Effects of traditional Chinese medicine on intestinal mucosal permeability in early phase of severe acute pancreatitis

Background Traditional Chinese medicine has been used widely for many years in China to treat acute pancreatitis.We have investigated the effects of Dachengqi decoction on intestinal mucosal permeability and outcome in patients withsevere acute pancreatitis (SAP).Methods Forty patients with sustained SAP that required admission to the surgical intensive care unit were enrolledprospectively in the study. All of these patients were divided randomly into the Dachengqi decoction group (n=20) andcontrol group (n=20) on admission. Intestinal permeability was assessed by measuring absorption of two metabolicallyinert markers, lactulose (L) and mannitol (M), which were administered orally. Serum concentrations of endotoxin(lipopolysaccharide, LPS) and the ratio of lactulose to mannitol in urine (L/M) were detected in all patients.Results Compared with those in the control group, urinary L/M ratio decreased significantly in the Dachengqi decoctiongroup on the 7th day after admission (P=0.001). Also, serum concentrations of LPS were reduced on the 5th and 7th dayafter admission (P=0.006, P=0.008, respectively). Incidence of multiple organ dysfunction syndrome (MODS) andpancreatic infection was significantly lower in the Dachengqi decoction group compared with those in the control group(P=0.038, P=0.025, respectively).Conclusion Dachengqi decoction may promote the recovery of intestinal mucosal permeability and decrease theincidence of MODS and pancreatic infection in patients with SAP.