Paper - WANFANG MED ONLINE

You Position: Home > Paper

Effects of traditional Chinese medicine on intestinal mucosal permeability in early phase of severe acute pancreatitis

( views:203, downloads:24 )

Author:: No author available

Journal Title:: CHINESE MEDICAL JOURNAL

Issue:: 12

DOI:: 10.3760/cma.j.issn.0366-6999.2010.12.011

Key Word:: medicine,Chinese traditional;Dachengqi decoction;pancreatitis,acute necrotizing;bacterial translocation

Abstract： Background Traditional Chinese medicine has been used widely for many years in China to treat acute pancreatitis.We have investigated the effects of Dachengqi decoction on intestinal mucosal permeability and outcome in patients with severe acute pancreatitis (SAP).Methods Forty patients with sustained SAP that required admission to the surgical intensive care unit were enrolled prospectively in the study. All of these patients were divided randomly into the Dachengqi decoction group (n=20) and control group (n=20) on admission. Intestinal permeability was assessed by measuring absorption of two metabolically inert markers, lactulose (L) and mannitol (M), which were administered orally. Serum concentrations of endotoxin (lipopolysaccharide, LPS) and the ratio of lactulose to mannitol in urine (L/M) were detected in all patients.Results Compared with those in the control group, urinary L/M ratio decreased significantly in the Dachengqi decoction group on the 7th day after admission (P=0.001). Also, serum concentrations of LPS were reduced on the 5th and 7th day after admission (P=0.006, P=0.008, respectively). Incidence of multiple organ dysfunction syndrome (MODS) and pancreatic infection was significantly lower in the Dachengqi decoction group compared with those in the control group (P=0.038, P=0.025, respectively).Conclusion Dachengqi decoction may promote the recovery of intestinal mucosal permeability and decrease the incidence of MODS and pancreatic infection in patients with SAP.

Reference

[1]GU Xi-dong,ZHANG Qin.Clinical Progress in the Treatment of Severe Acute Pancreatitis with Integrative Chinese and Western Medicine[J].2007,(3).
[2]Yu-qing ZHAO,Xiao-Hong Liu,Tetsuhide Ito,etc.Protective effects of rhubarb on experimental severe acute pancreatitis[J].2004,(7).
[3]YANG Dong-jie,HE Yu-long,CAI Shi-rong,etc.Early operation for fulminant acute pancreatitis: a possible way to decrease mortality[J].2009,(13).
[4]MAO En-qiang,TANG Yao-qing,FEI Jian,etc.Fluid therapy for severe acute pancreatitis in acute response stage[J].2009,(2).
[5]Min-Jie Zhang,Guo-Lei Zhang,Wen-Bin Yuan,etc.Treatment of abdominal compartment syndrome in severe acute pancreatitis patients with traditional Chinese medicine[J].2008,(22).
[6]程宇星,王萌,程霞,等.大柴胡汤治疗肝郁气滞型急性轻症胰腺炎的临床观察[J].2008,(9).
[7]张敏,朱德增,李兆申,等.赤芍煎剂治疗重症急性胰腺炎随机对照临床研究[J].2008,6(6).
[8]Shun-Cai Zhang,Wei Wang,Wei-Ying Ren,etc.Effect of cisapride on intestinal bacterial and endotoxin translocation in cirrhosis[J].2003,(3).
[9]薛平,邓力珲,张肇达,等.柴芩承气汤减轻急性胰腺炎大鼠胰腺钙超载的机制研究[J].2008,6(10).
[10]PENG Jun-sheng,LIU Zhong-hui,LI Chu-jun,etc.Development of a real-time PCR method for the detection of bacterial colonization in rat models of severe acute pancreatitis[J].2010,(3).
[11]Deitch EA,Magnotti LJ.Burns, bacterial translocation, gut barrier function, and failure.[J].2005,26(5).
[12]Uhl W,Rau B,Buchler MW,etc.Surgical treatment of infected necrosis.[J].1997,21(2).
[13]W A, Knaus,E A, Draper,D P, Wagner,etc.APACHE II: a severity of disease classification system.[J].1985,13.
[14]C. J. McKay,G. Gallagher,B. Brooks,etc.Increased monocyte cytokine production in association with systemic complications in acute pancreatitis[J].1996,83(7).
[15]Mayer J,Beger HG,Pralle U,etc.Natural course of acute pancreatitis.[J].1997,21(2).
[16]H G, Beger,R, Bittner,S, Block,etc.Bacterial contamination of pancreatic necrosis. A prospective clinical study.[J].1986,91.
[17]Munoz C,Feu F,Laveda R,etc.A Study of Intestinal Permeability in Relation to the Inflammatory Response and Plasma Endocab IgM Levels in Patients with Acute Pancreatitis.[J].2004,38(6).
[18]W, Qiong,W, Yiping,Y, Jinlin,etc.Chinese medicinal herbs for acute pancreatitis.[J].2005,(1).
[19]K S, Guice,K T, Oldham,M G, Caty,etc.Neutrophil-dependent, oxygen-radical mediated lung injury associated with acute pancreatitis.[J].1989,210.
[20]J H, Ranson,K M, Rifkind,D F, Roses,etc.Prognostic signs and the role of operative management in acute pancreatitis.[J].1974,139(1).
[21]S H, S?rensen,F J, Proud,A, Adam,etc.A novel HPLC method for the simultaneous quantification of monosaccharides and disaccharides used in tests of intestinal function and permeability.[J].1993,221(1-2).
[22]Gower WR Jr,Franz M,Norman J,etc.Interleukin-1 receptor antagonist decreases severity of experimental acute pancreatitis.[J].1995,117(6).
[23]A. C. De Beaux,A. S. Goldie,J. A. Ross,etc.Serum concentrations of inflammatory mediators related to organ failure in patients with acute pancreatitis[J].1996,83(3).
[24]J C, Marshall,D J, Cook,N V, Christou,etc.Multiple organ dysfunction score: a reliable descriptor of a complex clinical outcome.[J].1995,23.
[25]E L, Bradley.A fifteen year experience with open drainage for infected pancreatic necrosis.[J].1993,177(3).
[26].Study Progress in Therapeutic Effects of Traditional Chinese Medicine Monomer in Severe Acute Pancreatitis[J].2007,(2).
[27]G W, Fink,J G, Norman.Specific changes in the pancreatic expression of the interleukin 1 family of genes during experimental acute pancreatitis.[J].1997,9(12).
[28]A. C. de Beaux,J. A. Ross,J. P. Maingay,etc.Proinflammatory cytokine release by peripheral blood mononuclear cells from patients with acute pancreatitis[J].1996,83(8).
[29]Rosamonde E. Banks,S.W. Evans,D. Alexander,etc.Is fatal pancreatitis a consequence of excessive leukocyte stimulation? The role of tumor necrosis factor α[J].1991,3(1).
[30]R. Bittner,S. Block,M. BüchlerH. G. Beger.Pancreatic abscess and infected pancreatic necrosis[J].1987,32(10).
[31]E J Balthazar,D L Robinson,A J Megibow,etc.Acute pancreatitis: value of CT in establishing prognosis.[J].1990,174(2).
[32]G. Farkas,J. Márton,Y. Mándi,etc.Surgical strategy and management of infected pancreatic necrosis[J].1996,83(7).
[33]R D, Berg,A W, Garlington.Translocation of certain indigenous bacteria from the gastrointestinal tract to the mesenteric lymph nodes and other organs in a gnotobiotic mouse model.[J].1979,23.
[34]Basil J. Ammori,Paul C. Leeder,Roderick F. G. J. King,etc.Early increase in intestinal permeability in patients with severe acute pancreatitis: Correlation with endotoxemia, organ failure, and mortality[J].1999,3(3).