A clinical research of external application of mirabilite on intestinal mucosal barrier and prognosis in patients with acute pancreatitis / 中国中西医结合急救杂志

ABSTRACT

Objective To investigate the effect of external application of mirabilite on gastrointestinal dysfunction, permeability of intestinal mucosa, morbidity of complications and prognosis in patients with acute pancreatitis (AP).Methods A prospective, randomized, controlled study was conducted, a total of 64 patients with AP admitted to the Department of Gastroenterology of the First People's Hospital of Wujiang District from July 2014 to December 2016 were enrolled, and they were randomly divided into a mirabilite group and a control group, 32 cases in each group. The patients in both groups received conventional therapy for AP, while the patients in mirabilite group additionally received external application of mirabilite for consecutive 7 days. The changes of gastrointestinal function score, intra-abdominal pressure (IAP), serum diamine oxidase (DAO) and D-lactate were observed after treatment for 1, 3, 7 days, and the morbidity of complications, the rate of transfer to another hospital, the beginning time of enteral nutrition (EN) and length of stay in hospital of the two groups were statistically analyzed.Results After treatment in the two groups, the levels of gastrointestinal function score, levels of IAP, DAO and D-lactate in two groups showed a tendency firstly increased and then decreased, the gastrointestinal function score, DAO level after treatment for 3, 7 days and IAP and D-lactic acid levels after treatment for 7 days were significantly lower in the mirabilite group than those in the control group [the gastrointestinal function score: 3 days was 2.23±0.18 vs. 2.35±0.19, 7 d was 1.76±0.27 vs. 1.92±0.28; DAO (kU/L): 3 days was 3.24±0.25 vs. 3.41±0.31, 7 days was 3.13±0.24 vs. 3.31±0.32; 7 days IAP (mmHg, 1 mmHg = 0.133 kPa) was 6.43±2.34 vs. 8.22±2.97, D-lactic acid (mmol/L) was 18.09±3.99 vs. 20.02±3.58, all P < 0.05]. The beginning time of EN (days: 2.21±0.42 vs. 2.46±0.38), morbidity of abdominal compartment syndrome [ACS: 3.13%(1/32) vs. 21.88%(7/32)] and the length of stay in hospital (days: 19.25±4.67 vs. 22.14±6.31)in mirabilite group were all significantly lower than those in control group (allP < 0.05).Conclusions The external application with mirabilite might reduce gastrointestinal function score and IAP, improve permeability of intestinal mucosa, and lower the morbidity of ACS and hospital length of stay.