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Evidence-Based Complementary and Alternative Medicine
Volume 2013, Article ID 759748, 8 pages
http://dx.doi.org/10.1155/2013/759748
Research Article

Traditional Chinese Medicine Diagnosis “Yang-Xu Zheng”: Significant Prognostic Predictor for Patients with Severe Sepsis and Septic Shock

1Department of Chinese Medicine, National Defense Medical Center, Tri-Service General Hospital, Taipei 11490, Taiwan
2Graduate Institute of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung 40402, Taiwan
3School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung 40402, Taiwan
4Department of Internal Medicine, Nantou Hospital, Department of Health, Executive Yuan, Nantou 54062, Taiwan
5Rehabilitation Institute of Chicago, Chicago, IL 60611, USA
6Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
7Graduate Institute of Biostatistics, China Medical University, Taichung 40402, Taiwan
8Department of Traditional Chinese Medicine, Taichung Veterans General Hospital, Taichung 40705, Taiwan

Received 14 July 2013; Accepted 13 September 2013

Academic Editor: Shibing Su

Copyright © 2013 Sunny Jui-Shan Lin et al. 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

Pathogenesis of sepsis includes complex interaction between pathogen activities and host response, manifesting highly variable signs and symptoms, possibly delaying diagnosis and timely life-saving interventions. This study applies traditional Chinese medicine (TCM) Zheng diagnosis in patients with severe sepsis and septic shock to evaluate its adaptability and use as an early predictor of sepsis mortality. Three-year prospective observational study enrolled 126 septic patients. TCM Zheng diagnosis, Acute Physiology and Chronic Health Evaluation (APACHE) II score, and blood samples for host response cytokines measurement (tumor necrosis factor-α, Interleukin-6, Interleukin-8, Interleukin-10, Interleukin-18) were collected within 24 hours after admission to Intensive Care Unit. Main outcome was 28-day mortality; multivariate logistic regression analysis served to determine predictive variables of the sepsis mortality. APACHE II score, frequency of Nutrient-phase heat, and Qi-Xu and Yang-Xu Zhengs were significantly higher in nonsurvivors. The multivariate logistic regression analysis identified Yang-Xu Zheng as the outcome predictor. APACHE II score and levels of five host response cytokines between patients with and without Yang-Xu Zheng revealed significant differences. Furthermore, cool extremities and weak pulse, both diagnostic signs of Yang-Xu Zheng, were also proven independent predictors of sepsis mortality. TCM diagnosis “Yang-Xu Zheng” may provide a new mortality predictor for septic patients.