Treatment of abdominal compartment syndrome in severe acute pancreatitis patients with traditional Chinese medicine

Zhang, Minjie; Zhang, Guolei; Wang, Yuan; Ni, Jun; Huang, Lifeng

doi:10.3748/wjg.14.3574

Cited by 48 publications

(32 citation statements)

References 24 publications

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“…Patients with SAP tend to have aelevated IAP, which can lead to IAH and subsequently to ACS. About 11-40 % of SAP patients suffer from complications of ACS (3,15). SAP patiets with ACS complications tend to have a mortality rate of 10-75 % (3,15,18).…”

mentioning

confidence: 99%

Intra-abdominal hypertension and acute pancreatitis

Mifkovič¹,

Skultety²,

Sýkora³

et al. 2013

BLL

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Intra-abdominal hypertension (IAH) contributes to organ dysfunction and leads to the development of the abdominal compartment syndrome (ACS). IAH and ACS are relatively frequent fi ndings in patiens with severe acute pancreatitis (SAP) and are associated with deterioration in organ functions. The most affected are cardiovascular, respiratory and renal functions. The incidence of IAH in patients with SAP is approximately 60-80%. There is an accumulating evidence in human and animal studies that changes of perfusion, particularly to the microvasculature, are crucial events in the progression of acute pancreatitis (AP). The perfusion of the small and large intestine is impaired due to reduced arterial pressure, increased vascular resistence and diminished portal blood fl ow. Bacterial translocation has been described in patients with ACS, and this may apply to patients with SAP. Approximately 30-40% of SAP patients develop ACS because of pancreatic (retroperitoneal) infl ammation, peripancreatic tissue edema, formation of fl uid collections or abdominal distension. Surgical debridement was the preferred treatment to control necrotizing pancreatitis in the past. However, the management of necrotizing pancreatitis has changed over the last decade. The main objective of this article is to describe the association between IAH and AP and to emphasize this situation in clinical praxis as well (Fig. 1

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mentioning

confidence: 99%

Intra-abdominal hypertension and acute pancreatitis

Mifkovič¹,

Skultety²,

Sýkora³

et al. 2013

BLL

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“…In order to improve the therapeutic effect of SAP, seeking cheap and effective drugs with fewer side effects has always been a hot spot during clinical studies of this disease [18][19][20][21]. The raw material of Salvia miltiorrhizae injection is the root of wild Salvia miltiorrhizae.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Mechanism of Salvia Miltiorrhizae Injection in the Treatment of Rats with Severe Acute Pancreatitis

Zhang

et al. 2009

Inflammation

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To study the efficacy and mechanism of Salvia miltiorrhizae injection in the treatment of severe acute pancreatitis. SAP rat models were prepared and randomly divided into model control group and treated group. The sham-operated group was also set. At 3, 6 and 12 h after operation, the mortality rate, ascitic volumes, pathological changes in the pancreas, contents of amylase and endotoxin in plasma as well as IL-6, IL-18, ET-1 and NO in serum, the staining intensity of Bax and NF-kappaB p56 proteins, and the changes in apoptosis index of pancreatic cells in rats in each group were observed. The pathological severity scores (at 3, 6 and 12 h after operation), contents of plasma endotoxin (at 6 and 12 h after operation) and serum IL-6 (at 6 and 12 h after operation) were significantly lower than those in model control group (P < 0.05, P < 0.01 and P < 0.01, respectively); the staining intensity and the product of the staining intensity and positive staining rate of Bax protein in the pancreas were significantly higher than those in model control group (P < 0.01). Salvia miltiorrhizae is able to reduce the contents of plasma endotoxin and serum IL-6, promote the expression of Bax protein in pancreas, improve the pathological changes in the pancreas, and decrease the mortality rate of rats, thereby showing therapeutic effect on rats with SAP.

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“…Decoction have usually applied to treat SAP in ancient and modern times (Zhang, 2008). They have a significant effect on SAP, and the main medicine of these two-classical herbal formula is rhubarb, indicating that rhubarb is used for the treatment of pancreatitis from ancient times.…”

Section: Classic Herbal Compounds Including Dachengqi Decoction and Qmentioning

confidence: 99%

Rhubarb combined with trypsin inhibitor for severe acute pancreatitis: A systematic review and meta‐analysis

Zhang

2018

Phytotherapy Research

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The objective of this study is to evaluate the efficacy and safety of rhubarb combined with trypsin inhibitor for severe acute pancreatitis (SAP). This meta-analysis was performed in accordance with the Transparent Reporting of Systematic Reviews and Meta-analysis protocol (PRISMA-P) and Cochrane Handbook. Relevant studies from inception to 2016 were searched through 7 related databases. The Cochrane Library was searched to assess the bias of the included trials. Data were analysed with Review Manager 5.3 software. A total of 16 randomized controlled trials (RCTs) involving 912 participants with SAP were included in this meta-analysis. The result showed that when compared with trypsin inhibitor used alone, rhubarb combined with trypsin inhibitor showed intensive effects on decreasing mortality, increasing overall efficacy, shorting length of hospitalization, reducing abdominal pain relief time, and decreasing the level of serum amylase. There was no serious adverse event reported in these RCTs. It should be noted that potential publication bias was observed. This meta-analysis demonstrated that rhubarb combined with trypsin inhibitor could be an effective and safe treatment for patients with SAP. However, the small sample size and poor quality of these RCTs should be noted. And more rigorously designed, multicentre, large-scale worldwide trials with more practitioners and higher quality are required.

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Treatment of abdominal compartment syndrome in severe acute pancreatitis patients with traditional Chinese medicine

Cited by 48 publications

References 24 publications

Intra-abdominal hypertension and acute pancreatitis

Intra-abdominal hypertension and acute pancreatitis

Efficacy and Mechanism of Salvia Miltiorrhizae Injection in the Treatment of Rats with Severe Acute Pancreatitis

Rhubarb combined with trypsin inhibitor for severe acute pancreatitis: A systematic review and meta‐analysis

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