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Horváth IL, Bunduc S, Fehérvári P, Váncsa S, Nagy R, Garmaa G, Kleiner D, Hegyi P, Erőss B, Csupor D. The combination of ulinastatin and somatostatin reduces complication rates in acute pancreatitis: a systematic review and meta-analysis of randomized controlled trials. Sci Rep 2022; 12:17979. [PMID: 36289288 PMCID: PMC9606296 DOI: 10.1038/s41598-022-22341-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 10/13/2022] [Indexed: 01/30/2023] Open
Abstract
Currently, there is no specific pharmaceutical agent for treating acute pancreatitis (AP). Somatostatin and its analogues have been used to prevent the autolysis of the pancreas in AP, however, their effectiveness has not been confirmed. This investigation aimed to examine the efficacy of ulinastatin, a protease inhibitor, combined with somatostatin analogues in the treatment of AP. We conducted a systematic database search in 4 databases to identify randomized controlled trials in which the efficacy of ulinastatin in combination with somatostatin analogue was compared to somatostatin analogue alone in patients with AP. Since the patient populations of analysed papers were slightly different, we used random effect models to pool odds ratios (OR) and mean differences (MD) and the corresponding 95% confidence intervals (CI). A total of 9 articles comprising 1037 patients were included in the meta-analysis. The combination therapy significantly reduced the complication rates for acute respiratory distress syndrome, acute kidney injury, and multiple organ dysfunction. Symptoms were relieved threefold with the combination therapy compared to somatostatin alone, and combination therapy significantly shortened the length of hospital stay. The decrease in mortality was not statistically significant..
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Affiliation(s)
- István László Horváth
- grid.11804.3c0000 0001 0942 9821Centre for Translational Medicine, Semmelweis University, Üllői út 26, 1085 Budapest, Hungary ,University Pharmacy Department of Pharmacy Administration, Hőgyes Endre utca 7-9, 1092 Budapest, Hungary
| | - Stefania Bunduc
- grid.11804.3c0000 0001 0942 9821Centre for Translational Medicine, Semmelweis University, Üllői út 26, 1085 Budapest, Hungary ,grid.11804.3c0000 0001 0942 9821Division of Pancreatic Diseases, Heart and Vascular Center, Semmelweis University, Baross út 22-24, 1085 Budapest, Hungary ,grid.8194.40000 0000 9828 7548Carol Davila University of Medicine and Pharmacy, Dionisie Lupu Street 37, 020021 Bucharest, Romania ,grid.415180.90000 0004 0540 9980Fundeni Clinical Institute, Fundeni Street 258, 022328 Bucharest, Romania
| | - Péter Fehérvári
- grid.11804.3c0000 0001 0942 9821Centre for Translational Medicine, Semmelweis University, Üllői út 26, 1085 Budapest, Hungary ,grid.483037.b0000 0001 2226 5083Budapest Department of Biomathematics and Informatics, University of Veterinary Medicine, István utca 2, 1078 Budapest, Hungary
| | - Szilárd Váncsa
- grid.11804.3c0000 0001 0942 9821Centre for Translational Medicine, Semmelweis University, Üllői út 26, 1085 Budapest, Hungary ,grid.11804.3c0000 0001 0942 9821Division of Pancreatic Diseases, Heart and Vascular Center, Semmelweis University, Baross út 22-24, 1085 Budapest, Hungary
| | - Rita Nagy
- grid.11804.3c0000 0001 0942 9821Centre for Translational Medicine, Semmelweis University, Üllői út 26, 1085 Budapest, Hungary ,grid.9679.10000 0001 0663 9479Institute for Translational Medicine, Medical School, University of Pécs, Szigeti út 12, 7624 Pécs, Hungary ,grid.413987.00000 0004 0573 5145Heim Pál National Pediatric Institute, Üllői út 86, 1089 Budapest, Hungary
| | - Gantsetseg Garmaa
- grid.11804.3c0000 0001 0942 9821Centre for Translational Medicine, Semmelweis University, Üllői út 26, 1085 Budapest, Hungary ,grid.11804.3c0000 0001 0942 9821Institute of Translational Medicine, Semmelweis University, Nagyvárad tér 4, 1089 Budapest, Hungary
| | - Dénes Kleiner
- grid.11804.3c0000 0001 0942 9821Centre for Translational Medicine, Semmelweis University, Üllői út 26, 1085 Budapest, Hungary ,University Pharmacy Department of Pharmacy Administration, Hőgyes Endre utca 7-9, 1092 Budapest, Hungary
| | - Péter Hegyi
- grid.11804.3c0000 0001 0942 9821Centre for Translational Medicine, Semmelweis University, Üllői út 26, 1085 Budapest, Hungary ,grid.9679.10000 0001 0663 9479Institute for Translational Medicine, Medical School, University of Pécs, Szigeti út 12, 7624 Pécs, Hungary ,grid.11804.3c0000 0001 0942 9821Division of Pancreatic Diseases, Heart and Vascular Center, Semmelweis University, Baross út 22-24, 1085 Budapest, Hungary ,grid.9679.10000 0001 0663 9479János Szentágothai Research Center, University of Pécs, Szigeti út 12, 7624 Pécs, Hungary
| | - Bálint Erőss
- grid.11804.3c0000 0001 0942 9821Centre for Translational Medicine, Semmelweis University, Üllői út 26, 1085 Budapest, Hungary ,grid.9679.10000 0001 0663 9479Institute for Translational Medicine, Medical School, University of Pécs, Szigeti út 12, 7624 Pécs, Hungary ,grid.11804.3c0000 0001 0942 9821Division of Pancreatic Diseases, Heart and Vascular Center, Semmelweis University, Baross út 22-24, 1085 Budapest, Hungary ,grid.9679.10000 0001 0663 9479János Szentágothai Research Center, University of Pécs, Szigeti út 12, 7624 Pécs, Hungary
| | - Dezső Csupor
- grid.11804.3c0000 0001 0942 9821Centre for Translational Medicine, Semmelweis University, Üllői út 26, 1085 Budapest, Hungary ,grid.9679.10000 0001 0663 9479Institute for Translational Medicine, Medical School, University of Pécs, Szigeti út 12, 7624 Pécs, Hungary ,grid.9008.10000 0001 1016 9625Institute of Clinical Pharmacy, University of Szeged, Szikra utca 8, 6725 Szeged, Hungary
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Yang JF, Chen S, Xia HW. Efficacy of ulinastatin combined with octreotide for patients with severe pancreatitis: Effect on clinical symptoms, serological markers and safety. Shijie Huaren Xiaohua Zazhi 2018; 26:1778-1783. [DOI: 10.11569/wcjd.v26.i30.1778] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM To evaluate the efficacy of ulinastatin combined with octreotide in the treatment of severe pancreatitis and the effect on clinical symptoms, serological indicators and safety.
METHODS Ninety-four patients with severe pancreatitis who were treated at Guangdong Provincial People's Hospital from February 2016 to January 2018 were randomly divided into an experimental group (46 cases) and a reference group (48 cases). The reference group was treated with octreotide alone, and the experimental group was treated with octreotide combined with ulinastatin. The treatment lasted 2 wk in both groups. Clinical curative effect, serological parameters, amylase, intestinal mucosal function index and complications were compared between the two groups.
RESULTS The total effective rate in the experimental group was 95.65%, which was significantly higher than that of the reference group (83.33%; P < 0.05). Time to disappearance of abdominal pain, nausea, vomiting and peritoneal irritation, time to first defecation, time to bowel sound recovery and hospital stay in the experimental group were significantly shorter than those of the reference group (P < 0.05), and the mortality rate was significantly lower than that of the reference group (P < 0.05). There was no significant difference in serum C-reactive protein, tumor necrosis factor-α, interleukin-18, interleukin-6, blood amylase, urine amylase, occludin, diamine oxidase or endotoxin levels between the two groups before treatment (P > 0.05). After treatment intervention, the above-mentioned indicators improved significantly in both groups, and the experimental group improved significantly better than those of the reference group (P < 0.05). The incidence of acute respiratory distress syndrome, acute renal failure and shock in the experimental group was significantly lower than that of the reference group (P < 0.05). There was no significant difference in the incidence of pancreatic encephalopathy syndrome or metabolic dysfunction between the two groups (P > 0.05).
CONCLUSION Ulinastatin combined with octreotide has good clinical effects in severe pancreatitis patients and can improve treatment efficiency, clinical symptoms and serological indicators, protect the intestinal mucosal function, and reduce the incidence of complications.
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Affiliation(s)
- Jin-Fen Yang
- Department of Pharmacy, Zhejiang Rongjun Hospital, Jiaxing 324000, Zhejiang Province, China
| | - Sheng Chen
- Department of General Surgery (Division Ⅲ), Guangdong Provincial People's Hospital, Guangzhou 510000, Guangdong Province, China
| | - Heng-Wu Xia
- Department of General Surgery (Division Ⅲ), Guangdong Provincial People's Hospital, Guangzhou 510000, Guangdong Province, China
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Liang YY, Huang LF, Wang JY. Value of continuous blood purification combined with Qingyi Lidan granules in treatment of severe acute pancreatitis. Shijie Huaren Xiaohua Zazhi 2018; 26:735-741. [DOI: 10.11569/wcjd.v26.i12.735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM To observe the effect of continuous blood purification combined with Qingyi Lidan granules in patients with severe acute pancreatitis with regard to biochemical indexes, inflammatory indexes, and therapeutic effects.
METHODS The clinical data of 150 patients with severe acute pancreatitis treated at Shaoxing Second Hospital from April 2012 to April 2017 were retrospectively analyzed. Among them, 70 patients were given continuous blood purification therapy as a control group, and the other 80 patients were given continuous blood purification combined with Qingyi Lidan granules based on conventional therapy, as an observation group. Biochemical indicators, inflammatory indicators, APACHE Ⅱ score, CTSI score, and therapeutic effects were compared between the two groups.
RESULTS After treatment, APACHE II score was significantly lower in the observation group than in the control group (10.22 ± 2.58 vs 14.03 ± 2.91, P < 0.05). The time to disappearance of abdominal distension and abdominal pain and hospital stay were significantly shorter in the observation group than in the control group (P < 0.05). AMS, LPS, Cr, AST, ALT, and PCT in the observation group were significantly lower than those in the control group (P < 0.05). The levels of IL-8, IL-6, TNF-α, HSP70, HSP72, and HMGB1 in the observation group were also significantly lower than those in the control group (P < 0.05). The total effective rate was significantly higher in the observation group than in the control group (93.75% vs 71.43%, P < 0.05). The mortality rate did not differ significantly between the control group and observation group (8.57% vs 6.25%). The incidence of complications in the control group was significantly higher than that of the observation group (28.57% vs 12.5%, P < 0.05).
CONCLUSION Continuous blood purification combined with Qingyi Lidan granules in patients with severe acute pancreatitis can significantly reduce the inflammatory response and improve biochemical indexes and therapeutic effects.
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Affiliation(s)
- Ying-Ying Liang
- Department of ICU Nursing, Shaoxing Second Hospital, Shaoxing 312000, Zhejiang Province, China
| | - Lan-Fang Huang
- Department of ICU Nursing, Shaoxing Second Hospital, Shaoxing 312000, Zhejiang Province, China
| | - Jin-Ying Wang
- Department of ICU Nursing, Shaoxing Second Hospital, Shaoxing 312000, Zhejiang Province, China
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