Therapeutic effects of continuous blood purification combined with traditional Chinese medicine on systemic inflammatory response syndrome of severe acute pancreatitis patients

Abstract

Objective To observe the therapeutic effects of continuous blood purification(CBP) combined with traditional Chinese medicine on systemic inflammatory response syndrome(SIRS) of severe acute pancreatitis(SAP) patients on the base of routine treatment. Methods A total of 60 cases of severe acute pancreatitis patients were randomly divided into treatment group (continuous blood purification plus traditional Chinese medicine group,n=30) and control group(n=30).For all SAP patients,except recording vital signs daily, the changes of WBCs and biochemical indicator were recorded at the 0,1st,3rd,5th,7th day. The scores of APACHEⅡ were measured before and 7 days after treatment. The relief time of abdominal pain, the first defecation time, the incidence of operation and multiple organ dysfunction syndrome (MODS), case-fatality rate and mean hospitalized days were recorded and compared between the two groups. Results The 1st,3rd,5th,7th day after treatment every indicator (including body temperature, heart rate, respiratory rate, the sum of white blood cell and the level of plasma CRP and arterial blood lactate) in treatment group was reduced significantly more than that in control group(P＜0.05). At the 7th day after treatment, the score of APACHEⅡwas lower than that before treatment in the two groups(P＜0.05), and in treatment group that was more dramatically lowered(P＜0.01). The relief time of abdominal pain and the first defecation time in treatment group were significantly less than those in control group(P＜0.01). In the two groups,the serum amylase levels decreased at 1st compared to the value before therapy,but there was no difference between the two groups(P＞0.05),and the declination was most significant after therapy for 3,5 and 7 days. In addition, the serum amylase value was much lower in treatment group than that in control group at 3,5,7 days(P＜0.01); In treatment group, the incidence of operation and MODS, case-fatality rate were lower than those in control group(P＜0.05),and mean hospitalized days were lower significantly(P＜0.01).Conclusions On the base of routine treatment, application of continuous blood purification(CBP) combining with traditional Chinese medicine could significantly prevent SIRS development, improve prognosis.So we suggest early use of CBP and traditional Chinese medicine in SAP patients. Key words: Continuous blood purification; Traditional Chinese medicine; Severe acute pancreatitis; Systemic inflammatory response syndrome; Multiple organ dysfunction syndrome