Treatment Of Hyperlipidemic Pancreatitis Research Articles

Narrative review of the mechanisms of action of dachengqi decoction in the treatment of hyperlipidemic pancreatitis on six-hollow-organs to be unblocked theory

The incidence rate of acute pancreatitis (AP) caused by hyperlipidemia is increasing year by year. The primary treatment goal is to reduce blood lipids rapidly. On the theory of "Six-hollow-organs to be unblocked" we used dachengqi decoction (original prescription of Zhang Zhongjing in Shanghan Lun) to block the peroxisome proliferator-activated receptor γ (PPARG) pathway and rapidly reduce blood lipid to achieve the purpose of treating hyperlipidemic acute pancreatitis (HLAP). In this review, we summarize the etiology and pathogenesis of HLAP and the progress of traditional Chinese medicine in treating HLAP. The mechanisms of action of dachengqi decoction in the treatment of HLAP and the involvement of the PPARG pathway were discussed. In brief, the dachengqi decoction has the effect of resolving phlegm and clearing waste substances and can improve intestinal function; can inhibits the production of interleukin-1, interleukin-6, and tumor necrosis factor-α, and reduces the damage of SIRS to human body; also it improves the microcirculation system by inhibiting the production of inflammatory factors, reducing, or eliminating the damage to vascular endothelial cells and microvessels, and improving vascular permeability. The clarification of the mechanisms of action of the drug is conducive to the extensive clinical application of the classical formula.

Saikosaponin a attenuates hyperlipidemic pancreatitis in rats via the PPAR-γ/NF-κB signaling pathway.

The therapeutic effect of saikosaponin a (SSa) on hyperlipidemic pancreatitis (HP) is not completely understood. The aim of the present study was to investigate the therapeutic effect and the underlying mechanism of SSa using a rat model of HP. Following successful establishment of the HP rat model, different doses of SSa (low dose group, 10 mg/kg or high dose group, 20 mg/kg) were administrated. Histopathological examination, the wet/dry (W/D) ratio and myeloperoxidase (MPO) activity of the pancreatic tissues were assessed. The lipid, amylase (AMY), lipase and proinflammatory cytokine profiles in serum, as well as the expression of peroxisome proliferator-activated receptor (PPAR)-γ and the NF-κB signaling pathway-related proteins in pancreatic tissues were evaluated. The results showed that SSa effectively attenuated pancreatic pathological injury and reduced both the W/D ratio and MPO activity compared to the HP model rats. SSa also improved lipid metabolism by significantly decreasing the serum levels of total cholesterol and triglycerides (P<0.05). Following the administration of SSa, the activity of AMY and lipase, as well as the levels of the proinflammatory cytokines tumor necrosis factor-α, interleukin (IL)-1β and IL-6 were reduced, particularly in the high dosage group (P<0.05). Furthermore, SSa activated PPAR-γ expression and suppressed the NF-κB signaling pathway in pancreatic tissues. The present study suggested that SSa attenuated HP in rats by increasing lipid metabolism and inhibiting the release of proinflammatory cytokines via the NF-κB inflammatory pathway. The results from the present study indicated that SSa might be a promising therapeutic agent for the treatment of HP.

Plasmapheresis Treatment for a Pregnant Woman with Extremely Severe Hyperlipidemic Pancreatitis: A Case Report

Background: The etiology and pathogenesis of hyperlipidemic pancreatitis are not yet fully understood, and the relationship between the severity and different causes of this disease is still not clear. Now the treatment of hyperlipidemic pancreatitis is mainly to reduce the elevated serum triglyceride and control the secondary risk factors. For severe hyperlipidemic pancreatitis, which can deteriorate in a very fast speed, more efficient and effective therapeutic methods are needed. Case presentation: The patient was a 32-year-old Chinese woman in her 32-week gestation. She was previously healthy, and came to have a sudden onset of acute pancreatitis induced by hyperlipidemia. Her situation deteriorated rapidly, and she simultaneously developed fetal death, respiratory failure, acute renal injury, and severe infections in the lungs, abdominal cavity and the wound. Besides traditional therapies, we used plasmapheresis treatment and successfully saved her life. Conclusion: In recent years, hyperlipidemic pancreatitis and hyperlipidemic pancreatitis during pregnancy seem to happen more frequently than before. For the extremely severe hyperlipidemic pancreatitis, plasmapheresis seems to be a safe and efficient therapeutic approach, and is often needed to save the patients’ lives. However, evidence for evaluating the efficiency and safety of plasmapheresis in the treatment of hyperlipidemic pancreatitis is still scarce, and we think high-quality, large-scale RCTs in this field are needed for further studies. In addition, by reporting this case, we want to remind general readers to pay attention to adopting a healthy lifestyle, and to encourage researchers and healthcare professionals to continue this research.

Hypolipemic treatment of hyperlipidemic pancreatitis with enema

Objective To investigate hypolipemic treatment of hyperlipidemic panereatiti(HLP)with integrated traditional Chinese and western medicine.Methods Cinical data of 20 patients of HLP were analyzed retrospectively.Eight patients in the control group were treated with conventional therapies,while 12 patients in the treatment group were treated as follows:①Enema with 180ml solution(50% magnesium sulfate 30 ml.Glycerin 60ml,water 90ml).②Rhubarb gastrogavage with 9 g tid.③Intravenous drip with 24 g salvia miltiorrhiza qd.Results The treatment group had significant difference comparing with the control group in terms of the serum TG in 48 hours(P<0.01),time of autonomous bowel movement recover(P<0.01),days of abdominal pain disappear(P<0.05),days of hospitalization(P<0.01).Conclusion The treatment of Enema with 180 ml solution.Rhubarb gastrogavage with 9g tid,and Intravenous drip with 24 g salvia miltiorrhiza qd can relieve the symptoms of HLP and decrease blood-fat greatly. Key words: Hyperlipidemic panereatitis; Hypolipcmic treatment; Integrated traditional Chinese and western medicine

Treatment of Hyperlipidemic Pancreatitis in Pregnancy With Total Parenteral Nutrition

A 29-yr-old pregnant woman presented in her third trimester with severe pancreatitis, hyperlipidemia, and small-for-dates fetus. Studies suggested that her pancreatitis was caused by profound hypertriglyceridemia, which was the result of an underlying lipoprotein disorder exacerbated by pregnancy. Throughout the first 7 wk of hospitalization, attempts to refeed the patient with solid food and various elemental diets resulted in the induction of hypertriglyceridemia and relapses of pancreatitis. Concern for the nutritional status of the mother and the possibility of further growth retardation of the fetus prompted the use of total parenteral nutrition for the last 2 wk of gestation. This treatment was well tolerated by the mother, promptly reversed maternal weight loss, caused a rapid resolution of her pancreatitis, and did not induce further hypertriglyceridemia. This report documents that total parenteral nutrition may be safely and effectively used in the management of hyperlipidemic pancreatitis in pregnancy.