RESUMO
Objective:To observe clinical efficacy of Shengma Biejia Tang combined with Shenfutang on sepsis-induced myocardial dysfunction (SIMD) and study the controlling effect on inflammatory reaction. Method:Eighty-eight patients with SIMD were randomly divided into control group (44 cases) and observation group (44 cases) by random number table. Patients in control group received the early bundle therapy of sepsis, including fluid resuscitation, anti-infection treatment and vasoactive drugs. In addition to the therapy of control group, patients in observation were also given Shengma Biejia Tang combined with Shenfutang, 1 dose/day. And a course of treatment was 7 days. Before and after treatment, levels of troponin (cTnI), creatine kinase isoenzyme (CK-MB), N terminal brain natriuretic precursor (NT-proBNP), calcitonin (PCT), hypersensitivity C reactive protein (hs-CRP), tumor necrosis factor-α (TNF-α), interleukins-6 (IL-6) and blood lactic acid (LAC) were detected. And color Doppler ultrasound examination of the heart was performed to record left ventricular ejection fraction (LVEF), blood flow velocity of early mitral valve diastole and ratio of blood flow velocity at atrial systolic peak (E/A) and stroke volume (SV). And lactate clearance rate (LCR) was calculated. And sequential (sepsis-related) organ failure assessment (SOFA), acute physiology and chronic health (APACHEⅡ) and traditional Chinese medicine(TCM)syndromes were scored. Result:After treatment, levels of cTnI, NT-ProBNP, CK-MB, Hs-CRP, IL-6, PCT, TNF-α and LAC in observation group were lower than those in control group (PPPConclusion:In addition to the integrated western medicine, Shengma Biejia Tang combined with Shenfutang can control inflammatory reaction, relieve myocardial inhibition and myocardial damage, and protect and improve heart function, and alleviate the symptoms.
RESUMO
Shenfutang is a famous prescription used in clinic. It has been used for more than one thousand years, and currently is still widely used in clinic, with a significant effect. Shenfutang was first recorded in the Shengji Collection. It consists of two herbs, namely Ginseng Radix Et Rhizoma and Aconiti Lateralis Radix Praeparata. It can be used to mainly treat syncope and collapse due to sudden collapse of Yang Qi, and the symptoms include disfigurement of the extremities, cold sweats, cold limbs, umbilical and abdominal pain, weak breathing, and slight desire. Ginseng supports healthy Qi, and comforts five organs. Aconitum is good at activating twelve meridians and collaterals. With the effect of returning the yang to rescue the enemy, aconitum can also support yang. Different ratios of ginseng and aconitum are combined for reinforcing Yang of heart, kidney and spleen, so as to treat various syndromes. However, the occurrence and development of diseases are complicated and changeable. Different ratios of Shenfutang may increase the efficacy due to the synergistic effect, or weaken or even lose the original efficacy due to mutual antagonism. Different ratios of ginseng and aconitum can be used for different diseases, such as cardiovascular disease, various types of inflammation, respiratory diseases. In the existing literatures on Shenfutang, there is a lack of systematic summarization for how to adjust the ratios. This paper introduces the effect and mechanism of the combination, and summarizes different ratios of the two herbal ingredients, so as to provide certain reference for the clinical application.