Effects of traditional Chinese medicine on intestinal mucosal permeability in early phase of severe acute pancreatitis
Effects of traditional Chinese medicine on intestinal mucosal permeability in early phase of severe acute pancreatitis
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DOI：
10.3760/cma.j.issn.0366-6999.2010.12.011
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发表时间：
2010-06-20
影响因子：
6.1
通讯作者：
Sun Jia-bang
中科院分区：
文献类型：
--
作者：
Chen Hong;Li Fei;Sun Jia-bang
背景：中国多年来广泛应用中医药治疗急性胰腺炎。目的探讨大承气汤对重症急性胰腺炎(SAP)患者肠粘膜通透性及预后的影响。方法前瞻性研究40例重症急性胰腺炎(SAP)患者。入院时随机分为大承气汤组和对照组各20例。通过测定两种代谢惰性标志物乳果糖(L)和甘露醇(M)的吸收来评估肠道通透性。结果与对照组比较，大承气汤组入院第7天尿L/甘露醇比值明显降低(P=0.001)。入院后第5天和第7天血清内毒素水平均降低(P=0.006，P=0.008)。大承气汤组多器官功能障碍综合征(MODS)和胰腺感染的发生率明显低于对照组(P=0.038，P=0.025)。结论大承气汤可促进重症急性胰腺炎患者肠粘膜通透性的恢复，降低MODS和胰腺感染的发生率。中华医学杂志2010；123(12)：1537-1542
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. Chin Med J 2010;123(12):1537-1542