Effects Of Rhubarb And Mirabilite On The Patients’ Intra-abdominl Pressure And The Prognosis Of Acute Pancreatitis

ObjectiveTo observe the effects of rhubarb and mirabilite on the patients’intra-abdominl pressure andthe effects on the prognosis of acute pancreatitis and compare with western conventionalmedicine, and verify its effectiveness, safety in order to promote clinical applicationMethods:1.Clinical data：All60cases are hospitalized patients with acute pancreatitis.of2006-01to2011-09from Affiliated Hospital of Hebei University Department of Integrated Chinese andWestern medicine.Using a randomized, parallel method, according to the1:1ratio, the casesare divided into the treatment group (Western medicine treatment adding rhubarb andmirabilite group) in30cases and the comparasion group (Western medicine therapy group)in30cases. All cases of acute pancreatitis diagnosis: clinical symptoms are abdominal pain,nausea, vomiting, fever, blood and serum amylase significantly increased performance;Ultrasound or CT confirmed pancreas have corresponding imaging changes, with diagnosticand classification criteria (Digestive Disease Branch of Chinese Medical Association ofpancreatic disease study group of Chinese acute pancreatitis. Diagnosis and treatmentguidelines (draft). Diagnosis of traditional Chinese medicine (Chinese medicine according tothe principle of clinical research on new drugs (first series) associated with acute pancreatitis:epigastric tingling or pain, abdominal distention, nausea and vomiting, fever, throat pain,urine yellow, constipation, dark red tongue petechia, ecchymosis or tongue yellow, dry, pulsea few strings or sliding. The treatment group and the comparasion group patients in sex, age,course of disease, clinical manifestation etc, by statistical inspection, no significantdifferences (p>0.05).2.Therapeutic method:The comparasion group is treated with no eating, gastrointestinaldecompression; inhibiting pancreatic enzyme secretion, application of proton pump inhibitors,somatostatin; the supply liquid, preventing shock microcirculation improvement; the earlynutritional support, TPN, EN after the recovery of gastrointestinal function; the preferred antibiotic selection of quinolone or three generation cephalosporins; the maintenance of vitalorgan function such as machinery ventilation for respiratory support, CRRT removal ofinflammatory mediators to improve renal function. The treatment group: in the comparasiongroup on the basis of the treatment adding rhubarb15grams, boiling water10minutes andcooling before into stomach, each100ml, closed tube for1hours, three times a day. Externalapplication of mirabilite on abdomen: mirabilite of500grams twisted into fine foam, placedin the bag to pave, placed in the upper and middle abdomen, fixed by abdominal belt, hardcrystalline timely replacement of2-3times, every day, until the symptoms disappear. Thecomparasion group and the treatment group both underwent intra-abdominal pressuremeasurement. Pressure measurement using the indirect method, which is bladder pressuremeasurement. Recording intra-abdominal pressure changes, C-reactive protein concentrationand APACHEII score of two groups before and after treatment, ie preliminarw diagnosis dayand course of treatment finished day. Then the treatment effect was evaluated.3. The effect and safety of observation: The clinical symptoms before and after treatment(exhaust defecation time, abdominal pain, abdominal distention disappearance time, bloodamylase recovery time) and intra-abdominal pressure changes as efficacy evaluation statistics.Testing C-reactive protein and APACHEII score changes before and after treatment as aprognostic evaluation of statistical data. Before and after treatment in newly diagnosed on thefirst day and after administration of the7d for laboratory examination, including the blood,urine, excrement routine, liver and kidney function (alanine aminotransferase, urea nitrogen,creatinine and ALT BUN Cr), coagulation (TT PT thrombin time, prothrombin time,fibrinogen FB, activated partial thromboplastin time APTT), results of laboratoryexamination as the safety observation statistics.4. Statistical Methods: we analyze the data，the count materials were examined withχ2, themeasuring materials were examined with t-test, the grade materials with Ridit.Result:1. Acute pancreatitis outcome analysis: The treated group’s total effective rate is90.00%, thecomparasion group’s total effective rate is73.33%. There is difference between the two groups with statistical analysis (P<0.05). The results show that rhubarb and mirabilite onacute pancreatitis obviously improve the recovery of patients.2. Change of intra-abdominal pressure: The treated group’s total effective rate is93.33%, thecomparasion group’s total effective rate is73.33%. There is difference between the twogroups with statistical analysis (P<0.05).The results show that rhubarb and mirabilite on acutepancreatitis of intra-abdominal pressure can obviously improve the recovery of patients.3. C-reactive protein and APACHEII score changes: after the treatment, the treatment groupand the comparasion group of C-reactive protein concentration and APACHEII score bystatistical analysis, two groups were decreased, and the treatment group decreasedsignificantly better than the comparasion group. The results show that rhubarb and mirabiliteon the prognosis of acute pancreatitis have significant improvement.4. Adverse effects and side effects: There are no side-effects in both groups. Two groups oflaboratory results (three conventional, liver and kidney function, blood clotting) before andafter the treatment all did not appear in the abnormal changes associated with therapy. Itexplains that the drug is non-toxic, without side effects, safety, and its curative effect isreliable.ConclusionThe results of the study indicate that:the treatment group and the comparasion group withacute pancreatitis clinical judgement, intra-abdominal pressure changes, C-reactive proteinconcentration and APACHEII score, by statistical analysis comparison, the result has thedifference (P <0.05). The results show that rhubarb, Mirabilite significantly reducedintra-abdominal pressure,in patients with acute pancreatitis and significantly improved theprognosis of patients. At the same time the safety testing, suggests that the drug has notoxicity and side effects, safe and reliable, has good clinical application prospect.