Treatment Effects of Xuebijing Injection in Severe Septic Patients with Disseminated Intravascular Coagulation

Evidence-Based Complementary and Alternative Medicine, Mar 2014

The treatment effects of Xuebijing (XBJ) injection in severe septic patients with disseminated intravascular coagulation (DIC) were investigated in this study. 171 severe septic patients with DIC were divided into the control group () or intervention group (). Routine therapies were administered in both groups, and XBJ injection was administered additionally in the intervention group. Incidence of DIC, clinical severity scores, and coagulation parameters at 7 days after administration of XBJ injection were compared between the two groups, and short-term prognosis was evaluated by 28-day mortality. Compared with the control group, incidence of DIC in the intervention group was significantly lower at 7 days after administration of XBJ injection (). In addition, differences of platelet count and prothrombin time were significantly greater in the intervention group than in the control group ( all <0.05), and similar results were also found for differences of the Mortality in Emergency Department Sepsis score and Acute Physiology and Chronic Health Evaluation II score ( all <0.05). Furthermore, 28-day mortality was significantly lower in the intervention group (). These results demonstrate that XBJ injection can effectively treat DIC caused by severe sepsis and improve short-term prognosis of severe septic patients with DIC.

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Treatment Effects of Xuebijing Injection in Severe Septic Patients with Disseminated Intravascular Coagulation

Treatment Effects of Xuebijing Injection in Severe Septic Patients with Disseminated Intravascular Coagulation Qin Yin and Chunsheng Li Emergency Department, Beijing Chaoyang Hospital, Capital Medical University, No. 8 Workers’ Stadium South Road, Beijing 100020, China Received 15 December 2013; Revised 18 February 2014; Accepted 19 February 2014; Published 23 March 2014 Academic Editor: Yuping Tang Copyright © 2014 Qin Yin and Chunsheng Li. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract The treatment effects of Xuebijing (XBJ) injection in severe septic patients with disseminated intravascular coagulation (DIC) were investigated in this study. 171 severe septic patients with DIC were divided into the control group () or intervention group (). Routine therapies were administered in both groups, and XBJ injection was administered additionally in the intervention group. Incidence of DIC, clinical severity scores, and coagulation parameters at 7 days after administration of XBJ injection were compared between the two groups, and short-term prognosis was evaluated by 28-day mortality. Compared with the control group, incidence of DIC in the intervention group was significantly lower at 7 days after administration of XBJ injection (). In addition, differences of platelet count and prothrombin time were significantly greater in the intervention group than in the control group ( all <0.05), and similar results were also found for differences of the Mortality in Emergency Department Sepsis score and Acute Physiology and Chronic Health Evaluation II score ( all <0.05). Furthermore, 28-day mortality was significantly lower in the intervention group (). These results demonstrate that XBJ injection can effectively treat DIC caused by severe sepsis and improve short-term prognosis of severe septic patients with DIC. 1. Introduction Despite advancements in modern antibiotics and supportive therapies, the mortality of severe sepsis remains high. In the United States, severe sepsis accounts for 751,000 hospital admissions and 215,000 deaths every year, with an in-hospital mortality of 28.6% [1]. Disseminated intravascular coagulation (DIC), a serious complication of severe sepsis, is characterized by widespread fibrin deposition in microvessels resulting from coagulation activation, inhibition of anticoagulation and fibrinolysis, and subsequent consumption of clotting factors and hyperfibrinolysis [2]. DIC is closely associated with the development of multiple organ failure, and mortality in patients with DIC is much higher than in those without DIC [3]. Current management of DIC relies on treating the underlying disease aggressively, along with supplementary therapy with clotting factors and platelets as required [4]. In addition, anticoagulation is also the main target of treatment. Heparin is the most widely used anticoagulant in clinical practice, but controlled trials did not confirm the survival benefit of heparin [5, 6]. Another anticoagulant, recombinant human activated protein C (rhAPC), was reported to decrease mortality in the Recombinant Human Activated Protein C Worldwide Evaluation in Severe Sepsis (PROWESS) study [7], and post hoc data analysis demonstrated that patients with DIC may have a survival benefit in particular [8]. However, this drug was found not to offer a survival benefit in the recent PROWESS-SHOCK study [9]. In the latest guidelines of Surviving Sepsis Campaign, rhAPC has been withdrawn [10]. Taken together, there is an urgent need for new effective therapies for DIC. Xuebijing (XBJ) injection is an intravenous preparation made from five traditional Chinese medicines, namely, Chishao (Radix Paeoniae Rubra), Danggui (Radix Angelica Sinensis), Chuanxiong (Rhizoma Chuanxiong), Honghua (Flos Carthami), and Danshen (Radix Salviae Miltiorrhizae). The bioactive roles of XBJ injection include activating circulation, removing blood stasis, and clearing away toxins [11]. Previous studies have confirmed that XBJ injection is effective for treating sepsis [12], and this drug has been formally approved by the State Food and Drug Administration of China for use in clinical practice. Although the effects of XBJ injection for treating sepsis have been established, there are few studies on XBJ injection in DIC. Some studies have shown that XBJ injection is also effective in treating patients with DIC [13, 14]. However, the dose and time of XBJ injection were not uniform, and the sample sizes were relatively small in these studies. Therefore, the main purpose of this study was to investigate the treatment effects of XBJ injection on DIC caused by severe sepsis. 2. Patients and Methods2.1. Patients and Settings This study included 171 adult severe septic patients with DIC who were admitted to the emergency intensive ca (...truncated)


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Qin Yin, Chunsheng Li. Treatment Effects of Xuebijing Injection in Severe Septic Patients with Disseminated Intravascular Coagulation, Evidence-Based Complementary and Alternative Medicine, 2014, 2014, DOI: 10.1155/2014/949254