• 대한한방내과학회지
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• 제41권3호
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• pp.306-325
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• 2020

Objectives: The aim of this study is to investigate the effect of a Dachaihu decoction for hyperlipidemic acute pancreatitis (HLAP) by systematic review and meta-analysis of Chinese clinical studies. Methods: China National Knowledge Infrastructure (CNKI) was utilized as the major search engine. The date of the literature search was March 7, 2020. Randomized controlled trials (RCTs) about using a Dachaihu decoction for HLAP were included in this study. Meta-analysis was performed by synthesizing outcome data, including total effective rate, abdomen pain relief time, first bowel movement time, blood amylase recovery time, and triglyceride (TG) levels (mmol/L). The selected literature was assessed using Cochrane's risk of bias (RoB). Results: Twelve of 44 RCTs met the inclusion criteria. Most studies were evaluated with RoB as having unclear risk. The total effective rate of herbal medicine treatment based on the Dachaihu decoction was significantly higher than that of symptomatic supportive treatment in 10 articles (risk ratio=1.15, 95% CI: 1.08 to 1.21, p<0.00001, I²=0%). Herbal medicine treatment based on a Dachaihu decoction was significantly more effective than symptomatic supportive treatment in terms of reducing abdomen pain relief time (in all articles; mean difference=-1.70, 95% CI: -1.91 to -1.41, p<0.00001, I²=45%), first bowel movement time (in 7 articles; mean difference=-1.46, 95% CI: -1.86 to -1.05, p<0.00001, I²=73%), blood amylase recovery time (in 8 articles; mean difference=-1.48, 95% CI: -2.04 to -0.92, p<0.00001, I²=90%), and TG levels (in 8 articles; mean difference=-1.59, 95% CI: -2.28to -0.91, p<0.00001, I²=90%). Only one article reported side effects of treatment among the intervention group and control group, citing pancreatic ulcer and pancreatic pseudocyst formation. Conclusions: This study suggests that herbal medicine treatment based on a Dachaihu decoction could yield higher efficacy for HLAP than symptomatic supportive treatment alone. However, the results might be somewhat biased because of the poor quality and small sample size of the included RCTs. Well-qualified clinical studies are needed to prove the effectiveness of Dachaihu decoction therapy for HLAP.

• 대한본초학회지
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• 제36권1호
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• pp.59-66
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• 2021

Objectives : Forsythiae Fructus has been reported to have anti-inflammatory effects in many diseases, and Corydalis Tuber has been used as a pain suppressor in Eastern Asia. However, the protective effects of individual water extract of Forsythiae Fructus (FF) and Corydalis Tuber (CT) and the mixture of FF and CT (FC) on chronic pancreatitis (CP) were not well-investigated. Therefore, we investigated the protective effects of FF, CT, and FC on CP in mice. Methods : To induce CP, cerulein was injected 6 times a day, 4 times a week for 3 weeks. 1 h before the every cerulein injection, 200 mg/kg of FF, CT, or FC was intraperitoneally injected to mice. Histological analysis of pancreas was examined by hematoxylin and eosin stain and collagen deposition was examined by Masson's trichrome stain. Fibrogenic parameters such as α-smooth muscle actin (α-SMA), extracellular matrix (ECM) deposition, and fibrotic cytokines such as transforming growth factor (TGF)-β1 and platelet-derived growth factor (PDGF) were also analyzed by immunofluorescence stain and real-time PCR. Results : Histological damages in pancreas were inhibited by pre-treatment of FF or FC but not CT. α-SMA and ECM in pancreas were inhibited by pre-treatment of CT or FC but not FF. Moreover, the expression of TGF-β1 and PDGF in pancreas were inhibited by FF, CT or FC. Conclusions : Our results suggest that FC have protective effect on CP in mice through inhibition of α-SMA, ECM, TGF-β1 and PDGF in pancreas, and these findings could suggest new clinical strategy for CP.

• 대한본초학회지
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• 제29권3호
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• pp.11-17
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• 2014

Objective : Portulaca oleracea (PO) has been used as an important traditional medicine for inflammatory and bacterial diseases in East Asia. However, the protective effects of PO on acute pancreatitis (AP) is not well-known. Therefore, this study was performed to identify the anti-inflammatory and prophylactic effects of PO on cerulein-induced AP. Methods : AP was induced in mice via intraperitoneal injection of supramaximal concentrations of the stable cholecystokinin analogue cerulein ($50{\mu}g/kg$) given every hour for 6 times. Water extracts of PO (100, 300, or 500 mg/kg) was administrated intra-peritoneally 1 h prior to the first injection of cerulein. The mice were killed at 6 h after the final cerulein injection. Pancreas and lung were rapidly removed for morphologic and histochemical examination, myeloperoxidase (MPO) assay. Blood samples were taken to determine serum amylase and lipase activities. Results : Administration of PO significantly inhibited pancreatic weight/body weight ratio, pancreas and lung histological injury. And MPO activity which indicates neutrophil infiltration was inhibited by PO extracts on cerulein-induced pancreatitis. In addition, PO administration inhibited digestive enzymes such as serum amylase and lipase activity on cerulein-induced pancreatitis. Conclusion : Our results could suggest that pre-treatment of PO reduces the severity of cerulein-induced AP, thereby, PO could be used as a protective agent against AP. Also, this study could give a clinical basis that PO could be a drug or agent to prevent AP.

• 대한본초학회지
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• 제34권1호
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• pp.75-80
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• 2019

Objectives : Dictamni Radicis Cortex (DRC) has been used as an important traditional medicine for inflammation and fungal diseases. However, the protective effect of DRC water extract on acute pancreatitis (AP) has not been deeply reported. Therefore, we aimed to evaluate the protective effects of DRC water extract on cerulein-induced AP. Methods : AP was induced via intraperitoneal injection of supramaximal concentrations of stable cholecystokinin analogue cerulein ($50{\mu}g/kg$) every hour for 6 times. DRC water extract (0.05, 0.1, or 0.2 g/kg) or saline was administrated intraperitoneally 1 h before to the first injection of cerulein. The mice were sacrificed at 6 h after the final cerulein injection. Pancreas was rapidly removed for histochemical examination and myeloperoxidase (MPO) assay. In addition, polymerase chain reaction (PCR) was performed to examine mRNA levels of proinflammatory cytokines such as Interleukin $(IL)-1{\beta}$, IL-6 and Tumor necrosis factor $(TNF)-{\alpha}$. Results : Administration of DRC water extract significantly inhibited the pancreatic weight to body weight ratio, pancreas histological damages and increase of pancreatic MPO activity during cerulein-induced AP. In addition, increased pancreatic mRNA levels of $IL-1{\beta}$, IL-6 but not $TNF-{\alpha}$ were significantly inhibited by treatment of DRC water extract against cerulein-induced AP. Conclusions : In conclusion, we have revealed that pre-treatment of DRC water extract reduces the severity of cerulein-induced AP. Accordingly, our results could give a clinical basis that DRC could be used as a drug or agent to prevent AP.

• 대한화상학회지
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• 제22권1호
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• pp.10-14
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• 2019

Purpose: To find progression and prognosis of pancreatitis developed in massive burn patients through retrospective analysis. Methods: A retrospective study was conducted on 32 patients with abnormal increase of serum lipase level among 2523 acute burn patients admitted to our burn center from January 1, 2017 to June 30, 2018. Pancreatitis in this study was defined as a serum lipase concentration level that is higher than 180 IU/L which is three times more than the normal level (less than 60 IU/L). In this study, a retrospective analysis was performed on patients with serum lipase level higher than 300 IU/L to better understand causality of burns and pancreatitis. Results: 32 patients (1.27%) had serum lipase level higher than 180 IU/L among 2523 acute burn subjects. And 13 patients (0.52%) of these 32 patients had serum lipase level elevated more than 300 IU/L. The study indicated serum lipase level was increased around 7 days after the injury. It returned to normal level early as after 1 to 2 weeks and late as after 4 to 6 weeks of injury. The serum amylase level was increased as similar modality as to the serum lipase level increase. The serum bilirubin, AST, ALT, LD, and GGT were also observed to be elevated when serum lipase was more than 1000 IU/L. Conclusion: The pancreatitis developed in burn patients are mostly as mild symptom. It could due to the ischemic injury and can easily be treated by a temporary fasting, TPN, and Gabexate intravenous injection.

• 한방재활의학과학회지
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• 제15권1호
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• pp.99-108
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• 2005

Objectives : Patrinia scabiosaefolia (PS) has long been as a remedy for treating infectious diseases in Korea. In the present experiments, the author examined the effects of PS on the cholecystokinin-octapeptide (CCK)-induced pancreatitis (AP) in rats. Methods : Male Wister rats weighing 200 to 250 g were divided into two group. Normal untreated group, in treatment with PS group; PS was administered orally, followed by $75{\mu}g/kg$ CCK subcutaneously three times, after 1, 3 and 5 h. This whole procedure was repeated for 5 days. In treatment with saline group, the protocol was the same as in treatment group with PS. The author determined the pancreatic weight/body weight ratio, the levels of pancreatic heat shock proteins(HSP)60, HSP72 and the secretion of pro-inflammatory cytokines. Results and Conclusion : PS was significantly decreased the pancreatic weight/body weight ratio in CCK-induced AP. PS increased HSP60 and HSP72 compared with CCK-induced AP. Additionally, the secretion of tumor necrosis factor(TNF)-${\alpha}$, interleukin(IL)-$1{\beta}$ and IL-6 the levels of amylase and lipase were lower than that of saline. These results suggest that PS may has a inhibitory effect against CCK-induced AP.

• Journal of Yeungnam Medical Science
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• 제33권1호
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• pp.33-36
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• 2016

Metformin, commonly prescribed for type 2 diabetes, is considered safe with minimal side-effect. Acute pancreatitis is rare but potentially fatal adverse side-effect of metformin. We report a patient on hemodialysis with metformin-related acute pancreatitis and lactic acidosis. A 62-year-old woman with diabetic nephropathy and hypertension presented with nausea and vomiting for a few weeks, followed by epigastric pain. At home, the therapy of 500 mg/day metformin and 50 mg/day sitagliptin was continued, despite symptoms. Laboratory investigations showed metabolic acidosis with high levels of lactate, amylase at 520 U/L (range, 30-110 U/L), and lipase at 1,250 U/L (range, 23-300 U/L). Acute pancreatitis was confirmed by computed tomography. No recognized cause of acute pancreatitis was identified. Metformin was discontinued. Treatment with insulin and intravenous fluids resulted in normalized amylase, lipase, and lactate. When she was re-exposed to sitagliptin, no symptoms were reported.

• 대한임상독성학회지
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• 제4권2호
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• pp.161-165
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• 2006

Organophosphate insecticides, commonly used in agriculture, are a gradually increasing cause of accidental and suicidal poisoning. Intoxication can occur by ingestion, inhalation or dermal contact. Exposure to organophosphorus agents causes a sequentially triphasic illness consisting of the cholinergic phase, the intermediate syndrome, and organophosphate-induced delayed polyneuropathy. Acute pancreatitis as a rare complication of organophosphate intoxication has also been infrequently observed. We report a case of intoxication with organophosphate (phos-phamidon) by parenteral exposure (inhalation and/or dermal contact). A 34-year-old male patient was transferred to our Emergency Medical Center and was intubated due to a progressive respiratory failure. He presented with meiotic pupils, cranial nerve palsies, weak respiration, and proximal limb motor weaknesses without sensory changes. He had been employed in filling syringes with phosphamidon during the previous month. Because the patient's history and symptoms suggested organophosphate intoxication with intermediate syndrome, he was mechanically ventilated for 18 days with continuous infusion of atropine and pralidoxime (total amounts of 159 mg and 216 g, respectively). During his admission, hyperamylasemia and hyperli-pasemia were detected, and his abdominal CT scan showed a finding compatible with acute pancreatitis. He was administered a conservative treatment with NPO and nasogastric drainage. The patient was discharged and showed neither gastrointestinal nor neurologic sequelae upon follow up at one week and three months.

• Journal of Acupuncture Research
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• 제22권5호
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• pp.57-66
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• 2005

Objectives : We examined the effects of electroacupuncture on the cholecystokinin-octapeptide-induced acute pancreatitis in rats. Methods : Rats were administered with $75{\mu}g/kg$ cholecystokinin-octapeptide subcutaneously three times (1, 3 and 5h after shaving) for 5days. Three days after finishing cholecystokinin-octapeptide administration, high frequency electroacupuncture (100Hz) and low frequency electroacupuncture (2Hz) were applied to acupoint equivalent to ST36 (Zusanli) for 7 days. The author determined the pancreatic weight/body weight ratio, the levels of pancreatic heat shock protein HSP60 and HSP72. The author also assay the secretion of ${\beta}-amylase$, lipase and pro-inflammatory cytokines in serum. Repeated cholecysokinin-octapeptide treatment resulted in the typical laboratory and morphological changes of experimentally induced pancreatitis. Results : Eelectroacupuncture significantly decreased the pancreatic weight/body weight ratio in cholecystokinin-octapeptide-induced acute pancreatitis, increased the pancreatic levels of HSP60 and HSP72, and decreased ${\beta}-amylase$ and lipase levels in cholecystokinin-octapeptide-induced acute pancreatitis. Additionally, the secretion of $Interleukin-1{\beta}$ and tumor necrosis $factor-{\alpha}$ was decreased in the animals treated with electroacupuncture. Conclusion : These results suggest that electroacupuncture may have protective effects against cholecystokinin-octapeptide-induced acute pancreatitis.

• 대한본초학회지
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• 제27권5호
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• pp.9-14
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• 2012

Objective : We investigated the effect of Poncirus trifoliata and Citrus aurantium extract in mice with cerulein-induced acute pancreatitis (AP) model. Methods : AP was induced via intraperitoneal injection of cerulein (50 ${\mu}g/kg$) given every hour for 6h. Poncirus trifoliata (PT: 200 or 400 mg/kg) and Citrus aurantium (CA: 200 or 400 mg/kg) extract were injected 1 h before in mice with cerulein-induced AP. Mice were sacrificed at 6 h after last injection of cerulein. Blood samples were taken to determine serum amylase and lipase levels. The pancreas and lungs were rapidly removed for morphological examination, myeloperoxidase assay. Results : PT pre-treatment significantly protected the pancreas and lung damages and reduced the MPO activity and serum amylase in cerulein-induced AP. However, CA pre-treatment did not significantly protected the pancreas and lung inflammation in cerulein-induced AP. Conclusion : These results suggest that PT but not CA could protect the cerulein-induced AP. Conclusion : These results suggest that PT but not CA could protect the cerulein-induced AP.