Dr. WangEditor | Wu YoufollowSepsis is a common complication in some critically ill patients in clinical practice,Commonly seen in infections, severe trauma, major burns, and major surgical proceduresAfter surgery, it can induce septic shock and multiple organ dysfunction syndrome

Dr. Wang

Editor | Wu You

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Sepsis is a common complication in some critically ill patients in clinical practice,Commonly seen in infections, severe trauma, major burns, and major surgical proceduresAfter surgery, it can induce septic shock and multiple organ dysfunction syndrome.

This disease can occur at any age and in any underlying disease background, often developing rapidly and with a high mortality rate.

At present, the incidence rate and mortality of sepsis are still at a high level. According to statistics, about 20 million people worldwide suffer from sepsis every year, and up to half of them suffer from septic shock.

The proportion of patients who died from sepsis is about 26%, while according to another report covering nearly 2 million deaths.

Among them, the proportion of deaths related to sepsis is 12.6%, and it is inferred that China died of about 1 million cases of sepsis that year.

The pathogenesis of this disease is complex,Its pathological and physiological processes involve multiple aspects such as inflammation, immune and coagulation dysfunction, mainly caused by immune dysfunction in the body.

In response to this disease, modern medicine mainly adopts comprehensive treatment methods such as liquid resuscitation, the use of vasoactive drugs, glucocorticoids, anticoagulation, kidney replacement therapy, mechanical ventilation, etc. based on the treatment of the primary disease and standardized anti infection treatment.

But there are also challengesThe emergence of drug-resistant bacteria, the occurrence of multiple infections, combined gastrointestinal dysfunction, and coagulation dysfunction are various issues.

With the deepening of research on the treatment of sepsis with traditional Chinese medicine, it has been found that traditional Chinese medicine can improve clinical efficacy, reduce adverse reactions caused by high-dose or long-term use of antibiotics, glucocorticoids, and other drugs, reduce gastrointestinal dysfunction, thrombosis, and other complications, and reduce mortality,Traditional Chinese medicine gradually exerts its unique advantages in terms of thinking and methods.

This study adoptedQingfei Jiedu TangThe treatment of sepsis has achieved good results, as reported below.

General information: 70 patients with sepsis caused by pulmonary infection admitted to the Sixth People's Hospital of Zhengzhou from June 2020 to June 2021 were selected as the research subjects. They were randomly divided into a control group and an observation group, with 35 patients in each group. The control group consisted of 19 males and 16 females.

There was no statistically significant difference in general data between the two groups. This study was approved by the Ethics Committee of the hospital, and the patient truthfully understood the protocol and signed a consent form.

Inclusion criteria: Refer to the diagnostic criteria for sepsis in the Chinese Guidelines for the Treatment of Severe Sepsis/Septic Shock (2014).

Traditional Chinese Medicine Syndrome DifferentiationSyndrome of excessive heat toxicity, characterized by high fever, sweating, thirst, thirst, wheezing, or restlessness, or dizzinessUrine is short and red, bowel movements are secretive, tongue texture is red and crimson, fur is yellow and dry, and pulse count is high.

Exclusion criteria: Those with severe underlying diseases such as heart, liver, and kidney that cannot be controlled; Patients with malignant tumors; Those with severe hematological diseases; Immune deficiency or use of Immunosuppressive drug; Individuals who cannot tolerate traditional Chinese medicine decoction or are allergic to traditional Chinese medicine ingredients; Those in an irreversible deathbed state; Individuals with concomitant cognitive impairment or mental illness.

Method: Both groups of patients were given routine treatment plans, while the control group received empirical anti infection treatment as soon as the diagnosis was confirmed. The anti infection treatment plan was adjusted based on the efficacy, pathogenic basis, and drug sensitivity test results.

At the same time, strengthen liquid resuscitation and nutritional support treatment,Actively control blood sugar, prevent Irritability ulcer, inhibit the formation of capillary micro thrombus, correct electrolyte disorder and acid-base imbalance.

Qingfei Jiedu Tang

Qingfei Jiedu Tang12g10g10g12g15g10g12g10g8g

Stool obstruction with Houpu and Zhishi; Greatly thirsty, add gypsum and trichosanthin; Add water buffalo horn, black ginseng, and forsythia suspensa to your mind's confusion and irritability; Shortness of breath with almonds; Phlegm dampness inhibition plus Dannanxing and Zhuru; Add Danshen and Chuanxiong to blood stasis and internal obstruction.

Traditional Chinese medicine is prepared by the Traditional Chinese Medicine Department of the Sixth People's Hospital of Zhengzhou City, and taken orally twice in the morning and evening. Both groups had a treatment period of 7 days.

Observation indicators: Two or more attending physicians participated in the comparison of the changes in traditional Chinese medicine syndrome scores before and on the 3rd, 5th, and 7th days after treatment between the two groups.

PCT was detected using immunofluorescence assay.

Evaluate on the 1st, 3rd, and 7th days respectively.

At the same time, anticoagulant venous blood was collected to detect the levels of CD14+Monocyte human leukocyte DR antigen and T lymphocyte subsets in peripheral blood.

Result: After treatment, the TCM syndrome scores of the two groups of patients were significantly lower than before, and the observation group was lower than the control group.

The theory of uncontrolled inflammatory response in the body is considered an important foundation for the pathogenesis of sepsisBasic research has confirmed that the imbalance between pro-inflammatory and anti-inflammatory responses will initiate an inflammatory cascade reaction, thereby mediating the occurrence of sepsis.

It can counteract anti-inflammatory factors such as IL-10 and is closely related to multiple organ damage in sepsis.

From an immunological perspective, the essence of sepsisAfter the occurrence of severe infection or traumatic disease, the immune response of the body is disrupted, which in turn leads to multiple organ dysfunction.

The key to sepsis is not only systemic inflammatory reaction, but also the disorder of immune regulation mechanism. In the early stage of sepsis, the immune response is mainly reflected in the excessive production and release of inflammatory mediators, resulting in fever, rapid heart rate and Tachypnea.

This process not only eliminates the pathogenic bacteria, but also inevitably increases the body's immune damage, which can further exacerbate the inflammatory response. During the progression of sepsis, immune response suppression occurs, manifested as a decrease in the number and function of immune cells,Macrophage inactivation, decreased antigen presentation ability, and decreased lymphocyte proliferation activity occur.

The release of inhibitory cytokines and lymphocyte apoptosis can also cause immune suppression in sepsis. After immune suppression occurs, the risk of secondary infection in the body will also significantly increase, and the mortality rate will also increase.

CD4+T lymphocytes can help produce antibodies and participate in Humoral immunity. At the same time, CD4+can also help CD8+and macrophage function,It also participates in the Immunological memory process and regulates the immune response through multiple ways.

The decrease in the number or function of CD4+cells can increase the body's susceptibility and reactivate dormant viruses, as well as lead to opportunistic bacterial infections.

CD8+cells are cytotoxic, which can inhibit antibody synthesis and T cell proliferation, regulate Humoral immunity and cellular immunity, and maintain Internal environment stability.

In addition to using CD4+and CD8+cell counts to evaluate cellular immune function, HLA-DR levels are gradually attracting attention in evaluating immune function.

HLA-DR expression plays a crucial role in antigen presentation and helper T cell processes, and a decrease in HLA-DR expression often indicates immune suppression. Studies have found that patients with severe sepsis with low HLADR levels often have a higher mortality rate.

Considering the impact of inflammatory response and immune imbalance in the pathogenesis of this disease,Anti infection therapy, the use of glucocorticoids, and immunotherapy have played important roles in the treatment of sepsis.

Long term use of antibiotics faces problems such as the generation of drug-resistant bacteria and the occurrence of multiple infections.

Glucocorticoids have strong anti-inflammatory capabilities, but they can also accelerate specific immune cell apoptosis. Therefore, there is still controversy over whether to use glucocorticoids routinely in the treatment of sepsis.

Ulinastatin can antagonize downstream toxic inflammatory mediators and exert protective effects on multiple organs, demonstrating good clinical efficacy.

Traditional Chinese medicine can play its unique advantages in combating inflammation and immune regulation.

Poison and evil are the key pathological basis in the occurrence and development of sepsis. In the early stages of sepsis, due to the lack of positive qi in the body, external toxin and evil energy are re felt, damaging the body, damaging the collaterals, and leading to systemic reactions.

With the further deepening of toxins, blood stasis and toxins can merge, blocking the meridians and releasing a large amount of endogenous toxins. Both internal and external toxins can coalesce and become diseases.

The accumulation of heat and toxin can damage the vital energy over time, and can form blood stasis and phlegm turbidity. Therefore, in the treatment of sepsis, attention should be paid to cultivating and supplementing the vital energy while clearing heat and detoxifying, while also taking into account the specimen.

This study adoptedQingfei Jiedu Tang

Qingfei Jiedu TangComposed of Coptis chinensis, Scutellaria baicalensis, Cortex Phellodendri, Gardenia jasminoides, and Rhubarb, Coptis chinensis can relieve spleen fire in the middle energizer and also clear heart fire, making it a monarch medicine; Huangqin is used as a medicinal herb to purge lung fire in the upper energizer; Huangbai Xie Shen Huo Yu Xia Jiao; Gardenia jasminoides can clear the fire of the three energizers and emerge from the bladder.

If yang is strong, yin will decline, and if fire is strong, water will decline. Therefore, using rhubarb, which is bitter and cold, to suppress yang and support yin, and to relieve excessive fire, are all adjuvants.

Modern pharmacological research has found that,Huanglian Jiedu Tang can reduce serum inflammatory factor water through multiple pathways and targets

APACHESOFAPCTQingfei Jiedu TangIt can effectively alleviate patients' clinical symptoms, control infection, alleviate functional failure status, and improve clinical efficacy.

Qingfei Jiedu TangEffectively reducing the levels of inflammatory factors in patients with sepsis, regulating immune response, and thereby improving clinical efficacy, is worthy of clinical promotion.

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