Effect of Integrated Traditional Chinese Medicine定向透药 Therapy with Oral and External Application of Raw Rhubarb on Patients with Gastrointestinal Dysfunction in Severe Acute Pancreatitis

doi:10.12104/j.issn.1674-4748.2025.24.017

Abstract：Objective: To explore the effect of integrated traditional Chinese medicine directional drug permeation therapy combined with oral and external application of raw rhubarb on patients with gastrointestinal dysfunction in severe acute pancreatitis. Methods: A total of 240 patients with severe acute pancreatitis combined with gastrointestinal dysfunction who were hospitalized in the Department of Critical Care Medicine at Jiangxi Provincial People's Hospital from January 2020 to December 2024 were selected as the study subjects. According to different intervention methods, the patients were divided into four groups: the control group (basic comprehensive treatment), the TCM directional drug permeation therapy group (basic comprehensive treatment plus TCM directional drug permeation therapy), the rhubarb group (basic comprehensive treatment plus oral and external application of raw rhubarb), and the combined treatment group (basic comprehensive treatment plus TCM directional drug permeation therapy and oral and external application of raw rhubarb), with 60 cases in each group. The time of first defecation and total number of defecations within 72 hours after treatment were compared among the four groups. Serum amylase, urinary amylase, serum lipase, serum calcium, white blood cell count, C-reactive protein (CRP), and procalcitonin (PCT) levels before and 72 hours after treatment were compared. Abdominal circumference, bowel sounds, gastrointestinal dysfunction score, and Acute Physiology and Chronic Health Evaluation II (APACHE II) score before and 7 days after treatment were also compared. Results: Compared with the other three groups, the combined treatment group had shorter time for first defecation and more total defecations within 72 hours. After 72 hours of treatment, the combined treatment group showed significantly lower levels of serum amylase, urinary amylase, serum lipase, white blood cell count, CRP, and PCT, and significantly higher serum calcium levels compared to the other three groups. After 7 days of treatment, the combined treatment group had significantly smaller abdominal circumference, more bowel sounds, and significantly lower gastrointestinal dysfunction scores and APACHE II scores compared to the other three groups (all P < 0.05). Conclusion: The combination of TCM directional drug permeation therapy with oral and external application of raw rhubarb in treating patients with gastrointestinal dysfunction in severe acute pancreatitis can shorten the time of first defecation, increase defecation and bowel sounds, improve the recovery of abdominal circumference, gastrointestinal function, and traditional Chinese medicine clinical symptoms, enhance the efficacy of TCM syndrome differentiation, and reduce the risk of disease deterioration.