大承气汤降低急性胰腺炎腹内高压

Da-Cheng-Qi Decoction reduces intra-abdominal hypertension in severe acute pancreatitis: a pilot study

We evaluated effect of modified Da-Cheng-Qi Decoction (DCQD) on intra-abdominal hypertension (IAH) in patients with severe acute pancreatitis (SAP). A randomised, placebo controlled trial of modified DCQD therapy in patients with predicted SAP was conducted. Forty-two patients were enrolled from West China Hospital over the period January to December 2008, and were randomly divided to DCQD treatment group and placebo group. Randomisation stratified for Acute Physiology and Chronic Health Evaluation II (APACHE II) score, treatment group and placebo group were similar at baseline. Intra-abdominal pressure (IAP) was assessed by measuring intravesical pressure. Compared to placebo group, modified DCQD treatment significantly decreased IAP on day 4-8 (p < 0.05), APACHE-II score on day 6-8 (p < 0.05), CRP on day 8 (p < 0.01), renal failure rate (p < 0.05) and length of hospitalization (LOH) (p < 0.05). Moreover, oxygenation index was significantly improved in DCQD group than placebo group (p < 0.05). However, there were no statistically significant differences in Balthazar CT score, shock rate, intensive care unit transfer rate, and mortality between the two groups.In conclusion, this study provided evidence that modified DCQD can effectively relieve IAH and decrease LOH for patients with SAP. However, larger clinical trials are still needed to justify our findings.