Journal of Internal Medicine Concepts & Practice >

2024 , Vol. 19 >Issue 03: 153 - 158

DOI: https://doi.org/10.16138/j.1673-6087.2024.03.01

Original article

Effect of Shenfu injection on immune function in elderly patients with sepsis

  • LIU Di ,
  • QÜ Hongping ,
  • XÜ Zhihong ,
  • CAO Jiumei ,
  • ZHENG Lan ,
  • BAI Tingting
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  • a. Department of Critical Care Medicine; b. Department of Geriatrics; c. Department of Traditional Chinese Medicine，Ruijin Hospital, Shanghai Jiao Tong University School of Medicine,Shanghai 200025, China

Received date: 2023-08-30

  Online published: 2024-09-09

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Abstract

Objective To explore the effect of Shenfu injection on immune function in elderly patients with sepsis. Methods This study was a retrospective analysis. The elderly patients(n=126) with sepsis admitted to 4 hospitals including Shanghai Ruijin Hospital from January 2019 to December 2020 were divided into two groups according to whether Shenfu injection was used (61 cases in Shenfu group, 65 cases in control group). Basic data, comorbidities, relevant test results (including inflammatory factors, humoral immune indicators, cellular immune indicators, etc.), disease severity score, mortality rate, etc., were collected for statistical analysis. Results After seven days of Shenfu injection treatment, the indexes including the mean artery pressure (MAP), lactate (Lac), C-reactive protein (CRP), procalcitonin (PCT), prothrombin time (PT), activated partial thromboplastin time (APTT), interleukin-6(IL-6), IL-10, tumor necrosis factor-α(TNF-α), CD3 count, CD4 count, CD8 count, IgG, IgA and IgM of patients in 2 groups were significantly improved (all P<0.05). Compared with the control group, MAP(P=0.034), and the absolute count of CD3(P=0.002) and CD4(P=0.002) were significantly increased in the Shenfu treated group. Conclusions Shenfu injection combined with standard bundled regimen can improve the immune function and reduce inflammation in elderly patients with sepsis.

Key words： Elderly; Sepsis; Immune function; Inflammatory factors

Cite this article

LIU Di , QÜ Hongping , XÜ Zhihong , CAO Jiumei , ZHENG Lan , BAI Tingting . Effect of Shenfu injection on immune function in elderly patients with sepsis[J]. Journal of Internal Medicine Concepts & Practice, 2024 , 19(03) : 153 -158 . DOI: 10.16138/j.1673-6087.2024.03.01

References

[1] Singer M, Deutschman CS, Seymour CW, et al. The third international consensus definitions for sepsis and septic shock (sepsis-3)[J]. JAMA, 2016, 315(8):801-810.
[2] Levy MM, Evans LE, Rhodes A. The surviving sepsis campaign bundle: 2018 update[J]. Crit Care Med, 2018, 46(6):997-1000.
[3] Rudd KE, Johnson SC, Agesa KM, et al. Global, regional, and national sepsis incidence and mortality, 1990-2017[J]. Lancet, 2020, 395(10219):200-211.
[4] Mankowski RT, Anton SD, Ghita GL, et al. Older sepsis survivors suffer persistent disability burden and poor long-term survival[J]. J Am Geriatr Soc, 2020, 68(9):1962-1969.
[5] Martín S, Pérez A, Aldecoa C. Sepsis and immunosenescence in the elderly patient[J]. Front Med (Lausanne), 2017, 4:20.
[6] Hou X, Li C, Gu W, et al. Effect of Shenfu on inflammatory cytokine release and brain edema after prolonged cardiac arrest in the swine[J]. Am J Emerg Med, 2013, 31(8):1159-1164.
[7] 智屹惠, 王坤根, 王灵聪. 《中国严重脓毒症/脓毒性休克治疗指南(2014)》中医药部分解读[J]. 中华危重病急救医学, 2015, 27(6): 429-434.
[8] 高戈, 冯喆, 常志刚, 等. 2012国际严重脓毒症及脓毒性休克诊疗指南[J]. 中华危重病急救医学, 2013, 25(8): 501-505.
[9] Markwart R, Condotta SA, Requardt RP, et al. Immunosuppression after sepsis: systemic inflammation and sepsis induce a loss of na?ve T-cells but no enduring cell-autonomous defects in T-cell function[J]. PLoS One, 2014, 9(12): e115094.
[10] 中国医师协会急诊医师分会中国研究型医院学会休克与脓毒症专业委员会. 参附注射液急重症临床应用专家共识[J]. 中国急救医学, 2018, 38(11): 925-931.
[11] Huang P, Guo Y, Feng S, et al. Efficacy and safety of Shenfu injection for septic shock[J]. Am J Emerg Med, 2019, 37(12):2197-2204.
[12] 奚小土, 朱满刚, 刘云涛, 等. 参附注射液对脓毒症患者免疫功能、炎症指标的影响[J]. 新中医, 2018, 50(6): 72-76.
[13] Hotchkiss RS, Tinsley KW, Swanson PE, et al. Sepsis-induced apoptosis causes progressive profound depletion of B and CD4+ T lymphocytes in humans[J]. J Immunol, 2001, 166(11):6952-6963.
[14] McDunn JE, Turnbull IR, Polpitiya AD, et al. Splenic CD4+ T cells have a distinct transcriptional response six hours after the onset of sepsis[J]. J Am Coll Surg, 2006, 203(3):365-375.
[15] Martin MD, Badovinac VP, Griffith TS. CD4 T cell responses and the sepsis-induced immunoparalysis state[J]. Front Immunol, 2020, 11:1364.
[16] 张文钊, 王志斌. 脓毒症免疫抑制相关效应T细胞亚群稳态失衡的研究进展[J]. 中华危重病急救医学, 2022, 34(1): 95-99.
[17] Jensen IJ, Sjaastad FV, Griffith TS, et al. Sepsis-induced T cell immunoparalysis: the ins and outs of impaired T cell immunity[J]. J Immunol, 2018, 200(5):1543-1553.
[18] 王静, 张毅, 高艳玲. 脓毒症患者免疫指标与预后的关系[J]. 中华危重病急救医学, 2022, 34(9): 931-934.
[19] Zhang N, Liu J, Qiu Z, et al. Shenfu injection for improving cellular immunity and clinical outcome in patients with sepsis or septic shock[J]. Am J Emerg Med, 2017, 35(1): 1-6.
[20] Shankar-Hari M, Culshaw N, Post B, et al. Endogenous IgG hypogammaglobulinaemia in critically ill adults with sepsis[J]. Intensive Care Med, 2015, 41(8):1393-1401.
[21] Venet F, Gebeile R, Bancel J, et al. Assessment of plasmatic immunoglobulin G, A and M levels in septic shock patients[J]. Int Immunopharmacol, 2011, 11(12):2086-2090.
[22] Dietz S, Lautenschl?ger C, Müller-Werdan U, et al. Serum IgG levels and mortality in patients with severe sepsis and septic shock[J]. Med Klin Intensivmed Notfmed, 2017, 112(5):462-470.
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