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OBJECTIVE: To investigate the efficacy and safety of Chinese herbal medicine in treating sepsis patients with bloodstream infection. METHODS: A 6-year retrospective study was carried out at a university hospital in China. Adult sepsis patients with bloodstream infection were included. The primary outcome was 28-day mortality after admission. Propensity score method was used to adjust for possible confounding. 28-day mortality was estimated by Kaplan-Meier analysis and compared using the log-rank test. Cox regression analysis was carried out to identify factors impacting in-hospital mortality outcomes. RESULTS: Following the application of the propensity score method, a total of 176 patients were included. The all-cause 28-day mortality in the control group and Chinese herbal medicine group was 21.6% and 14.8%, respectively. Kaplan-Meier survival analysis showed that Chinese herbal medicine was associated with a lower hazard ratio (HR) in all-cause 28-day death compared with the control group [HR = 0.44, 95% CI(0.22, 0.90), P < 0.05]. The complications were similar between the two groups (P >0.05). Blood-activating and stasis-eliminating herb administration was associated with reduced in-hospital mortality among sepsis patients with bloodstream infection [HR = 0.54, 95% CI(0.34, 0.94), P < 0.05]. CONCLUSIONS: Chinese herbal medicine, especially the blood-activating and stasis-eliminating herb, might have certain efficacy and safety in treating sepsis patients with bloodstream infection. Clinicians should prescribe blood-activating and stasis-eliminating herb in treating these two coalescent critical diseases as long as no contraindications exist. However, further studies are needed to validate our results.
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Medicamentos de Ervas Chinesas , Sepse , Adulto , Humanos , Medicamentos de Ervas Chinesas/efeitos adversos , Estudos Retrospectivos , Sepse/tratamento farmacológico , Medicina Tradicional Chinesa/métodos , Modelos de Riscos ProporcionaisRESUMO
Objective To prospectively survey the well-known experts of critical care and endocrine secretion to summarize their experience in treating diabetes mellitus complicated by sepsis for the purpose of providing guidance of theory and practice in making treatment schemes of traditional Chinese medicine for such disease.Methods The questionnaires were designed and submitted to the experts.The statistic analysis was undertook to investigate the rules.Results A total of 30 questionnaires were released and 28 were retrieved.The experts generally believed that eight-principle syndrome differentiation was the most useful method in the syndrome differentiation and treatment of this disease.The heat,stasis and toxin were usually acted as the main pathogenic factors while damp and phlegm commonly act as secondary pathogenic factors.They thought that weak body resistance under the invading of evil was the key mechanisms in the deterioration of the disease and they chose clearing heat,activating blood and detoxication as 3 core treatment principles.Conclusions The summarized opinions from the experts should be act as important reference in treating this disease,but its effectiveness and possibility for further generalization need to be validated in the clinical practice.
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This article briefly summarized the meaning, category and function of qi, tubes and viscera in human body respectively after combining exploring the theories of traditional Chinese medicine(TCM) and clinical practices. Afterward, we put forward the theory of Qi-Tube-Viscera and elaborated its close relationship with the physiological status of the human, and then we thought the relationships of qi, tube and viscera respectively, at last we draw a conclusion that qi, tube and viscera only came from qi. And the clinical guiding significance of the theory of Qi-Tube-Viscera and itsBalanced steady state, Nature and Man in One, State medicine were narrated to demonstrate that new theory of Qi-Tube-Viscera has high signifance in the theory of TCM and clinical practice.
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Objective To investigate the general information and death causes in the emergency department ( ED) with an epidemiological study in the death cases.Methods The clinical records of 1007 death cases in the ED admitted in three years from 2011 to 2013 were collected and statistically analyzed.Methods The clinical records of 1 007 death cases in the ED admitted in three years from 2011 to 2013 were collected and statistically analyzed.Results The mean age of the 1 007 deaths was ( 75.95 ±13.89 ) ears, and the mean score of APACHEⅡ at admission was ( 27.19 ±6.44 ) .Malignant neoplasm, pulmonary infection, chronic obstructive pulmonary disease, coronary heart disease, stroke, sepsis, acute coronary syndromes were main underlying causes of death, while respiratory failure, circulatory collapse, generalized debility, multiple organ dysfunction syndrome, emaciation from malignant neoplasm, septic shock, severe pulmonary infection were main direct lethal causes of death.Most patients were vulnerable to be dead in the spring season, January and around midnight from 23: 00 to 1: 00 (zi time).It is noteworthy that pulmonary infection accounted for 74.75%(151/202 ) of the nosocomial infection. Hyperlactacidemia and low oxygenation index indicated a poor prognosis.Conclusions The deaths were predominant in old age, and the order of incidence of the underlying death causes from high to low arranged was consistent with the sequence of death causes of the cities in China in 2010.To identify carefully the risk factors of death and concern about the early symptoms of exacerbation of underlying diseases can make a big difference in enhancing the success rate of rescuing the critical emergency patients.Besides, it's worth pondering over that the medical care of patients with malignant neoplasm spent abundant emergency resources.
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Objective To evaluate the teaching method of three-stage learning(STL) in ICU's ventilation education.Methods 18 ICU interns and transferred doctors were taught with STL method in ventilation education.The teaching effect was evaluated.Results Doctors with STL method got better effect.Conclusion STL method is practical and suitable for ventilation teaching in ICU.
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Objective To explore the effect and application of the clinical teaching method of stage-separated to targeted management in the comprehensive ICU. Methods ICU rotation learning plans were developed for 113 probationers and rotating physicians,who were given the training of stage-separated to targeted teaching. The program was divided into three stages based on corresponding teaching objective and comprehensive examination and assessment with combination the dynamic and static evaluation were carried out to three parts. Results The probationers and rotating physicians had significant improvement in the familiarity and mastery of ICU specialist knowledge and skills through the systematic training. Conclusion Such training program can effectively improve the ICU specialized quality and comprehensive ability of the probationers and rotating physicians and bring about better clinical teaching effect.
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[Objective] The disease distribution of in-patients in different age groups from 1993 to 2002 in respiratory disease department of Guangdong Provincial Hospital of Traditional Chinese Medicine (TCM) was analyzed to provide evidence for clinical treatment. [ Methods ] A retrospective research was adopted. Fourteen categories of diseases and 3 age groups were classified according to the case history recorded from 1993 to 2002 in respiratory disease department of Guangdong Provincial Hospital of TCM. Reasons for hospitalization of the in-patients in different age groups during 10 years were analyzed by descriptive analysis and Vilfredo Pareto analysis. [Results] The principal and secondary reasons for hospitalization were respiratory tract infection, pulmonary tuberculosis and pneumothorax in the young age group while in the old age group, they were chronic bronchitis, pulmonary emphysema, chronic pulmonary heart disease and lung cancer. [Conclusion] The focus of daily medical treatment in the department of respiratory disease should vary with the age groups and disease categories, and the control of infectious diseases should be generally strengthened.
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AIM: To study the effect of Aima recipe (AM), a traditional Chinese medicine, on the protein and mRNA expression of TNF? and ICAM-1 in the bronchus of rats with chronic bronchitis(CB). METHODS: 15 male Wistar rats were randomly divided into three groups: control group, chronic bronchitis (CB) group, CB plus AM group. The protein and mRNA expression of TNF? and ICAM-1 were assayed by immunohistochemistry and in situ hybridization methods. RESULTS: TNF?, ICAM-1 protein and mRNA were more strongly expressed in the area of bronchial epithelium in the CB group compared with control group ( P
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Objective To study the effect of Gualou Gancao Granules(GLGC)on influenza virus pneumonia mice.Methods The mice model of viral pneumonia was established by nose inhalation of influenza virus FM1.The treatment groups were administered GLGC with ribavirin served as control drug.The mortality,body weight,lung index,viral blood agglutination titer of influenza virus pneumonia mice were observed.Results Compared with the model group,GLGC can reduce the mortality of influenza virus pneumonia mice,prolong the average living days,inhibit the body weight decrease,and depress the lung index and viral titer distinguishingly.Conclusion GLGC,which derived from the therapeutic principle of clearing away heat-evil and eliminating sputum,has an affirmative effect on influenza virus pneumonia mice.
