Effect of glutamine combined with external application of rhubarb and mirabilite on T-lymphocytes subsets and cytokines in patients with severe acute pancreatitis

Objective To observe the effect of glutamine combined with external application of rhubarb and mirabilite on patients with severe acute pancreatitis (SAP). Methods Eighty patients diagnosed with SAP were divided into observation group (40 cases) and control group (40 cases) by random table method. Patients in observation group were given glutamine combined with external application of rhubarb and mirabilite based on the conventional treatment, while patients in control group only accepted conventional treatment according to guidelines. Adverse events were collected during treatment. Fasting venous blood were obtained from all patients in the morning on the second day and the seventh day of admission, blood count and C-reactive protein were detected. The levels of CD3+ , CD4+ , CD8+ and CD4+ /CD8+ of T-lymphocytes subsets were examined by flow cytometry, and serum levels of interleukin-6 (IL-6), tumor necrosis factor-α(TNF-α), interleukin-10 (IL-10) were determined by ELISA method. The recovery times and clinical syndromes were recorded, the number of infection and admission to intensive care unit (ICU) in the two groups were recorded. Results The abdominal pain, flatulence and gastrointestinal function recovery time in observation group were significantly shorter than those in control group, there were significant differences between the two groups (P<0.05), the infection rate and admission to ICU rate of observation group were lower significantly higher than those of control group (P<0.05). At the seventh day, the white blood cell (WBC), C-reactive protein(CRP) and neutrophil-to-lymphocyte (NLR) ratio significantly decreased in observation group (P<0.05). Compared with control group, the levels of CD3+ , CD4+ and CD4+ /CD8+ in observation group increased respectively (P<0.05), the level of CD8+ significantly decreased (P<0.05). The levels of IL-6, IL-10 and TNF-α significantly decreased (P<0.05). Conclusions Glutamine combined with external application of rhubarb and mirabilite is effective for treatment of SAP, with short symptom recovery time, lower rate of infection and admission to ICU, and could regulate the disorder of T-lymphocyte subsets and alleviate the inflammatory reaction at acute stage. Key words: Severe acute pancreatitis; Alanyl-glutamine; T-lymphocytes subsets; Cytokines