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


CONCLUSIONS
Dachengqi decoction may promote the recovery of intestinal mucosal permeability and decrease the incidence of MODS and pancreatic infection in patients with SAP.
Chen
Hong
H
Department of General Surgery, Xuan Wu Hospital of Capital Medical University, Beijing 100053, China.
Li
Fei
F
Jia
Jian-guo
JG
Diao
Yong-peng
YP
Li
Zong-xin
ZX
Sun
Jia-bang
JB
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004365:Drugs, Chinese Herbal / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000378:metabolism; D007413:Intestinal Mucosa / Q000187:drug effects* / Q000378:metabolism / Q000473:pathology*; D008297:Male; D008516:Medicine, Chinese Traditional / Q000379:methods*; D008875:Middle Aged; D010195:Pancreatitis / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism; D055815:Young Adult
D004365:Drugs, Chinese Herbal; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha