Objective  To explore the clinical efficacy of modified Xiaochaihu decoction combined with ulinastatin in the treatment of severe acute pancreatitis (SAP), and its effect on the markers of intestinal mucosal barrier function and inflammatory factors in patients.

Methods   The clinical data of SAP patients admitted to Wuhan Traditional Chinese Medicine Hospital Affiliated to Hubei University of Traditional Chinese Medicine from April 2020 to November 2022 were retrospectively collected for the study, and according to the treatment methods, the patients were divided into the treatment group of modified Xiaochaihu decoction combined with ulinastatin (double drug group) and ulinastatin monotherapy group (single drug group). Patients in the single drug group were treated with ulinastatin, and patients in the double drug group were treated with a combination of modified Xiaochaihu decoction on the basis of the single drug group for 2 weeks. The scores of traditional Chinese medicine (TCM) syndromes, Acute Physiology and Chronic Health Evaluation II (APACHE II) scores, intestinal mucosal barrier function, inflammatory factor levels, and total effective rate were compared between the two groups before and after treatment.

Results  A total of 82 SAP patients were included, including 41 in the double drug group and 41 in the single drug group. There was no difference between the single drug group and the double drug group in the TCM syndrome scores, APACHE II scores, serum diamine oxidase (DAO), D-lactate, interleukin-6 (IL-6), C-reactive protein (CRP), and tumor necrosis factor alpha (TNF-α) before treatment (P>0.05). After treatment, the TCM syndrome scores, APACHE II scores, serum DAO, D-lactate, IL-6, CRP, and TNF-α were all reduced (P<0.05), and these indicators in the double drug group were lower than those in the single drug group (P<0.05). After treatment, the total effective rate in the double drug group was higher than that in the single drug group [92.68% (38/41) vs. 75.61% (31/41), P<0.05].

Conclusion  The combination of modified Xiaochaihu decoction with ulinastatin can significantly improve the clinical symptoms, alleviate the progression of the disease, improve the barrier function of the gastrointestinal mucosa, reduce the level of inflammatory factors, and improve the clinical efficacy compared with ulinastatin alone, which is worthy of wide application in the clinic.

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