[Effect of Wenyang Baidu Yin on early microcirculation disturbance in patients with sepsis (syndrome of Yang deficiency and turbid toxin): a randomized controlled trial].

Abstract

Objective: To observe the effect of Wenyang Baidu Yin on early microcirculation indicators in patients with sepsis (syndrome of Yang deficiency and turbid toxin), analyze the specific therapeutic effect, and provide a new perspective for clinical treatment of microcirculation disorders in sepsis.

Methods: Sixty-four patients with sepsis admitted to the intensive care unit (ICU) of Shanxi Province Hospital of Integrated Traditional Chinese and Western Medicine from January 2022 to July 2023 were enrolled. Patients were divided into control group and observation group by randomly number table method, with 32 cases in each group. The control group received conventional Western medicine treatment. On the basis of conventional Western medicine treatment, the observation group was given Wenyang Baidu Yin 200 mL/d (100 mL each time, with an interval of 12 hours) orally or by nasal feeding for 3 consecutive days. The central venous oxygen saturation (ScvO₂), difference of central venous-to-arterial partial pressure of carbon dioxide (Pcv-aCO₂), arterial lactic acid (Lac), pulse perfusion index (PI), capillary refill time (CRT), and skin mottling score (SMS) of two groups were detected before treatment and at 6, 12, 24, and 48 hours of treatment; simultaneously record the traditional Chinese medicine (TCM) syndrome score before treatment and at 72 hours of treatment, as well as the sequential organ failure assessment (SOFA) and acute physiology and chronic health evaluation (APACHE) before treatment and at 24 hours and 72 hours of treatment.

Results: There were no statistically significant differences in gender, age, and various microcirculation indicators before treatment between the two groups, indicating consistent baseline characteristics. Compared with before treatment, the microcirculation indicators ScvO₂, Pcv-aCO₂, Lac, PI, CRT, and SMS in both groups showed significant improvement after treatment. Moreover, the observation group showed more significant improvements in Lac and PI compared to the control group at 24 hours and 48 hours of treatment [Lac (mmol/L): 2.45±0.92 vs. 3.07±1.07 at 24 hours, 2.06±0.87 vs. 2.59±1.01 at 48 hours; PI: 3.45±0.89 vs. 2.92±0.98 at 24 hours, 3.56±0.99 vs. 3.01±0.87 at 48 hours, all P < 0.05]. CRT and SMS showed more significant improvements compared to the control group at 48 hours of treatment [CRT (s): 2.04±1.08 vs. 2.62±0.99, SMS: 0.5 (0.0, 1.0) vs. 1.0 (1.0, 1.0), both P < 0.05], while there were no statistically significant differences in ScvO₂ and Pcv-aCO₂ at each time point between the two groups. After treatment, the APACHE score, SOFA score, and TCM syndrome score improved in both groups compared to before treatment, and the improvement degree of each score in the observation group was significantly higher than that in the control group [72 hours APACHE II score: 15.0 (12.2, 16.0) vs. 17.0 (13.5, 20.0), 72 hours SOFA score: 6.0 (6.0, 8.0) vs. 10.0 (8.0, 13.0), 72 hours TCM syndrome score: 10.13±3.73 vs. 14.63±5.55, all P < 0.05].

Conclusions: On the basis of conventional Western medicine treatment, the combination of Wenyang Baidu Yin can significantly improve microcirculation disorders in patients with sepsis (syndrome of Yang deficiency and turbid toxin) to a certain extent, thereby improving patient prognosis.