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Journal of Chinese Integrative Medicine ›› 2005, Vol. 3 ›› Issue (2): 103-107.doi: 10.3736/jcim20050206

Special Issue: Traditional Chinese Medicine

• Original Clinical Research • Previous Articles     Next Articles

Immuno-modulatory effect of somatostatin combined with traditional Chinese medicine on severe acute pancreatitis at early stage: A randomized control trial

Wen-fu Tang,Mei-hua Wan,Lin Zhu,Guang-yuan Chen,Qing Xia,Xi Huang   

  1. Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province 610041, China
  • Received:2005-01-16 Online:2005-03-20 Published:2005-03-20
  • Contact: Xi Huang E-mail:huangren@fmmu.edu.cn

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Objective

To evaluate the immuno-modulatory effect of short course administration of somatostatin (stilamin) continuously at early stage in patients with severe acute pancreatitis (SAP).

Methods

Thirty-nine patients with SAP (22 men, 17 women; the middle age was 49 years)were randomly allocated into control group (20 patients treated with non-surgical integrated traditional Chinese and Western medicine) and treatment group (19 patients treated with somatostatin administered intravenously at a dosage of 250 μg/h for consecutive 72 hours as well as the treatment for the control group). Laboratory parameters, including the expressions of CD3, CD4 and CD8 in lymphocytes (tested by flow cytometry) and C reactive protein (CRP), and indexes of therapeutic effect, including the occurrence of organic dysfunction, local complication and mortality between the two groups were compared. Another group of 30 healthy volunteers (19 men, 11 women; the middle age was 47 years) were recruited for testing the normal levels of CD3, CD4 and CD8.

Results

(1) The levels of CD3, CD4 and CD4/CD8 in lymphocytes before treatment in both groups were significantly lower than those in the healthy subjects (P<0.05), but there were no statistical differences between the two groups. At the 4th day, CD3, CD4 and CD4/CD8 increased significantly in the treatment group (P< 0.05) while no changes in the control group; the levels of CD4 and CD4/CD8 in the treatment group were also higher than those in the control group (P< 0.05). (2) The CRP levels of the 2 groups showed no statistical difference before and 4 days after the treatment, but the CRP level in the treatment group was significantly lower than that in the control group at the 7th day (P< 0.05). WBC count, serum levels of amylase, lipase, lactate dehydrogenase, aspartate aminotransferase, as well as the score of APACHE II in the treatment group recovered more quickly than those in the control group (P<0.05). (3) The occurrences of organic dysfunctions, local complications and mortality in both groups were not statistically different.

Conclusion

The short course administration of somatostatin continuously at early stage can reduce the inflammatory response, up-regulate the cell immune function and improve the conditions of the patients with SAP, but its effect on mortality and morbidity needs further study.

Key words: Acute pancreatitis, Somatostatin, Immune modulation, Chaiqin Chenqi Decoction, Integrated Chinese-Western therapy

CLC Number: 

  • R576.1

Tab 1

General patient data of 2 groups (Cases)"

Group n Age （years） Gender Cause of disease Severity degree
Male Female Cholelithiasis Alcohol High-fat food Others Ⅰ Ⅱ
Treatment 19 48±16 10 9 11 3 3 2 13 6
Control 20 50±15 12 8 12 2 4 2 12 8

Tab 2

Changes of laboratory parameters in 2 groups ($\bar{x}$±s)"

Group n WBC
(109/L)		 AST
(U/L)		 LDH
(U/L)		 Cr
(μmol/L)		 Amylase
(U/L)		 Lipase
(U/L)		 CRP
(mg/L)		 APACHE Ⅱ score
Control group
Before treatment 20 16.87±6.23 328±160 465±214 126±36 1 097±342 1 296±413 289±136 14.5±4.3
4 days after treatment 20 13.12±5.17 261±103 318±143 93±26 792±148 1 056±389 236±92 11.2±2.9
7 days after treatment 20 10.68±3.39 195±89 240±103 78±17 336±85 698±235 163±77 6.3±1.9
Treatment group
Before treatment 19 16.63±6.15 319±156 456±201 123±34 1 158±359 1 315±426 295±139 14.6±4.4
4 days after treatment 19 12.32±4.98 196±74* 211±97* 89±23 446±109* 840±255* 184±76 10.5±2.6
7 days after treatment 19 7.29±3.05* 102±81* 166±78* 80±19 125±39* 254±97* 109±43* 4.2±1.1*

Tab 3

Expression of cell markers of lymphocytes in 3 groups($\bar{x}$±s, %)"

Group n CD3 CD4 CD8 CD4/CD8
Healthy volunteers 30 60.50±11.36 28.03±6.14 32.47±7.90 0.91±0.28
Control group
Before treatment 20 43.05±17.89Δ 13.76±9.39Δ 31.05±10.24 0.41±0.19Δ
4 days after treatment 20 47.24±15.19Δ 14.25±8.34Δ 32.95±14.61 0.43±0.21Δ
Treatment group
Before treatment 19 40.23±21.37Δ 11.38±8.23Δ 28.91±17.12 0.42±0.21Δ
4 days after treatment 19 53.43±17.73*▲ 19.19±7.71*Δ▲ 33.06±18.18 0.65±0.26*Δ▲

Tab 4

Clinical results of 2 groups (Cases)"

Group n ARDS Ileus Gastrointestinal
hemorrhage		 Renal
dysfunction		 Sepsis Pseudocyst Pancreatic
infection		 Referred for
surgery		 Death
Control group 20 4 5 1 2 2 3 0 0 3
Treatment group 19 3 4 2 2 3 1 1 1 0
[1] Talamini G, Bassi C, Falconi M , et al. Risk of death from acute pancreatitis. Role of early, simple "routine" data[J]. Int J Pancreatol, 1996,19(1):15-24
doi: 10.1007/BF02788371
[2] Norman J . The role of cytokines in the pathogenesis of acute pancreatitis[J]. Am J Surg, 1998,175(1):76-83
doi: 10.1016/S0002-9610(97)00240-7 pmid: 9445247
[3] 唐文富, 陈光远, 张颖 , 等. CD4、CD8、CD95在急性胰腺炎中作用的中西医结合临床研究[J]. 华西医学, 2004,19(2):209-210
[4] 中华医学会外科学会胰腺学组. 急性胰腺炎的临床诊断及分级标准[J]. 中华外科杂志, 1997,35(12):773-775
[5] 黄宗文, 蒋俊明, 张肇达 , 等. 益活清下法为主治疗重症急性胰腺炎胰外器官损害与死亡原因分析[J]. 成都中医药大学学报, 1999,22(1):26-28
doi: 10.3969/j.issn.1004-0668.1999.01.011
[6] Larvin M , McMahon MJ.APACHE-Ⅱ score for assessment and monitoring of acute pancreatitis[J]. Lancet, 1989,2(8656):201-205
doi: 10.1016/S0140-6736(89)90381-4 pmid: 2568529
[7] Ferone D, van Hagen PM, Semino C , et al. Somatostatin receptor distribution and function in immune system[J]. Dig Liver Dis, 2004,36(Suppl 1):S68-S77
doi: 10.1016/j.dld.2003.11.020 pmid: 15077914
[8] Andriulli A, Leandro G, Clemente R , et al. Meta-analysis of somatostatin, octreotide and gabexate mesilate in the therapy of acute pancreatitis[J]. Aliment Pharmacol Ther, 1998,12(3):237-245
doi: 10.1046/j.1365-2036.1998.00295.x
[9] Cacallini G, Frulloni L . Somatostatin and octreotide in acute pancreatitis: the never-ending story[J]. Dig Liver Dis, 2001,33(2):192-201
doi: 10.1016/S1590-8658(01)80077-3 pmid: 11346150
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