A Clinical Study On Therapeutic Effects Of Rhubarb On Intestinal Permeability In Septic Patients

Backgroud Gut is the special organ which is in the body and interface with outside. Intestine is almost in the bacterialess state.It is the main organ which provide for energe for the body. At the same time , it involved in immunity, barrier, metabolize, incretion, and so on, inner the body. In the recent years, studys have showed that stomach and intestine actively involve in the critical physical and pathological course. Severe injury, shock and infection can result in the intestinal permeability. There are several reasons which lead to MODS. They are microzoology unbalance in the gastric and intestinal and bacterial translocation into the circle system. Rhubarb is a kind of traditional Chinese medicine.It is believed that Rhubarb has the function that can reduce the intestinal permeability. Lots of works Cheng Dechang have madeproved that rhubarb can prevent the bacterial translocation , reduce the intestinal permerbility. The most of his works were animal experiments. Because he used the endotoxin as the moniter index in his clinical experiment , the result can not reflect the intestinal permeability accurately. At present , the accurate index testing the intestinal permeability is the ratio of lactulose and mannitol. For using two molecule probes to monitor, at the same time , it excludes the effects of gastric and intestinal disease, kidney disfunction and so on.So it increase accuracy significantly. Our experiment is to study the therapeutic effect on the intestinal permeability and sepsis.Objective To study the therapeutic effects of rhubarb on intestinal permeability in septic patients.Methods A total of 40 septic patients were enrolled in this study and randomly divided into two groups, rhubarb treatment group (n=18) and control group(n=22). lactulose/mannitol test was performed on the first day and the 4th day after patients were enrolled. 10g of lactulose and 5gof mannitol were given, urine was collected for 6 hours. The mannitol and lactulose concentration were determined by HPLC-RI, and the L/M ratio can be counted. An observation was carried out on the effect of rhubarb on L/M ratio , levels of endotoxin and procalcitonin in serumn and D-lactate in plasma.Results No significant difference of L/M ratio, levels of endotoxin and procalcitonin in serumn and D-lactate in plasma on the first day were found between the rhubarb treatment group and the control group(P>0.05). The L/M ratio of the 4th day of control group was 0.1674 ± 0.0361 , and that of the rhubarb treatment group was 0.0621 ± 0.0128. There is significant difference between two groups(P<0. 05). The levels of procalcitonin in serumn and D-lactate in plasma of the 4th day of the the rhubarb treatment group were 2. 01 ±0. 61 ug/L and 0. 09 ±0. 03 ng/L respectively, were obviously higher than those of control group (5. 41 ±1.40 ug/L and 0.24 + 0.06 ng/L) (P<0.05). In addition, no evident difference of the level of endotoxin in serumn was found between the rhubarb treatment group and the control group of the 4th day(P>0. 05).conclusions Rhubarb can prevent the intestinal permeability and relieve the sepsis.