Flavored big radix bupleuri decoction for treating sepsis gastrointestinal dysfunction

Abstract

The invention discloses a modified radix bupleuri decoction for treating sepsis gastrointestinal dysfunction, which is prepared from the following components in parts by weight: 15 to 30 parts of radix bupleuri, 5 to 15 parts of raw radix scutellariae, 10 to 20 parts of ginger processed pinellia, 15 to 30 parts of parched white peony root, 10 to 20 parts of parched fructus aurantii, 6 to 12 parts of cooked rhubarb, 8 to 20 parts of fructus gardeniae praeparatus, 20 to 40 parts of fructus forsythiae, 3 to 8 parts of rhizoma zingiberis, 10 to 20 parts of fructus ziziphi jujubae and 6 to 12 parts of compound of glauber-salt and liquorice. The radix bupleuri is added into the original radix bupleuri decoction, and the fructus gardeniae, the fructus forsythiae and the compound of glauber-salt and liquorice are added, so that sepsis of intestines and stomach can be effectively relieved, and the probability of multi-organ dysfunction is reduced.

Description

Technical Field

[0001] The present application belongs to the technical field of traditional Chinese medicine, and specifically relates to a modified Da Chaihu decoction for treating gastrointestinal dysfunction caused by sepsis. Background Art

[0002] Sepsis is an organ dysfunction caused by the body's dysregulated response to infection. Sepsis is not only a major public health problem, but also a common cause of death in hospitalized patients. Currently, there are a lot of fluid resuscitation, hemodynamic support, the use of broad-spectrum antibiotics and corresponding treatment for the primary disease, but it has not significantly reduced the mortality rate of sepsis. The prognosis of patients with sepsis is still poor, with a mortality rate as high as 26%, and the number of deaths caused each year is about 5 million. Therefore, it is crucial to find new treatments for sepsis and reduce its mortality rate. Acute gastrointestinal dysfunction caused by sepsis has received increasing attention from the industry. Multiple studies have confirmed that up to 62% of patients in intensive care units (ICUs) experience gastrointestinal symptoms. Sepsis is prone to cause multiple organ dysfunction, with gastrointestinal dysfunction being more common. Studies have shown that gastrointestinal motility is closely related to the prognosis of patients with sepsis. Therefore, early intervention for gastrointestinal dysfunction in sepsis is of vital importance to control the progression of the disease and effectively reduce mortality. Summary of the invention

[0003] The present application provides a modified Da Chaihu Tang decoction for treating gastrointestinal dysfunction caused by sepsis to solve the above-mentioned technical problems.

[0004] To solve the above technical problems, a technical solution adopted in the present application is: a modified Da Chaihu Tang decoction for treating gastrointestinal dysfunction caused by sepsis, which is composed of the following components by weight: 15-30 parts of bupleurum, 5-15 parts of raw scutellaria, 10-20 parts of ginger pinellia, 15-30 parts of stir-fried white peony root, 10-20 parts of stir-fried fructus aurantii, 6-12 parts of cooked rhubarb, 8-20 parts of scorched gardenia, 20-40 parts of forsythia, 3-8 parts of dried ginger, 10-20 parts of jujube and 6-12 parts of xuanming powder.

[0005] A Qingjie Huagong decoction comprises the modified Da Chaihu decoction for treating gastrointestinal dysfunction caused by sepsis.

[0006] Furthermore, the concentration density of the modified Da Chaihu decoction in the Qingjie Huagong decoction is 1.5-2.3 g / cm 3 .

[0007] Furthermore, the Qingjie Huagong decoction is instilled through a gastric tube or a nasojejunal tube.

[0008] A method for preparing a modified Da Chaihu decoction for treating gastrointestinal dysfunction caused by sepsis, comprising:

[0009] According to weight, prepare 15-30 parts of bupleurum, 5-15 parts of raw scutellaria, 10-20 parts of ginger pinellia, 15-30 parts of stir-fried white peony root, 10-20 parts of stir-fried fructus aurantii, 6-12 parts of cooked rhubarb, 8-20 parts of scorched gardenia, 20-40 parts of forsythia, 3-8 parts of dried ginger, 10-20 parts of jujube and 6-12 parts of xuanming powder, mix and grind into fine powder;

[0010] The fine powder is then put into a container, 3000 to 4000 parts of water are added, the mixture is boiled and simmered for 60 to 80 minutes, and finally concentrated to obtain the flavored Da Chaihu Tang decoction.

[0011] The beneficial effect of the present application is that the present application adds more bupleurum to the original bupleurum decoction, and adds gardenia, forsythia, and xuanming powder, which can effectively relieve gastrointestinal sepsis, thereby reducing the probability of multiple organ dysfunction. DETAILED DESCRIPTION

[0012] In order to make the purpose, technical solutions and advantages of the present invention more clear, the present invention is further described in detail below in conjunction with specific embodiments.

[0013] In the following description, many specific details are set forth to facilitate a full understanding of the present invention. However, the present invention may also be implemented in other ways than those described herein. Therefore, the present invention is not limited to the specific embodiments of the following disclosure.

[0014] The present application provides a modified Da Chaihu Tang decoction for treating gastrointestinal dysfunction caused by sepsis, which is composed of the following components in parts by weight: 15-30 parts of bupleurum, 5-15 parts of raw scutellaria, 10-20 parts of ginger pinellia, 15-30 parts of stir-fried white peony root, 10-20 parts of stir-fried fructus aurantii, 6-12 parts of cooked rhubarb, 8-20 parts of scorched gardenia, 20-40 parts of forsythia, 3-8 parts of dried ginger, 10-20 parts of jujube and 6-12 parts of xuanming powder.

[0015] The present application also provides a Qingjie Huagong decoction, including the modified Da Chaihu decoction for treating gastrointestinal dysfunction in sepsis. The concentrated density of the modified Da Chaihu decoction in the Qingjie Huagong decoction is 1.5-2.3 g / cm3. The Qingjie Huagong decoction is infused through a stomach tube or a nasojejunal tube, 200 ml, twice a day, for 7-14 consecutive days.

[0016] A method for preparing a modified Da Chaihu decoction for treating gastrointestinal dysfunction caused by sepsis, comprising:

[0017] According to weight, prepare 15-30 parts of bupleurum, 5-15 parts of raw scutellaria, 10-20 parts of ginger pinellia, 15-30 parts of stir-fried white peony root, 10-20 parts of stir-fried fructus aurantii, 6-12 parts of cooked rhubarb, 8-20 parts of scorched gardenia, 20-40 parts of forsythia, 3-8 parts of dried ginger, 10-20 parts of jujube and 6-12 parts of xuanming powder, mix and grind into fine powder;

[0018] The fine powder is then put into a container, 3000 to 4000 parts of water are added, the mixture is boiled and simmered for 60 to 80 minutes, and finally concentrated to obtain the flavored Da Chaihu Tang decoction.

[0019] Example 1

[0020] The 94 patients were randomly divided into control group (n=31), DCHT group (n=31), and JWDCHT group (n=32) by random number table method. During the study, 1 patient dropped out of the control group, leaving 30 patients, including 15 males and 15 females; age (53.71±11.73) years old; primary diseases: 13 cases of lung infection, 5 cases of urinary tract infection, 6 cases of skin, soft tissue, bone and joint infection, 2 cases of bloodstream infection, and 4 cases of intracranial infection; gastrointestinal dysfunction score (1.86±0.24), acute physiology and chronic health examination II (APACHE II) score (17.7±4.74). One case dropped out in the DCHT group, leaving 30 cases, including 16 males and 14 females, aged (55.67±12.45) years old; primary diseases: 12 cases of lung infection, 5 cases of urinary tract infection, 7 cases of skin, soft tissue and bone and joint infection, 2 cases of bloodstream infection, 4 cases of intracranial infection, gastrointestinal dysfunction score (1.82±0.28) points, APACHEⅡ score (18.69±5.22) points. Two cases dropped out in the JWDCHT group, leaving 30 cases, including 14 males and 16 females, aged (57.67±11.35) years old; primary diseases: 14 cases of lung infection, 4 cases of urinary tract infection, 6 cases of skin, soft tissue and bone and joint infection, 3 cases of bloodstream infection, 3 cases of intracranial infection, gastrointestinal dysfunction score (1.84±0.23) points, APACHEⅡ score (17.09±5.70) points. There was no significant difference in general data among the three groups (P>0.05), which showed comparability. The cause of dropout in the three groups was death.

[0021] All patients received conventional basic treatment of Western medicine according to the corresponding disease guidelines based on their primary diseases. On the basis of conventional treatment, DCHT was treated with nasogastric administration of Da Chaihu Decoction, which consisted of 10g of Bupleurum, 10g of Scutellaria, 10g of Rhubarb, 10g of Citrus aurantium, 15g of Pinellia, 20g of White Peony, 15g of Jujube, and 6g of Ginger. On the basis of conventional treatment, JWDCHT was treated with nasogastric administration of Jiawei Da Chaihu Decoction, which consisted of 15g of Bupleurum, 10g of Raw Scutellaria, 15g of Ginger Pinellia, 20g of Stir-fried White Peony, 15g of Stir-fried Citrus aurantium, 10g of Cooked Rhubarb, 15g of Scorched Gardenia, 30g of Forsythia, 6g of Dry Ginger, 15g of Jujube, and 10g of Xuanming Powder. The decoction was uniformly prepared by the Chinese medicine pharmacy of Nantong Hospital of Traditional Chinese Medicine, and 400mL of water was decocted and fed nasogastricly after warming in the morning and evening. A course of treatment is 7 days. If the course is less than 7 days, it will be calculated as 7 days.

[0022] Implementation of enteral nutrition:

[0023] Within 72 hours of admission, after hemodynamic stabilization, enteral nutrition was started as soon as possible. During the study, MI was measured every morning in the fasting state of the patient, and the enteral nutrition plan for the day was set according to the MI value. Two hours after each MI measurement, routine nasogastric enteral nutrition suspension (TPF) (National Medicine Standard H20030011, Nutricia Pharmaceuticals, 500mL / bottle) was routinely fed through a nasogastric tube. When MI≤0.4, the speed of enteral nutrition solution was set to 20-30ml / h; when 0.4<MI≤0.8, the speed of enteral nutrition solution was set to 40-60ml / h, and when MI>0.8, the speed of enteral nutrition solution was set to 70ml / h, and gradually increased to the target speed according to the patient's tolerance. Enteral nutrition was considered to be up to standard when 25kcal / (kg·d) could be given, and enteral nutrition was stopped when the patient had feeding intolerance.

[0024] The APACHE II scores and gastrointestinal dysfunction scores on the 7th day of treatment were recorded for the three groups of patients. The total score of gastrointestinal dysfunction score was 0-3 points, and the higher the score, the worse the gastrointestinal function. The number of days required for the patients to achieve enteral nutrition, the time they stayed in the ICU, and whether adverse reactions occurred during the study were recorded.

[0025] Every morning when the patients were fasting, the SonoSite Edge color Doppler ultrasound convex array probe was used with a probe frequency of 2-5mHz. The patients were placed in a supine position with the head of the bed raised 30°. The ultrasound probe was placed under the xiphoid process. The superior mesenteric vein, abdominal aorta and left lobe of the liver were used as landmarks to detect the gastric antrum section. 300ml of warm water was injected through the gastric tube within 2min. The number of gastric antrum contractions was continuously recorded for 6min. The number of gastric antrum contractions every 2min was the gastric antral contraction frequency (ACF). The average area change of the maximum antral relaxation (S relaxation) and contraction (S contraction) of the gastric antrum was measured three times continuously (△S = (S relaxation-S contraction). The antrum contraction amplitude (ACA) = △S / S relaxation, MI = ACF × ACA was calculated. The MI values ​​of the two groups of patients were recorded before treatment and 7 days after treatment.

[0026] Nutritional status: Three groups of serum albumin (ALB), prealbumin (PA), and hemoglobin (HGB) were tested before treatment and 7 days after treatment. All tests were performed by the laboratory department of Nantong Traditional Chinese Medicine Hospital.

[0027] 1. Digestive tract hormones and infection indicators:

[0028] Before treatment and on the morning of the 7th day of treatment, venous blood was drawn from the patient's cubital vein in a fasting state to test the levels of motilin (MTL), gastrin (GAS), white blood cell count (WBC), procalcitonin (PCT), and C-reactive protein (CRP). All tests were performed by the Laboratory Department of Nantong Traditional Chinese Medicine Hospital.

[0029] SPSS 25.0 statistical software was used. Measurement data were expressed as mean ± standard deviation (x ± s), and t test was used for comparison between groups. Enumeration data were expressed as cases, and chi-square test or rank sum test was used. P < 0.05 was considered statistically significant.

[0030] The time to reach the enteral nutrition target in the control group was 7.39±1.96 days, in the DCHT group was 6.01±1.12 days, and in the JWDCHT group was 5.01±1.32 days. There were statistical differences between the DCHT group and the JWDCHT group compared with the intervention group (P<0.05), and the JWDCHT group was shorter than the DCHT group (P<0.05). The ICU hospitalization time was 16.11±4.84 days in the intervention group, 12.89±3.78 days in the DCHT group, and 12.26±3.04 days in the JWDCHT group. There were statistical differences between the DCHT group and the JWDCHT group compared with the intervention group (P<0.05), and there was no significant statistical difference between the JWDCHT group and the DCHT group (P>0.05).

[0031] Before treatment, there were no significant differences in the indicators of the three groups (P>0.05), which were comparable. On the 7th day of treatment, the gastrointestinal disorder scores and APACHEⅡ scores of the three groups were lower than those before treatment (P<0.05), and the JWDCHT and DCHT groups were lower than the control group at the same period, with statistical differences (P<0.05), and the JWDCHT group was lower than the DCHT group at the same period (P<0.05); while the MI value, ALB, PA, and HGB were higher than those before treatment (P<0.05), and the JWDCHT and DCHT groups were higher than the control group at the same period, with statistical differences (P<0.05), and the JWDCHT group was higher than the control group at the same period, with statistical differences (P<0.05), and the JWDCHT group was higher than the DCHT group at the same period (P<0.05) (see Table 1).

[0032] Table 1 Comparison of gastrointestinal disorder scores, MI values, APACHEⅡ scores, and nutritional status between the two groups

[0033]

[0034]

[0035] Note: Compared with the control group on day 0, *P<0.05; compared with the DCHT group on day 0, #P<0.05; compared with the JWDCHT group on day 0, □P<0.05; compared with the control group on day 7, △P<0.05; compared with the DCHT group on day 7, ▲P<0.05.

[0036] 2. Comparison of changes in digestive tract hormones and infection indicators between the two groups:

[0037] Before treatment, there was no statistical difference in MTL and GAS among the three groups (P>0.05). On the 7th day of treatment, the levels of MTL and GAS in the three groups were higher than those before treatment (P<0.05). The MTL and GAS in the DCHT group and JWDCHT group were higher than those in the control group during the same period, with statistical differences (P<0.05), and the levels in the JWDCHT group were higher than those in the DCHT group during the same period (P<0.05).

[0038] Before treatment, there was no statistical difference in WBC, PCT and CRP among the three groups of patients (P>0.05). On the 7th day of treatment, WBC, PCT and CRP of the two groups decreased (P<0.05). The WBC, PCT and CRP of the DCHT group and JWDCHT group were lower than those of the control group in the same period (P<0.05), and those of the JWDCHT group were lower than those of the DCHT group in the same period (P<0.05) (see Table 2).

[0039] Table 2 Comparison of changes in digestive tract hormones and infection indicators between the two groups

[0040]

[0041]

[0042] Note: Compared with the control group on day 0, *P<0.05; compared with the DCHT group on day 0, #P<0.05; compared with the JWDCHT group on day 0, □P<0.05; compared with the control group on day 7, △P<0.05; compared with the DCHT group on day 7, ▲P<0.05.

[0043] During the above treatment, the patients in the intervention group did not experience obvious allergies, adverse reactions such as reflux after medication, and no allergic symptoms such as blisters and exudation occurred at the local acupuncture site.

[0044] In summary, the modified Da Chaihu decoction of the present application can effectively relieve gastrointestinal sepsis, thereby reducing the probability of multiple organ dysfunction.

[0045] The above description is only an embodiment of the present application and does not limit the patent scope of the present application. Any equivalent structure or equivalent process transformation made using the contents of the present application specification, or directly or indirectly applied in other related technical fields, are also included in the patent protection scope of the present application.

Claims

1. A modified Da Chaihu decoction for treating gastrointestinal dysfunction caused by sepsis, characterized in that: The invention is composed of the following components by weight: 15-30 parts of bupleurum, 5-15 parts of raw scutellaria, 10-20 parts of pinellia tuber, 15-30 parts of stir-fried white peony root, 10-20 parts of stir-fried fructus aurantii, 6-12 parts of cooked rhubarb, 8-20 parts of scorched gardenia, 20-40 parts of forsythia, 3-8 parts of dried ginger, 10-20 parts of jujube and 6-12 parts of xuanming powder.

2. A decoction of Qingjie Huagong prescription, characterized in that: The invention comprises the modified Da Chaihu decoction for treating gastrointestinal dysfunction caused by sepsis.

3. The Qingjie Huagong decoction according to claim 2, characterized in that: The concentrated density of the modified Da Chaihu decoction in the Qingjie Huagong decoction is 1.5-2.3 g / cm 3 .

4. The Qingjie Huagong decoction according to claim 2, characterized in that: The Qingjie Huagong decoction is instilled through a stomach tube or a nasojejunal tube.

5. A method for preparing a modified Da Chaihu Tang decoction for treating gastrointestinal dysfunction caused by sepsis, characterized in that: include: According to weight, prepare 15-30 parts of bupleurum, 5-15 parts of raw scutellaria, 10-20 parts of ginger pinellia, 15-30 parts of stir-fried white peony root, 10-20 parts of stir-fried fructus aurantii, 6-12 parts of cooked rhubarb, 8-20 parts of scorched gardenia, 20-40 parts of forsythia, 3-8 parts of dried ginger, 10-20 parts of jujube and 6-12 parts of xuanming powder, mix and grind into fine powder; The fine powder is then put into a container, 3000 to 4000 parts of water are added, the mixture is boiled and simmered for 60 to 80 minutes, and finally concentrated to obtain the flavored Da Chaihu Tang decoction.

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