| Objective:To study the effects on intestinal barrier function of Qing fei cheng qi granules in severe acute pancreatitis complicated with ALI/ARDS patients. Subjects and methods:45patients of severe acute pancreatitis complicated with ALI/ARDS, who are28males and17females with a median age of54.95±10.09years old(range18-70years),have been continuously observed in SICU of Naikai hospital. Their APACHE II scores are11.50±2.37points. The study is a randomized, controlled, double-blind clinical study. Through the China Academy of traditional Chinese medicine clinical evaluation center.we randomized patients. Qing fei cheng qi granules are provided form the Jiang yin Tian jiang Pharmaceutical Company. Complete the study task, We applied for a blind exposure, confirmed the experimental agent group and placebo group. On the1st,3rd,7th day. we put the20ml lactulose and25ml mannitol through the stomach tube into their stomach. Then collected6h urine. Examed the L/M value. By using the Limulus Amebocyte Lysate (LAL) test for the peripheral blood endotoxin. Calculation of APACHE II scores, number of involved organs, oxygenation index, whether the use of respirator, statistical prognosis.Results:24cases in the experimental group,1case of death, for males, survived for30days. The control group of21cases,3cases died, including2male cases, female1cases, the survival days were10days,13days,30days. Overalled in45cases,4cases died, the overall mortality rate was8.89%.Two groups of SICU days, total hospital stay, hospital charges, ventilator days, using the number of blood purification are significant different. The experimental group, the median survival time was45days,25days in control group, the experimental group was significantly lower than the control group (P<0.05).In two groups before treatment showed intestinal barrier dysfunction, and L/M, the serum endotoxin level (ET), oxygenation index showed no significant differences.With the treatment is carried out,showed significant difference in two group, P<0.05. L/M and ET, oxygenation index are closely related to.[the correlation coefficient (r) were0.876,-824].Endotoxin level and oxygenation index were significantly correlated (r=-0.854).Conclusion:The Qing fei cheng qi granules,by reducing the permeability of the intestinal mucosa,decreasing endotoxmia, protecing intestinal barrier function, made its fatality rate significantly lower than that of placebo (control) group, prolonging the survival time, reducing the length of hospital stay and hospital costs, its efficacy is worth affirmation. Objective:To study the influence on immune balance of Qing fei cheng qi granules in severe acute pancreatitis complicated with ALI/ARDS patients. Subjects and methods:45patients of severe acute pancreatitis complicated with AII/ARDS, who are28males and17females with a median age of54.95±10.09years old (range18-70years), have been continuously observed in Naikai hospital SICU.Their APACHE II scores were11.50±2.37points. The study is a randomized, controlled, double-blind clinical study. Through the China Academy of traditional Chinese medicine clinical evaluation center,we randomized patients.Qing fei cheng qi granules are provided form the Jiang yin Tian jiang Pharmaceutical Company. Complete the study task, We applied for a blind exposure,confirmed which was the experimental agent group and placebo group. On the1st,3rd,7th day, we examed their human leucocyte antigen DR site(HLA-DR),the helper T lymphocyte1/2(Thl/Th2) and the regulatory T lymphocyte in the peripheral blood. Calculated their APACHE II scores, number of involved organs, oxygenation index, whether the use of respirator, statistical prognosis.Results:the experimental group24cases,1cases of death, for males, survived for30days. The control group of21cases,3cases died, including2male cases, female1cases, the survival rate was10days,13days,30days. Overall in45cases,4cases died, the overall mortality rate of8.89%.Two groups of SICU days, total hospital stay, hospital charges, ventilator days, using the number of blood purification are significant different. The experimental group, the median survival time was45days,25days in control group, the experimental group was significantly lower than the control group (P<0.05). In two groups before treatment in patients with HLA-DR (%), Th1/Th2, Treg (%) had no significant difference (<0.05).With treatment, the experimental group at each time point (HLA-DR%) values were significantly higher than that of control group (P<0.05).The experimental group after the treatment group,3rd day HLA-DR (%) were significantly higher than those before treatment, after treatment, the7st day value was significantly higher than that in3rd day (P<0.05).The control group, at each time point showed no difference (P<0.05).The experimental group Th1/Th2showed increased first then decreased, while the control group showed continued to decline. The experimental group Treg (%) showed decreased first and then increased, while the control group showed continued to rise. The value of experimental group were significantly lower than in control group (P<0.05).The experimental group, after treatment with3r day Treg%was significantly lower than that before treatment, after treatment, the7th day value was significantly higher than that in3rd day (P<0.05), and significantly higher than those before treatment. The control group, after treatment with3rd day Treg%was significantly higher than before treatment, after treatment, the7th day value was significantly higher than that in3rd day (P<0.05). and significantly higher than those before treatment. Treg%and Thl/Th2were closely related, r=-0.854.Conclusion:The Qing fei Cheng qi granules promoted the expression of HLA-DR, developed the ability of presenting antigen, removing of pathogens, while kept the immune balance, the anti-inflammatory/pro-inflammatory reaction tends to balance, improved immunity, thereby ameliorating oxygenation index, promoting the restoration of organ function, improving the survival rate. |
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