Traditional Chinese medicine bundle therapy for septic acute gastrointestinal injury: A multicenter randomized controlled trial. (December 2019)

• Record Type: Journal Article
• Authors: Xing, Xi; Zhi, Yihui; Lu, Jun; Lei, Shu; Huang, Liquan; Zhu, Meifei; Fang, Kun; Wang, Qiuyan; Wu, Jiannong; Wu, Yanchun; Liao, Lvzhao; Mao, Shihao; Chen, Zheqi; Zhang, Geng; Jiang, Ronglin
• Is Part Of: Complementary therapies in medicine. Volume 47(2019)
• Publication Date: 2019-12
• Subjects: Traditional Chinese medicine -- Bundle therapy -- Sepsis -- Acute gastrointestinal injury; Alternative medicine -- Periodicals; Complementary Therapies -- Periodicals; Médecines parallèles -- Périodiques; Thérapeutique -- Périodiques; Alternative medicine; Electronic journals; Periodicals; 615.5
• DOI: 10.1016/j.ctim.2019.102194
• Languages: English
• ISSNs: 0965-2299

Abstract

Highlights: AGI plays an important role in sepsis and participates in sepsis. Traditional Chinese medicine (TCM) has some efficacy against AGI. TCM bundle therapy in the early stage of sepsis can improve survival. TCM bundle therapy in the early stage of sepsis can improve markers of gastrointestinal function. The results provide a novel method to manage AGI in patients with sepsis. Abstract: Objective: Current conventional treatments for sepsis associated with acute gastrointestinal injury (AGI) have limited efficacy. This study aimed to study traditional Chinese medicine (TCM) bundle therapy (based on TCM syndrome differentiation) as add-on to conventional treatments on the incidence of AGI and on the prognosis of patients with sepsis. Design: This was a prospective multicenter randomized single-blind controlled trial. Setting: Intensive care units (ICUs) of five university teaching hospitals in Zhejiang Province (China) from December 2012 to December 2014. Interventions: The control group received conventional treatment for sepsis and AGI. The intervention group received the conventional treatment combined with TCM bundle therapy. Measurements and main results: The primary outcome was 28-day mortality. The secondary outcomes included the clinical indicators of sepsis. The 28-day mortality (35.3% vs. 48.3%, P = 0.01) and AGI-attributable mortality (15.1% vs. 36.2%, P = 0.02) in the intervention group were significantly lower than in controls. Duration of mechanical ventilation (17.4 ± 10.4 vs. 19.9 ± 11.1 days, P = 0.049) and duration of ICU stay (17.3 ± 10.2 vs. 20.1 ± 11.5 days) were significantly shorter in the intervention group compared with controls. On days 7 and 14, D-lactate, diamine oxidase, lipopolysaccharides, tumor necrosis factor-α, intra-abdominal pressure, and abdominal circumference in the intervention group were significantly lower than in controls, and serum MTL levels and bowel sounds were significantly higher (all P < 0.05). Conclusions: TCM bundle therapy in the early stage of sepsis can improve survival and the markers of gastrointestinal function in patients with sepsis associated with AGI.