Therapeutic effectiveness analysis of Xuebijing, Xiyanping combined with naloxone in the treatment of acute coagulation disorders during severe thoracoabdominal injuries

Abstract

Objective To observe the therapeutic effectiveness of the early intervention of Xuebijing (XBJ) Xiyanping and Naloxone (NX) in acute coagulation disorders during severe thoracoabdominal injuries.Methods Severe thoracoabdominal injury patients with trauma index (TI) ≥ 17 points except the ones associated craniocerebral injuries and died in emergency department were randomly divided into two groups:a intervention group (n=82) and a control group (n=47); The patients were all collected at 253th Hosptital of PLA between January 2009 and June 2012.The intervention group was tested at the time of arriving at the emergency department and the time of leaving the emergency department to the inpatient department for platelet count (PLT),D-dimer (D-D),activated partial thromboplastin (APPT),prothrombin time (PT),thromboplastin time (TT),tumor necrosis factor-α (TNF-α),lipopolysaccharide (LPS),interleukin-6 (IL-6),phospholipase A2 (PLA2) and platelet-activating factor (PAF).The control group was just tested at the time of leaving the emergency department for the same items.Results At the time of arriving at the emergency department,PLT was (83.44±38.52) 109/L,D-D was (1 823.89±608.02) U/L,APTT was (68.24±24.12) s,PT was (28.42± 10.83) s,TT was (58.27 ± 12.44) s,PLA2 (41.35 ± 14.26) ng/ml,PAF (15 765.31 ± 4431.65) ng/L; At the time of leaving the emergency department,PLT was (127.59±27.18) 109/L,D-D was (769.42± 106.34)U/L,APTT was (49.11 ±12.76) s,PT was (19.51 ±8.23) s,TT was (31.44±9.17) s,PLA2 (19.16±7.11)ng/ml,PAF (6 722.56± 1 049.34)ng/L;At the time of leaving the emergency department the records of the control group of severe thoracoabdominal injury patients,PLT was (89.22±31.27) 109/L,D-D was (1 814.45±643.18) U/L,APTT was (63.48±28.27) s,PT was (27.79 ± 11.94) s,TT was (60.51 ± 14.23) s,PLA2 (44.71 ± 16.52) ng/ml、PAF (15 933.07 ± 4573.19) ng/L.After the intervention the records of PLT were higher,the ones of D-D、APTT、PT、TT were lower; the records of TNF-α、LPS、IL-6、PLA2 and PAF were significantly lower than the time before intervention and the control group (all P＜0.01).Conclusion XBJ,Xiyanping and NX can significantly improve the acute coagulation disorders during severe thoracoabdominal injuries which have important significance in reducing incidence rate of complication,preventing multiple organ dysfunction score (MODS),improving prognosis and increasomg survival rate. Key words: Severe thoraco-abdominal injuries; Acute coagulation disorders; Xuebijing; Xiyanping; Naloxone; Treatment effectiveness analysis