Clinical Observation on the Effect of Dexamethasone and Chinese Herbal Decoction for Purgation in Severe Acute Pancreatitis Patients

Objective: To investigate the effect of dexamethasone (Dx) combined with modified Dachengqi Decoction ((sic), DCQD), a Chinese herbal decoction for purgation, on patients with severe acute pancreatitis (SAP) accompanied with systematic inflammatory response syndrome (SIRS). Methods: A total of 81 patients diagnosed as SAP were randomly assigned to a control group or treatment group according to a random number table generated from in SPSS software. The patients in the control group (38 cases) received standard treatment and Chinese herbal decoction for purgation; those in the treatment group (43 cases) received additional 1 mg/(kg.d) dexamethasone (Dx) treatment for three days based on the above treatment. The mortality rate, acute respiratory distress syndrome (ARDS), renal failure, hemorrhage, sepsis, pancreatic pseudocyst, pancreatic abscess, operability, and days of hospitalization were compared between the two groups. Results: Three patients in the control group and eight patients in the treatment group dropped out from the study with a drop-out rate of 7.8% and 18.6%, respectively, and no statistics difference was shown between the two groups (P>0.05). Dx treatment significantly reduced ARDS rate and shortened the length of hospitalization compared to those in the control group (7/35, 20.0% versus 15/35, 42.9%, P=0.0394; 32.5 +/- 13.2 days versus 40.2 +/- 17.5 days, P=0.0344). Other parameters including the mortality rate were not significant different between the two groups. Conclusion: Dx combined with DCQD could decrease the risk of developing ARDS in SAP patients with SIRS and shorten their length of hospitalization.