ABSTRACT
Objective To observe the clinical efficacy of mirabilite and rheum officinale combined with pulse high-volume hemofiltration(PHVHF)in treatment of patients with severe acute pancreatitis(SAP). Methods A total of 11 patients with SAP in Department of Critical Care Medicine of Qiannan Traditional Chinese Medicine Hospital of Guizhou Province received the combined treatment of external application of mirabilite,gavage of rheum officinale decoction and PHVHF. The changes in abdominal symptoms,vital signs,blood gas analysis,blood biochemical indicators,and the acute physiology and chronic health evaluation(APACHEⅡ)score,Ranson score and prognosis were observed and compared before and after treatment. Results After treatment,the patients' fever〔body temperature(℃):37.31±0.13 vs. 39.12±0.12〕,tachycardia〔heart rate(beats/min):106±17 vs. 123±22〕, respiratory distress〔respiratory frequency(times/min):23±6 vs. 31±5〕and other symptoms were ameliorated in different degrees,and the APACHE Ⅱ score(9.1±2.2 vs. 21.2±8.2),Ranson score(3.2±1.1 vs. 5.8±1.3)were decreased significantly ,all the above indexes compared before and after treatment being of statistical significant differences(all P<0.05). The indexes of hemodynamics of 10 survival patients were stable,heart rate(beats/min:106±17 vs. 123±22)was decreased,and mean arterial pressure〔MAP,mmHg(1 mmHg=0.133 kPa):73±6 vs. 41±5〕was increased gradually(both P<0.05). After treatment,serum amylase〔AMY(U/L):367.3±102.3 vs. 923.5±351.7〕,alanine aminotransferase〔ALT(U/L):63.3±23.2 vs. 201.5±123.2〕,total bilirubin〔TBil (μmol/L):22.1±20.1 vs. 56.1±63.2〕,serum creatinine〔SCr(μmol/L):132.1±23.5 vs. 392.4±12.2〕,urea nitrogen〔BUN(mmol/L):9.5±4.9 vs. 19.2±5.9〕, K+(mmol/L:4.2±0.2 vs. 5.6±2.1) were significantly decreased,arterial partial pressure of carbon dioxide〔(PaCO2,mmHg):35.1±7.1 vs. 27.2±5.5〕,arterial partial pressure of oxygen〔PaO2(mmHg):93.2±13.2 vs. 49.1±7.2〕and oxygenation index(mmHg:187.1±28.5 vs. 148.2±32.7),Na+(mmol/L:132.1±19.1 vs. 127.1±42.1)were significantly increased compared with those before treatment, there were statistically significant differences(P<0.05 or P<0.01). Conclusion The combined treatment of mirabilite,rheum officinale and PHVHF has significant effects on the treatment of patients with SAP,and it can be one of the assistant therapies of SAP.