Influence of shenfu injection on intestinal mucosal barrier and SIR in severe multiple trauma patients

Abstract

Objective To observe the influence of Shenfu (SF) injection on intestinal mucosal barrier and systemic inflammatory response(SIR) in severe multiple trauma patients and study its mechanism.Methods Seventy- six multiple trauma patients [ injury severity score(ISS) ＞ 20 ] were selected and assigned randomly to SF treatment group (38 cases) or control group (38 cases).All patients were treated with classical therapy. Meanwhile,patients in SF group were infused with Shenfu (SF) injection.Shock index were measured at 12,24,48,72 h after trauma,and the gastric intramucosal pH value( pHi),blood samples were collected 1,3,7 d after trauma for plasma levels of D - lactate,and the plasma contents of TNF - α,IL - 6 were determined.Results At the beginning of SF treatment,there were no significant differences in gastric PHi,D - lactate,TNF - α and IL - 6 between the two groups ( P ＞ 0.05 ).In SF group,shock index at 12,24,48 h after trauma and PHi at 24,48,72 h were significantly different from that in control group( P ＜0.05).Plasma levels of D -lactate and the plasma contents of TNF -α,IL -6 3,7 d after trauma decreased significantly in SF group than that in control group ( P ＜0.05).Conclusions SF can protect gastrointestinal and inhibit SIR in severe multiple trauma patients,its mechanism may be that SF rapid restore hemodynamic stability,improve microcirculation and can improve gastrointestinal mucosal perfusion and oxygenization,protect structure of mucosal cell and its barrier function,inhibit inflammatory mediators release. Key words: Severe trauma; Shenfu injection; Intestinal mucosal barrier; Inflammatory mediators