Rhubarb combined with early enteral nutrition in the treatment of severe acute pancreatitis

Abstract:

Objective：To observe the efficacy of Rhubarb combined with early enteral nutrition in the treatment of severe acute pan－creatitis（SAP）. Methods：Totally 74 patients with SAP were admitted to intensive care unit（ICU） and were randomly divided into 3 groups：Rhubarb with early entneral nutrition group（Rhubarb group），total parenteral nutrition group（TPN group） and early enteral nutrition group（EEN group）. At the 1st，3rd，7th d and the 14th d after admission，serum interleukin-18（IL-18），C-reactive protein（CRP） and serum amylase（AMY） were detected；APACHE Ⅱ scores were recorded and length of abdominal pain，recovery time of bowel sounds and body temperature，length of stay in ICU，average length of stay were observed. Resuluts：The length of abdominal pain，recovery time of bowel sounds and body temperature，length of stay in ICU and average length of stay were significantly shorter in Rhubarb group compared with those in the other groups（P＜0.05）. At the 3th d，level of serum CRP was obviously lower in Rhubarb group than in TPN group（P＜0.05）；at the 7th d，level of serum CRP was the lowest in Rhubarb group，with statistaical differnces among three groups（P＜0.05）. At the 7th d and the 14th d，level of serum IL-18 was obviously lower in Rhubarb grpup than in EEN group and TPN group（P＜0.05）；at the 14th d，there were significant diffeneces in level of serum IL-18 between Rhubarb grpup and EEN group（P＜0.01）. Conclusions：Rhubarb combined with early enteral nutrition can enhance intestinal peristalsis，protect the gastroin－testinal barrier function，reduce bacteria and endotoxin translocation and releasing of inflammation mediators，especially IL-18 and reduce cost of treatment.