Qixue Shuangbu decoction and acupuncture combined with Western medicine in acute severe stroke patients

BACKGROUND Stroke is a common and frequently occurring disease of the nervous system and one of the three major diseases leading to human death.The incidence and mortality of stroke in China increase with age.Overall,70%of patients with stroke have serious disability,which results in heavy burden to their families and the society.AIM To analyze the effects of Qixue Shuangbu decoction and acupuncture combined with Western medicine on immune indexes and digestive tract function in patients with acute severe stroke.METHODS A total of 68 patients with acute severe stroke admitted to Lanzhou Second People’s Hospital between March 2018 and September 2021 were selected and divided into the control and observation groups according to a random number table method.The control group was administered routine Western medicine treatment,such as dehydration,lowering intracranial pressure,anticoagulation,improving cerebral blood circulation and cerebral nerve protection according to the“Guidelines for the Diagnosis and Treatment of Acute Ischemic Stroke in China.”The observation group was administered Qixue Shuangbu decoction via nasal feeding tube on the basis of the routine Western medicine treatment with simultaneous acupuncture.The two groups were compared.RESULTS The acute physiology and chronic health evaluation II,organ dysfunction syndrome score,National Institutes of Health Stroke Scale,and traditional Chinese medicine syndrome scores of the two groups were significantly decreased compared with those measured before treatment,and the complements C3 and C4,and immunoglobulins(Ig)M and G were significantly increased compared with those observed before treatment(P<0.05).After treatment,the scores of the observation group were lower than those of the control group,and the complement and Ig levels were higher than those of the control group(P<0.05).The levels of diamine oxidase(DAO),Dlactic acid(D-LA),and calcitonin gene-related peptide(CGRP)in the two groups were significantly higher than those before treatment,while the levels of lipopolysaccharide,ubiquitin carboxyl-terminal hydrolase 1(UCH-L1),tumor necrosis factor-α(TNF-α),interleukin(IL)-2,and IL-8 were significantly lower than those before treatment(P<0.05).After treatment,DAO,D-LA,and CGRP were higher in the observation group than in the control group,while lipopolysaccharide,UCH-L1,TNF-α,IL-2,and IL-8 were lower than in the control group(P<0.05).The hospitalization time of individuals in the observation group was shorter than that of the control group(P<0.05).CONCLUSION Qixue Shuangbu decoction and acupuncture combined with Western medicine for the treatment of acute severe stroke can regulate intestinal flora,reduce inflammation,improve intestinal mucosal barrier function and immune function related indicators,and promote recovery.

Comparing the clinical application values of the Degree of Ulcerative Colitis Burden of Luminal Inflammation(DUBLIN)score and Ulcerative Colitis Endoscopic Index of Severity(UCEIS)in patients with ulcerative colitis

Background:The significance of endoscopic evaluation in the diagnosis and management of ulcerative colitis(UC)has been widely recognized.Over the years,scholars have established several endoscopic scores.Herein,we assessed the clinical application value of the Mayo Endoscopic Subscore(Mayo ES),the Degree of Ulcerative Colitis Burden of Luminal Inflammation(DUBLIN)score,and the Ulcerative Colitis Endoscopic Index of Severity(UCEIS)score in UC patients,by comparing their correlation with disease activity and their predictive potential for treatment response and clinical outcomes.Methods:UC patients hospitalized from September 2015 to September 2019 were retrospectively analysed.We employed Spearman’s rank correlation coefficient to assess the linear association of the assessed endoscopic scores with the clinical parameters.The receiver-operating characteristic curve was applied to evaluate the predictive capabilities of the endoscopic scores for treatment escalation and 1-year readmission.Results:A total of 178 patients were enrolled;most of them(82%)suffered moderate or severe colitis.Among them,48(27%)patients received treatment escalation and 59(33%)were readmitted within 1 year.The DUBLIN and UCEIS scores demonstrated higher correlations with clinical parameters than the Mayo ES.The DUBLIN scores significantly differed between patients with mild,moderate,and severe colitis(all P<0.001).The UCEIS scores demonstrated the best predictabilities for treatment escalation and 1-year readmission with an area under the curve of 0.88 and 0.75,respectively.Compared to the UCEIS and DUBLIN scores,the predictive capabilities of the Mayo ES for treatment escalation(both P<0.001)and 1-year readmission(P<0.001 and P紏0.002,respectively)were lower.The UCEIS scores exhibited a significant difference between the steroid-responsive group and the steroid-dependent or steroid-refractory group(both P<0.001),while no significant differences in the Mayo ES and DUBLIN scores were found among the three groups(both P>0.05).Conclusion:This study demonstrates that both the DUBLIN and UCEIS scores outperform the Mayo ES in assessing disease severity and predicting treatment response and clinical outcomes in UC patients.