Sun BF, Zhang F, Chen QP, Wei Q, Zhu WT, Ji HB, Zhang XY. Improvement of inflammatory response and gastrointestinal function in perioperative of cholelithiasis by Modified Xiao-Cheng-Qi decoction. World J Clin Cases 2023; 11(4): 830-843 [PMID: 36818637 DOI: 10.12998/wjcc.v11.i4.830]
Corresponding Author of This Article
Qiang-Pu Chen, Doctor, Full Professor, Department of Hepatobiliary Surgery, Binzhou Medical University Hospital, No. 661 Huanghe Second Road, Binzhou 256603, Shandong Province, China. chenqiangpu@bzmc.edu.cn
Research Domain of This Article
Surgery
Article-Type of This Article
Randomized Clinical Trial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Feb 6, 2023; 11(4): 830-843 Published online Feb 6, 2023. doi: 10.12998/wjcc.v11.i4.830
Improvement of inflammatory response and gastrointestinal function in perioperative of cholelithiasis by Modified Xiao-Cheng-Qi decoction
Bao-Fang Sun, Fan Zhang, Qiang-Pu Chen, Qiang Wei, Wen-Tao Zhu, Hai-Bin Ji, Xing-Yuan Zhang
Bao-Fang Sun, Fan Zhang, Qiang-Pu Chen, Qiang Wei, Wen-Tao Zhu, Hai-Bin Ji, Xing-Yuan Zhang, Department of Hepatobiliary Surgery, Binzhou Medical University Hospital, Binzhou 256603, Shandong Province, China
Author contributions: Chen QP and Sun BF designed the study and developed the concept; Sun BF, Zhang F, Wei Q, Zhu WT, Ji HB, Zhang XY performed the experiments; Chen QP performed the statistical analysis, revised and finalized the manuscript; Sun BF wrote the manuscript; and all authors read and approved the final version of the manuscript.
Institutional review board statement: The study was reviewed and approved by the Institutional Review Board of Binzhou Medical University Hospital [No. Ethical research (2017-026-01)].
Clinical trial registration statement: This study is registered at ClinicalTrials.gov. The registration identification number is ChiCTR2000033125.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: Technical appendix, statistical code, and dataset are available from the corresponding author at chenqiangpu@bzmc.edu.cn. Participants gave informed consent for data sharing.
CONSORT 2010 statement: The authors have read the CONSORT 2010 statement, and the manuscript was prepared and revised according to the CONSORT 2010 statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Qiang-Pu Chen, Doctor, Full Professor, Department of Hepatobiliary Surgery, Binzhou Medical University Hospital, No. 661 Huanghe Second Road, Binzhou 256603, Shandong Province, China. chenqiangpu@bzmc.edu.cn
Received: October 1, 2022 Peer-review started: October 1, 2022 First decision: November 26, 2022 Revised: December 15, 2022 Accepted: January 9, 2023 Article in press: January 29, 2023 Published online: February 6, 2023 Processing time: 127 Days and 15.5 Hours
ARTICLE HIGHLIGHTS
Research background
In the perioperative period of biliary surgery, various factors can induce the release of a large number of inflammatory factors, leading to an imbalance in pro-inflammatory and anti-inflammatory responses and resulting in gastrointestinal (GI) dysfunction. It is crucial to reduce the inflammatory response and promote the recovery of GI function after biliary surgery, both of which are the basis and key for perioperative care and postoperative recovery.
Research motivation
Since lack of effective measures to reduce inflammatory response and promote the recovery of GI function after biliary surgery; therefore, it is necessary to develop novel interventions to reduce the stress response and accelerate postoperative recovery.
Research objectives
To better understand the effects of Modified Xiao-Cheng-Qi decoction (MXD) on the inflammatory response and GI function in perioperative of cholelithiasis, also their correlation, we conducted this study.
Research methods
This was a prospective randomized placebo-controlled trial, in which 162 patients who received biliary tract surgery, were randomly assigned to three groups: MXD group, XD group, and placebo-control group. The parameters included frequency of bowel sounds, time of first flatus and defecation, time of diet, and amount of activity after surgery. The serum levels of C-reactive protein (CRP), interleukin-6 (IL-6), IL-10, serum amyloid A (SAA) protein, and substance P were measured.
Research results
Compared to the placebo-control, improvements in GI function were observed in the MXD groups, such as reduced incidence of nausea, vomiting, and bloating, and the earlier first exhaust time, first defecation time, and feeding time after surgery (P < 0.05). On the 1st and 2nd d after surgery, serum levels of IL-6, CRP, and SAA in MXD group were lower than that in placebo control, but substance P level was higher, compared to the control (P < 0.05).
Research conclusions
Treatment with MXD can relieve inflammatory response and improve GI function after surgery. Moreover, there are significant correlations between them.
Research perspectives
The future research project will focus on the mechanism of MXD to reduce inflammatory reaction and improve GI function.
