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Objective To compare the clinical efficacy and safety of Qingyi Decoction (a preparation of Chinese herbal medicine) between two different routes of the administration by using nasogastric tube or nasojejunal tube for treatmnent of severe acute pancreatitis (SAP).Methods A total of 79 SAP patients enrolled were randomly divided into nasogastric tube group (n =41) and nasojejunal tube group (n =38) according to the random number table method.In addition to the conventional therapy,they were treated with Qingyi Decoction administered by using nasogastric tube or nasojejunal tube.Results After treatment for 14 days,the levels of C-reactive protein (CRP),procalcitonin (PCT) and white blood cell count (WBC),urinary bladder pressure,and APACHE Ⅱ score in nasojejunal tube group were significantly lower than those in nasogastric tube group (P ＜ 0.05).The time required for the recovery of bowel sounds,length of abnormal serum amylase persistence,the duration of abdominal pain,the time necessary for mechanical respiratory support in nasojejunal tube group was significantly shorter than those in nasogastric tube group.The blood fungus infection rate and pulmonary fungus infection rate in nasojejunal tube group were significantly lower than those in nasogastric tube group,and 28-day survival rate in nasojejunal tube group was significantly higher than that in nasogastric tube group (P ＜ 0.05).Conclusion The nasojejunal tube route for the administration of Qingyi Decoction for the treatment of SAP can effectively alleviate the severity of patient's condition,shorten the time required for improving clinical symptoms,reduce the incidence of morbidity and mortality,and it is worthy of further popularization in clinical practice.
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Objective To investigate the therapeutic mechanisms of Qingyi decoction on acute pan-creatitis in rats.Methods Forty-eight healthy male SD rats,weighing 250 ~300g,were randomly divided into 4 groups(n =12 each):sham operation group(group A),model group(group B),Qingyi decoction group(group C),and Sandostatin group(group D).AP models were established by injecting 5% sodium taurocholate(1ml/kg)into the biliopancreatic duct in group B,C,D.Qingyi decoction was administered oral-ly 1ml/100g)after model in group C and repeated after 12h.Sandostain (20μg/kg)was administrated by subcutaneous injection after model in group D and repeated after 12h.Groups A and B received equal vol-ume of normal saline.All rats were sacrificed 24 hours after AP modeling,At the same point time,the lev-els of serum amylase,tumor necrosis factor-α(TNF-α),interleukin-8 (IL-8)of the rats were measured, and the histopathological changes in pancreatic tissues were observed.Results The levels of serum amyl-ase,TNF-αand IL-8 were remarkably lower in Qingyi decoction group comparing with other group (P <0.05),When compared with the model group,the pathological manifestations in the pancreatic tissues were significantly attenuated in the Qingyi decoction group (P <0.05).Conclusions It indicated that Qingyi decoction can inhibit the release of TNF-αand IL-8 to reduce inflammation of SD rats with AP.
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Objective To explore the clinical efficacy of Qingyi decoction (a preparation of Chinese herbal medicine) combined with DAR (combined use of dexamethasone,anisodamine and rhubarb) for the treatment of acute pancreatitis.Methods A total of 387 eligible patients met the criteria of acute pancreatitis were enrolled from January 2005 to April 2012 for prospective study.All patients,mild acute pancreatitis (MAP) or severe acute pancreatitis (SAP),were divided (random niumber) into four groups,namely conventional therapy (T),DAR therapy (DAR),Qingyi decoction therapy (Q) and Qingyi decoction combined with DAR therapy (Q + DAR).Outcome,fasting time,serum amylase,abdominal pain relief time,pancreatic or peri-pancreatic complications and average hospital-stay were analvzed with SPSS 13.0 statistic software.P ＜ 0.05 was considered statistically significant.Results None of MAP patients died.Of SAP patients,there was no difference in mortality among different groups (P ＞ 0.05).length of fasting time,tine elapsed for abdominal pain relief,time required for normalized serum amylase level and length of hospital stay in MAP patients were significantly shorter than those in SAP patients regardless of different therapies (P ＜ 0.05).Either patients of SAP or MAP treated with Q + DAR or DAR suffered shorter length of time than those treated with T or Q in respect of fasting,abdominal paiu relief,serum amylase level normalization and hospital stay (P ＜ 0.05).For SAP or MAP patients,there was no difference in abdominal pain relief time between receiving DAR and Q + DAR treatment (P ＞ 0.05),but the fasting time in Q + DAR was shorter than that in DAR (P ＜ 0.05).Patients with SAP were more likely to suffer pancreatic or per-pancreatic complications than those with MAP,but there was no difference for SAP or MAP with different treatments.Conclusions DAR or Q + DAR was an alternative to conventional treatment for MAP or SAP,and they were both superior to conventional treatment.And Q + DAR was more advantageous than DAR when fasting time,hospital-stay time and cost were considered.
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10.3969/j.issn.1008-9691.2013.03.010
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[Objective] To discuss the clinical effect of SAP treated with Qingyi Decoction combined with mirabilite. [Method] Select 103 such cases, ran-domly divide them into treatment group 56 cases and control group 47 cases;both were given basic treatment of fasting, gastrointestinal decompression and anti-infection; the treatment group was added with Qingyi Decoction by nasal feeding and enema, and outer application of mirabilite. After treatment, compare their sitiuations of abdominal pain and distension, vomiting and nausea, recovery and relieve of life signs, in-hospital time and complications. [Result] The effecitve rate was 98.21% for treatment group, and 80.85% for control one, the difference between them had statistical meaning; the observa-tion indexes were better in treatment group than other one, with difference of statistical meaning. [Conclusion] Qingyi Decoction combined with mirabilite treating SAP can promote early recovery of gastro-intestinal function, effectively reduce infection, abdominal abscess, false cyst and other compli-cations, as wel as improve the prognosis.
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Objective To investigate the optimal initial timing of Qingyi Decoction and clyster with rhubarb in patients with severe acute pancreatitis (SAP). Methods Patients with SAP were randomly divided into 2 groups. The group A (n = 34) received clyster with rhubarb and Qingyi Decoction after 12 h of SAP onset and the group B (n = 27) received samel therapy after 72 h of onset of SAP. The serum levels of TNF-α, CRP and APACHE Ⅱ scores, time to abdominal pain cessation, length of hospital stay and medical costs were compared. Results The serum levels of TNF-α and CRP of patients in group A were (265±66)U/ml, (32.1 ±7.1) mg/L, and the score of APACHEⅡ were 6. 3±2.0, time to abdominal pain cessation was (4±2) d, length of hospital stay was (18±5)d, medical costs was (42 000±18 000) yuan; while the corresponding values in the group B were (491±81)U/ml, (43.5±11.0) mg/L, 9.1±1.8, (8±3)d, (34±8)d, (71 000±26 000)yuan, and the difference was statistically significantly (P<0.05). Conclusions Qingyi Decoction and clyster with rhubarb should be given in the early phase of SAP in order to achieve better outcomes.