Effect of combined therapy of Yinchenhao Chengqi decoction and endoscopic sphincterotomy for endotoxemia in acute cholangitis

ＩＮＴＲＯＤＵＣＴＩＯＮＥｎｄｏｔｏｘｅｍｉａ（ＥＴＭ）ｉｓｏｎｅｏｆｔｈｅｍｏｓｔｉｍｐｏｒｔａｎｔｐｈｙｓｉｏｐａｔｈｏｌｏｇｉｃｃａｕｓｅｓｏｆａｃｕｔｅｃｈｏｌａｎｇｉｔｉｓａｎｄｉｔｉｓｔｈｅｔｒｉｇｇｅｒｏｆｃｙｔｏｋｉｎｅｓａｎｄｉｎｆ...

AIM To evaluate the therapeutic mechanism of Yinchenhao Chengqi (YCHCQ) decoction (containing mainly Herba Artemisia capillaris) combined with endoscopic sphincterotomy (EST) for endotoxemia (ETM) in acute cholangitis.METHODS Twenty-one cases of acute cholangitis with ETM were divided randomly into two groups: group A, 10 patients treated with YCHCQ decoction combined with EST, group B, 11 patients treated with EST. The incidence rate of ETM, plasmic ET, serum superoxide dismutase (SOD) activity, malonyldialdehyde (MDA), complement C3 and C-reactive protein (CRP) were studied respectively.RESULTS The ET level of group A (35.92ng/L±8.30ng/L) was significantly reduced after 7 days of treatment (P＜0.05) in contrast to that of group B (47.8ng/L±11.62ng/L), so did the level of MDA and CRP. But the SOD activity and C3 level in group A increased significantly (P＜0.05).CONCLUSION YCHCQ decoction combined with EST had a beneficial effect for ETM in acute cholangitis.INTRODUCTIONEndotoxemia (ETM) is one of the most important physiopathologic causes of acute cholangitis and it is the trigger of cytokines and inflammatory factors. In recent studies it has been found that Yinchenhao Chengqi (YCHCQ) decoction has a beneficial effect on ETM in acute cholangitis. With the development of endoscopic surgery, endoscopic sphincterotomy (EST) has become an effective replacement for some operations in the treatment of acute cholangitis[1]. The effect of YCHCQ decoction combined with EST on ET, oxygen free radical and complement C3 was observed in order to find out its therapeutic mechanism.