Treatment of abdominal compartment syndrome in severe acute pancreatitis patients with traditional Chinese medicine.
OBJECTIVE
To investigate the therapeutic effect of traditional Chinese traditional medicines Da Cheng Qi Decoction (Timely-Purging and Yin-Preserving Decoction) and Glauber's salt combined with conservative measures on abdominal compartment syndrome (ACS) in severe acute pancreatitis (SAP) patients.


METHODS
Eighty consecutive SAP patients, admitted for routine non-operative conservative treatment, were randomly divided into study group and control group (40 patients in each group). Patients in the study group received Da Cheng Qi Decoction enema for 2 h and external use of Glauber's salt, once a day for 7 d. Patients in the control group received normal saline (NS) enema. Routine non-operative conservative treatments included non-per os nutrition (NPON), gastrointestinal decompression, life support, total parenteral nutrition (TPN), continuous peripancreatic vascular pharmaceutical infusion and drug therapy. Intra-cystic pressure (ICP) of the two groups was measured during treatment. The effectiveness and outcomes of treatment were observed and APACHE II scores were applied in analysis.


RESULTS
On days 4 and 5 of treatment, the ICP was lower in the study group than in the control group (P < 0.05). On days 3-5 of treatment, acute physiology and chronic health evaluation II (APACHE II) scores for the study and control groups were significantly different (P < 0.05). Both the effectiveness and outcome of the treatment with Da Cheng Qi Decoction on abdominalgia, burbulence relief time, ascites quantity, cyst formation rate and hospitalization time were quite different between the two groups (P < 0.05). The mortality rate for the two groups had no significant difference.


CONCLUSIONS
Da Cheng Qi Decoction enema and external use of Glauber's salt combined with routine non-operative conservative treatment can decrease the intra-abdominal pressure (IAP) of SAP patients and have preventive and therapeutic effects on abdominal compartment syndrome of SAP.
Department of General surgery, Affiliated Central Hospital of Huzhou Normal College, Huzhou 313000, Zhejiang Province, China. zmjys@yahoo.com.cn
Min-Jie
MJ
Zhang
Guo-Lei
GL
Zhang
Wen-Bin
WB
Yuan
Jun
J
Ni
Li-Feng
LF
Huang
D018806:APACHE; D034841:Abdominal Cavity / Q000503:physiopathology; D000208:Acute Disease; D000328:Adult; D000368:Aged; D003161:Compartment Syndromes / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D004365:Drugs, Chinese Herbal / Q000008:administration & dosage / Q000627:therapeutic use; D004733:Enema; D005260:Female; D006801:Humans; D006973:Hypertension / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008516:Medicine, Chinese Traditional; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D010195:Pancreatitis / Q000150:complications*; D010936:Plant Extracts; D016896:Treatment Outcome
D004365:Drugs, Chinese Herbal; D010936:Plant Extracts; C477169:dachengqi decoction