The Impact Of Chai Qin Cheng Qi Decoction On The Cholinergic Anti-inflammatory Pathway Of Patients With Severe Acute Pancreatitis

Objective To investigate the changes of the cholinergic anti-inflammatory pathway in patients with severe acute pancreatitis(SAP) and the impact of Chai Qin Cheng Qi Decoction (CQCQD) on the pathway.Methods To make a prospective study, 30 patients with AP that met the criteria were internalized, which have been admitted into the department of integrated western medicine and T.C.M of West China Hospital from June to Sepotember in 2006, there were 15 patients with mild acute pancreatitis (MAP) and 15 patients with SAP , and 10 healthy volunteers were taken as control group. Data that was recorded and analyzed in MAP and SAP group include: the severity of AP, biochemical indicators, hemogram, serum interleukin-6 (IL-6), TChE, and ChAT before and after treatment(the 5th day after admission) respectively.Results The serum IL-6 in SAP group were higher than those in MAP group (P=0.000) , both of them were higher than those in control group and decreased after treatment (P<0.05) . The serum TChE in SAP group were higher than those in MAP group and control group before treatment (P=0.000) , and the same result got after treatment (P=0.000) , but they decreased as compared with those before treatment (P=0.000) ; the serum ChAT in SAP group were lower than those in MAP group and control group before treatment and higher than the two groups after treatment (P<0.05) , they went up as compared with those before treatment (P=0.000). There was no significant difference between MAP group and control group of the serum TChE,ChAT before and after treatment (P>0.05). The APACHE II scores in SAP group and MAP group both declined after treatment (P<0.05) . The serum ALT,AST,TP,TG,Glu,CR,AMY,LIP and Hb,HCT in SAP group declined after treatment(P<0.05), and LDH went up(P<0.05), there was no significant difference between the serum Ca,TB and PLT,WBC before treatment and those after treatment (P> 0.05); the serum AST,Glu,AMY,LIP and Hb,HCT,WBC in MAP group declined after treatment (P<0.05) , and there was no significant difference between the serum Ca,TB,ALT,TP,TG,CR,LDH and PLT before treatment and those after treatment (P>0.05) .Conclusions 1.There is the changes of the cholinergic anti-inflammatory pathway in the pathophysiology process of SAP patients, the occurrence of SIRS is concerned with suppression of Cholinergic anti-inflammatory pathway, and this maybe have a hand in the transformation of SIRS to MODS in SAP patients. 2.CQCQD has an impact on the cholinergic antiinflammatory pathway of SAP patients with decreasing serum inflammatory mediator level and relieving SIRS. However, more studies are needed to reveal the mechanism of such impact.