摘要
Abstract
Objective To investigate the effect of intestinal mucosal barrier in the early enteral nutrition (EN) supplemented with Jinhong decoction in patients with severe acute pancreatitis (SAP). Methods Sixty-six SAP cases were randomly assigned into parenteral nutrition (PN) group , enteral nutrition(EN) group and Jin-hong decoction added EN(J+EN) group. In J+EN group, patients were given the nutrition same as that of EN, but added by Jinhong decoction .Blood samples were collected for the measurements of interleukin-6(IL-6)and tu-mor necrosis factor(TNF-α)by enzyme linked immunosorbent assay, and for C-reactive protein(CRP), procalcito-nin(PCT), amylase and lipase by biochemical assay the day before intervention of nutrition and on the 3rd and 8th days after intervention. Results The plasma levels of inflammatory mediators, amylase and lipase were sig-nificantly reduced after nutritional intervention as compared with their levels on the day before intervention in all three groups. The plasma levels of IL-6, TNF-α, CRP, PCT, amylase and lipase in EN group were(68.85± 15.99)ng/L、(29.11±9.15)ng/L、(2.88±2.27)ng/mL、(279.23±87.43)mg/L、(817±264)U/L、(1399±288)U/L at the third day after treatment, and (41.97 ± 11.11) ng/L、(12.37 ± 8.01) ng/L、(1.86 ± 1.05) ng/mL、(120.78 ± 34.45)mg/L、(250±78)U/L、(305±91)U/L at the eighty day after treatment, respectively. They were significant-ly less than those in PN group on the 3rd and 8th days. The plasma levels of IL-6, TNF-α, CRP, PCT, amylase(621 ± 204) U/L、(1266 ± 223) U/L, and (29.11 ± 9.11) ng/L、(10.91 ± 6.91) ng/L、(0.98 ± 0.75) ng/mL、(109.34 ± 27.58) mg/L、(196±59) U/L、(216±74) U/L at the eight day. They were significantly less than those in PN group and EN group. The levels of D-lactic acid in three groups had no significant difference at the 3rd day after treatment. The D-lactic acid level in EN group at the 8th day was(12.20±2.47) mg/L, less than that in J+EN group(10.01± 2.36) mg/L. Conclusion Early EN with Jinhong decoction would result in significant lowering levels of pro-in-flammatory cytokines and improve intestinal mucosal barrier, promote the recovery of SAP patients.关键词
重症急性胰腺炎/肠内营养/炎性介质/肠黏膜屏障/锦红汤Key words
Severe acute pancreatitis/enteral nutrition/intestinal mucosal barrier/inflammatory mediators/Jinhong decoction分类
医药卫生
