thus it possesses certain protective effect for endothelial function leading to amelioration of lung injury and reduction of lung pathological damage in rabbits with pulmonary embolism.
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Objective To observe the therapeutic effect of Qilin Xintongshu pill for treatment of patients with non-ST segment elevation acute coronary syndromes(NSTE-ACS)accompanied by gastrointestinal bleeding (GIB). Methods A prospective randomized controlled trial was conducted. A total of 67 hospitalized patients in Cardiovascular Department of Qionghai City Hospital of Traditional Chinese Medicine were divided into therapy group(35 cases)and control group(32 cases). Both groups were given conventional medical treatment(except anti-coagulative agent). In the therapy group,the patients received Qilin Xintongshu pill(the ingredients consisting of panax pseudo-ginsen,dragon's blood,immature orange fruit,etc.)oral administration,once 5 mg and 3 times a day,while in the control group,the patients accepted clopidogrel orally,once 75 g and once a day,the therapeutic course in both groups being 30 days. The major cardiovascular events(such as death,a newly-happened myocardial infarction(MI),MI secondary,obstinately ischemia)and incidence of massive hemorrhage of gastrointestinal tract were compared between the two groups,and the adverse events were observed. Results After treatment,the incidence of cardiovascular events and massive hemorrhage of gastrointestinal tract in the therapy group were decreased significantly compared to those in the control group 〔incidence of cardiovascular events:8.57%(3/35)vs. 28.13%(9/32), incidence of massive hemorrhage of gastrointestinal tract:2.86%(1/35)vs. 21.88%(7/32),both P<0.05〕. Adverse events were not observed in both groups,and the examinations of blood,urine,liver and renal functions were of no abnormalities before and after treatment. Conclusion Qilin Xintongshu pill can effectively reduce the incidences of cardiovascular events and massive hemorrhage of gastrointestinal tract in patients with NSTE-ACS accompanied by GIB in the therapeutic course of 30 days,therefore this traditional Chinese herbal medicine is an ideal agent for treatment of such disease.
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Objective To analyze the curative effect of traditional Chinese medicine(TCM)combined with early enteral nutrition(EN)for treatment of patients with severe acute pancreatitis(SAP). Methods 70 SAP patients were randomly divided into TCM plus EN group(36 cases)and conventional therapy group(34 cases). Both groups received routine treatment. Additionally,TCM+EN group received early EN and TCM decoction treatment〔the ingredients of decoction including radix bupleuri,radix paeoniae alba,radix scutellariae,fructus aurantii immaturus, magnolia bark,raw rhubarb(rhubarb was added at last during cooking the decoction)and natrii sulfas exsiccatus (dissolved in water to be administered)each 10 g,the decoction was concentrated to 150 mL and then administered via a stomach tube to the patient,afterwards the tube was clipped for 2.5-3 hours,twice a day,4-7 days constituting a therapeutic course〕. After treatment,the time for patients' symptoms improvement,the situation of intestinal recovery, the length of stay in hospital,the total medical cost,serum C-reactive protein(CRP),aspartate aminotransferase (AST), lactate dehydrogenase (LDH), amylase (AMY), acute physiology and chronic health evaluationⅡ(APACHEⅡ)score and complications,intensive care unit(ICU)transfer rate and case fatality rate in two groups were observed. Results The time for symptoms improvement of abdominal tenderness(day:1.68±1.01 vs. 3.89±1.07), abdominal distension(day:2.17±1.48 vs. 4.24±3.23),abdominal pain(day:3.12±1.14 vs. 4.94±3.21)and the intestinal recovery of exhaust defecation time(day:3.48±0.92 vs. 5.32±3.30)of SAP patients after treatment in the TCM+EN group were faster significantly than those in the conventional therapy group(all P0.05). Among the 70 patients with SAP,the cause of the disease due to gallstone accounted for 55.72%,hyperlipidemia for 37.14%,alcoholic for 4.28%and other 2.86%. Conclusion The use of TCM combined with early EN for treatment of patients with SAP can enhance the curative effect of SAP,reduce the hospitalization time and the total cost of patients,and decrease complications and mortality,that is conducive to the faster recovery of patients.
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10.3969/j.issn.1008-9691.2013.03.004
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10.3969/j.issn.1008-9691.2013.03.009
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Objective To observe the effects of Niupo Zhibao pellet, a compound traditional Chinese herbal medicine,on helper T cell(Th cell)expression in rats with endotoxin-induced rapid pulmonary fibrosis (RPF). Methods Two hundred and twenty-four Wistar rats were randomly divided into four groups:normal control,model,dexamethasone(DXM)and Niupo Zhibao pellet(NW)groups(each n=56). By using endotoxin three-hit regimen,the RPF model was established. Three days before and 7 days after the establishment of models in NW group,they were administered with the pellet by intragastric feeding,50 mg/100 g of distilled water twice a day,a total of 10 days medication. Rats in DXM group received DXM intraperitoneal injection,3.0 mg/kg once a day for consecutive 7 days. Rats in normal control group were administered with the same volume of distilled water by intragastric administration. On 1,3,7,9,14,21,28 days after the administration,blood and bronchoalveolar lavage fluid(BALF)specimens were collected. The contents of γ-interferon(IFN-γ)and interleukin-4(IL-4) in the serum and BALF were investigated by enzyme-linked immunosorbent assays(ELISA). The lung tissue was stained by hematoxylin-eosin(HE)and Van Gieson respectively. Morphological changes in lung tissue were observed under light microscope. Results HE staining showed that the pulmonary interstitial tissues of rats in model group were thickened,there was a large amount of inflammatory exudates,and micro thrombi were seem in alveolar space. The pulmonary interstitial tissues in rats of DXM group were thickened too,but the inflammatory exudate in alveolar space was much less. Compared to rats in DXM group,the rats in NW group had slightly more inflammatory exudate and their pulmonary interstitial tissues were basically normal. Van Gieson staining showed that the expression of collagen fiber in model group was obvious,that of DXM group less than the former one but not significant,while that in the NW group was reduced markedly. ELISA assays demonstrated that the levels of IFN-γin BALF and serum in model group were increased significantly,those in DXM group were lowered to the minimum on the 7th day,raised to the levels before treatment on the 14th day,and gradually declined on the 21st day. In the NW group,the IFN-γwas consistently at a high level,and then gradually declined at a slow rate. After 7 days of drug administration,the IFN-γ levels in BALF and serum at various time points in NW group were obviously higher than those in model and DXM groups〔BALF(ng/L):140.47±4.22 vs. 149.23±8.35,90.67±6.65;serum(ng/L):140.47±4.15 vs. 100.43±11.05,99.35±7.85,P<0.05 or P<0.01〕. The levels of IL-4 in BALF and serum in each group increased significantly,reached to their maximum on the 7th day,and then gradually decreased. After the drug administration for 28 days,those levels in NW group were obviously lower than those in model and DXM group〔BALF(ng/L):6.60±1.05 vs. 7.20±1.25,8.55±1.05,serum(ng/L):6.75±1.05 vs. 7.21±1.25,8.25±1.15,P<0.05 or P<0.01〕. Conclusion Niupo Zhibao pellet can suppress inflammation,ameliorate injury of lungs and inhibit lung fibrosis by promoting IFN-γsecretion,restraining IL-4 secretion and adjusting the imbalance of Th cells.
ABSTRACT
Objective To investigate the clinical efficacy of Shenmai injection (SMI) combined with heart transplantation of autologous bone marrow stem cells in the treatment of refractory heart failure(RHF). Methods Two hundred patients with RHF were selected from the Emergency Department of the First Affiliated Hospital of Zhengzhou University and the Cardiology Department of the First Affiliated Hospital of Henan College of Traditional Chinese Medicine. They were randomly divided into control group and treatment 1,2 and 3 groups(each 50 cases). In the control group,heart failure standard treatment was given;group 1 received a standard treatment for heart failure combined with autologous bone marrow stem cell heart transplantation;group 2 received a standard treatment for heart failure with SMI;group 3 received a standard treatment for heart failure combined with autologous bone marrow stem cell heart transplantation and SMI. The mean follow-up was 24 months. The prognosis,readmission rate,clinical efficacy,cardiac function and the change in levels of B-type natriuretic peptide(BNP)of patients in each group were observed during the therapeutic course and observation period. Results During the course of treatment,there were 10 cases dead in the control group,4 in each group 1 and 2 respectively,and 3 in group 3. Readmission rates in group 1,2 and 3 were significantly lower than that in control group(38%,36%,24%vs. 48%, P<0.05 or P<0.01). The rates of total efficiency in group 1,2 and 3 were obviously higher than that in the control group(88%,86%,94%vs. 76%,all P<0.05). After treatment,the left ventricular ejection fraction(LVEF),left ventricular fractional shortening(FS)and left ventricular end-systolic diameter(LVESD)in three therapeutic groups were significantly higher than those before treatment,while the left ventricular end-diastolic diameter(LVEDD)and BNP level were significantly lower than those before treatment. All the above indexes in three therapeutic groups after treatment were much more remarkably improved than those in the control group during the same period,and the group 3 being the most significant〔LVEF:0.477±0.099 vs. 0.396±0.098,FS:(30.0±5.1)%vs.(26.8±7.5)%,LVESD (mm):40.6±9.1 vs. 45.8±9.4,LVEDD(mm):44.9±9.8 vs. 52.8±10.1,BNP(ng/L):515±400 vs. 1 875±400, all P<0.05〕. Conclusion SMI combined with heart transplantation of autologous bone marrow stem cells has obvious therapeutic effect for treatment of RHF.
ABSTRACT
Objective To investigate the effects of Xuebijing injection on expression of myeloid cell triggering receptor-1(TREM-1)and the plasma levels of soluble TREM-1(sTREM-1),tumor necrosis factor-α(TNF-α), interleukin-6(IL-6)in patients with severe sepsis. Methods Twenty patients with severe sepsis admitted into Critical Care Medicine Department,Affiliated Hospital of Nantong University were given comprehensive treatments according to the guidelines for management of severe sepsis and septic shock(2004),and they were divided into Xuebijing group and control group(each 20 cases). The Xuebijing injection group was given Xuebijing injection 50 mL,3 times daily for 5-7 days followed by regular treatments. The changes in blood TREM-1 mRNA expression and plasma concentrations of sTREM-1,TNF-α,and IL-6 were detected before and after treatments on the 3rd and 5th day,and the above indexes were compared between the two groups. Results Before treatments,there were no significant differences in TREM-1 mRNA expression and levels of sTREM-1,TNF-α,IL-6 between two groups (all P>0.05). The TREM-1 expression and plasma concentrations of sTREM-1,TNF-α,and IL-6 of two groups were declined after treatments compared to their baselines,the degree of decline being more prominent in Xuebijing group〔TREM-1 mRNA 3 days:1.065±0.277 vs. 1.217±0.301,t=-3.267,P=0.047;5 days:0.912±0.239 vs. 1.071±0.254,t=-5.072,P=0.032;sTREM-1(ng/L):146.93±13.76 vs. 176.22±19.46,t=-5.442,P=0.033;TNF-α(ng/L):77.51±11.28 vs. 107.72±13.17,t=-4.355,P=0.032;IL-6(ng/L):288.35±14.59 vs. 323.89± 24.51, t=-3.941,P=0.028〕. Conclusion Early implication of Xuebijing injection is of great significance in patients with severe sepsis,it may reduce the expression level of TREM-1 and serum levels of downstream inflammatory mediators,that is beneficial to the control of inflammatory responses and improvement of systemic inflammatory response syndrome in such patients.