Effect of Taohua decoction on antibiotic associated diarrhea in intenive care unit: a multi-central randomized controlled study / 中国中西医结合急救杂志

ABSTRACT

Objective To evaluate the clinical efficacy of Taohua decoction in treating antibiotic-associated diarrhea (AAD). Methods Sixty-two patients diagnosed with AAD admitted to the department of intenive care unit (ICU) of Jiaxing Hospital of Traditional Chinese Medicine (TCM), Jiaxing First Hospital, Jiaxing Second Hospital and Haining Hospital of TCM from April 2015 to November 2016 were enrolled, and they were divided into an experimental group (32 cases) and a control group (30 cases) according to the random number table method. The two groups were given routine treatment of western medicine, the patients in experimental group were additionally given Taohua decoction (ingreients: red halloysite 30 g, zingiberis 15 g, japonica rice 30 g), while in the control group, the patients only received the routine treatment of western medicine. The therapeutic course in the two groups was 14 days. The TCM syndrome score, the duration of diarrhea, the time of abdominal pain relief and the time using antibiotics, besides acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score, albumin level, endoscopic and pathological changes were observed before and after treatment in the two groups. Results After treatment, the scores of TCM syndrome and APACHE Ⅱin the two groups were all lower than those before treatment, the level of albumin was higher than that before treatment, and the changes of above indexes in the experimental group were more significant than those in the control group [the scores of TCM syndrome: 9.32±8.86 vs. 13.50±6.52, APACHE Ⅱ score: 11.08±4.37 vs. 14.06±5.42, albumin (g/L): 33.89±5.02 vs. 30.85±6.44, all P < 0.05]; in experimental group, the time of diarrhea duration (days:12.28±2.28 vs. 15.36±8.68), time of abdominal pain relief (days: 10.09±6.41 vs. 14.27±7.52), time of using antibiotics (days: 11.77±4.72 vs. 15.08±6.98) were significantly shorter than those of the control group (all P < 0.05). The examinations of endoscopy and light microscopy showed that after treatment the numbers of patients with mild intestinal mucosal changes in the experimental group were increased compared with those in the control group (endoscope:18 cases vs. 8 cases, light microscopy: 19 cases vs. 9 cases), but the numbers of patients with moderate (endoscope:14 cases vs. 20 cases, light microscopy: 13 cases vs. 19 cases) and severe (endoscope: 0 vs. 2 cases, light microscopy:0 vs.2 cases) changes were less than those in the control group. Conclusions Taohua decoction can improve the clinical efficacy of mild AAD patients.