Acute Pancreatitis (Recovery Phase)
Acute pancreatitis (AP) is an inflammatory response caused by the activation of pancreatic enzymes due to various causes. This leads to autodigestion of pancreatic tissue, edema, hemorrhage, and, in some cases, necrosis. It is characterized clinically by acute upper abdominal pain, nausea, vomiting, fever, and elevated serum amylase, with or without changes in the function of other organs. The severity of the condition varies. In mild cases, pancreatic edema predominates; these cases are common, are often self-limiting, and generally have a good prognosis. They are also known as mild acute pancreatitis (MAP). In a small number of severe cases, pancreatic hemorrhage and necrosis may occur, often followed by complications such as infection, peritonitis, and shock. These cases have a high mortality rate and are known as severe acute pancreatitis (SAP).
TCM Pattern Identification and Medication Reference
|Common Symptoms
Clinical description:
Pain in the chest, flanks, and abdomen, fixed in location and aggravated by pressure, with a stabbing quality; a mass may be palpable in the upper abdomen, with marked tenderness. The complexion may be pale or dull, with fatigue, weakness, shortness of breath, and reluctance to speak. The tongue may be pale and dusky or have purple spots, and the pulse may be deep and unsmooth.
In plain language:
- Pain may occur in the chest, along both sides of the ribs, and in the abdomen. It stays in one place, worsens with pressure, and may feel sharp, like a needle prick.
- A mass may be felt in the upper abdomen. Touching or pressing it may cause marked pain and worsen local discomfort.
- The complexion may look pale or dull and lack luster.
- There may be easy fatigue and weakness, with increased tiredness after activity.
- There may be shortness of breath and little inclination to speak; the voice may sound low and weak.
- The tongue may look pale and dusky, or show purple spots or patches of blood stasis.
- The pulse may be deep and rough or unsmooth to the touch, with a weak beat.
|Treatment Approach
Clinical description:
Invigorate blood and resolve stasis; regulate qi and relieve pain.
In plain language:
- Aims to promote blood circulation and disperse stasis, potentially easing painful areas of blood stasis, localized swelling or hardness, or impaired menstrual flow.
- Aims to regulate the movement of qi and relieve stagnation, potentially easing fullness in the chest and flanks, abdominal distension and pain, or difficulty belching.
- Aims to relieve pain, such as headache, joint pain, or fixed, localized stabbing pain.
|Related Medication
The products below are provided for informational reference only and do not constitute medical advice or a prescription. Follow the product packaging and package insert, and use under the guidance of a physician or pharmacist.
|Common Symptoms
Clinical description:
Distending pain in the middle and upper abdomen, relieved after passing gas; fatigue and weakness, poor appetite, and stools that may be either dry or loose. The tongue is pale red with a thin white or thin yellow coating; the pulse is wiry or moderate.
In plain language:
- There may be uncomfortable distension and pain in the middle and upper abdomen, with a feeling of pressure or tightness.
- Passing gas may bring some relief, easing the distension and pain.
- There may be easy fatigue and weakness, with little energy for daily activities.
- Appetite may be poor, with little interest in food.
- Stools may sometimes be hard and sometimes loose, with irregular bowel movements.
- The tongue may be pale red in color rather than deeply red.
- The tongue coating may be thin and white or pale yellow.
- The pulse may feel taut like a stretched string, or steady and relatively slow.
|Treatment Approach
Clinical description:
Soothe the liver and relieve constraint; regulate qi and strengthen the spleen.
In plain language:
- Aims to soothe constrained liver qi, potentially easing fullness in the chest and flanks, low mood, or frequent sighing.
- Aims to regulate the movement of qi, potentially easing stuffiness in the chest and abdomen, frequent belching, or a feeling of pressure in the upper abdomen.
- Aims to support spleen and stomach function, potentially easing poor appetite, abdominal distension, loose stools, or fatigue and weakness.
|Related Medication
The products below are provided for informational reference only and do not constitute medical advice or a prescription. Follow the product packaging and package insert, and use under the guidance of a physician or pharmacist.
|Common Symptoms
Clinical description:
Fullness and distension in the epigastrium, dull pain, hiccups and belching, acid regurgitation and stomach discomfort. The tongue is pale red or dark red with a thin white or thin yellow coating; the pulse is deep or wiry.
In plain language:
- There may be a persistent feeling of fullness and pressure in the upper abdomen, particularly around the stomach area.
- There may be a dull ache in the upper abdomen that varies in intensity and can be felt during activity or at rest.
- There may be frequent burping or hiccups, with a feeling of trapped gas and an urge to sigh.
- Acid may rise into the mouth, along with churning or rumbling discomfort in the stomach.
- The tongue may be pale red or dark red in appearance.
- The tongue coating may be thin and white, or covered with only a thin layer of yellow coating.
- The pulse may be deep and noticeable only with pressure, or feel taut like a stretched string.
|Treatment Approach
Clinical description:
Soothe the liver and regulate qi; harmonize the stomach and direct rebellious qi downward.
In plain language:
- Aims to soothe liver qi and regulate its movement, potentially easing fullness in the chest and flanks, low mood, or frequent sighing.
- Aims to harmonize spleen and stomach function, potentially easing upper abdominal fullness, poor appetite, or indigestion.
- Aims to direct qi downward, potentially easing frequent belching, nausea and vomiting, or burning discomfort in the stomach area.
|Related Medication
The products below are provided for informational reference only and do not constitute medical advice or a prescription. Follow the product packaging and package insert, and use under the guidance of a physician or pharmacist.
|Common Symptoms
Clinical description:
Burning, dull pain in the middle and upper abdomen, dry mouth and tongue, irritability and thirst, poor appetite and dry retching; stools may be hard. The tongue is red and dry, or cracked with no coating; the pulse is thin and rapid.
In plain language:
- There may be a burning sensation and dull pain in the middle and upper abdomen, which may recur and vary in intensity.
- The mouth and tongue may feel dry, with noticeable dryness when speaking or swallowing.
- There may be restlessness and thirst, with a desire to drink water to relieve the dryness.
- Appetite may be poor, and dry retching may occur, with an urge to vomit but little or nothing brought up.
- Stools may be hard and difficult to pass, making bowel movements uncomfortable.
- The tongue may appear red and have little moisture, with a somewhat dry surface.
- The tongue may have cracks and little or no coating, and look smooth and dry.
- The pulse may feel thin and rapid, with a quick rhythm and a fine beat.
|Treatment Approach
Clinical description:
Nourish yin and generate fluids; nourish the stomach and relieve pain.
In plain language:
- Aims to nourish yin and generate fluids, potentially easing dry mouth and throat, restlessness, night sweats, or dry, cracked skin.
- Aims to nourish the stomach and support digestion, potentially easing burning in the upper abdomen, dull stomach pain, or poor appetite.
- Aims to relieve pain, potentially easing epigastric discomfort, burning pain, or cramping pain.
|Related Medication
The products below are provided for informational reference only and do not constitute medical advice or a prescription. Follow the product packaging and package insert, and use under the guidance of a physician or pharmacist.
References
- Pancreatic Surgery Group, Surgery Branch, Chinese Medical Association. Guidelines for the Diagnosis and Treatment of Acute Pancreatitis (2014)[J]. Chinese Journal of Practical Surgery, 2015, 35(1): 4–7.
- Spleen and Stomach Diseases Branch, China Association of Chinese Medicine. Expert Consensus on TCM Diagnosis and Treatment of Acute Pancreatitis[J]. China Journal of Traditional Chinese Medicine and Pharmacy, 2013, 28(6): 1826–1830.
- Pancreatic Diseases Group, Gastroenterology Branch, Chinese Medical Association; Editorial Committee of Chinese Journal of Pancreatology; Editorial Committee of Chinese Journal of Digestion. Guidelines for the Diagnosis and Treatment of Acute Pancreatitis in China (2013)[J]. Chinese Journal of Practical Internal Medicine, 2013, 33(7): 530–534.
- Yu Xian’en. Advances in Epidemiology and Severity Prediction and Assessment of Acute Pancreatitis[J]. Chinese Journal of Gastroenterology and Hepatology, 2015, 24(2): 234–237.
- Sun Bei, Li Le. Updates and Progress in Concepts for the Diagnosis and Treatment of Acute Pancreatitis[J]. Chinese Journal of Practical Surgery, 2014, 34(3): 235–239.
- Xu Yiping. Clinical Study of Chinese Patent Medicines as Adjunctive Treatment for Acute Pancreatitis Based on Pattern Identification[J]. Journal of Emergency in Traditional Chinese Medicine, 2013, 22(12): 2037–2038.
- Wang Quanquan, Chen Hailin, Huang Huimin. Clinical Observation of Qingkailing Injection for Acute Pancreatitis[J]. Journal of Emergency in Traditional Chinese Medicine, 2008, 17(1): 55–59.
- Xing Bai, Zeng Qi, Wang Rixing, et al. Preventive and Therapeutic Effects of Xuebijing on Acute Pancreatitis-Associated Kidney Injury[J]. Chinese Journal of Critical Care Medicine, 2008, 28(8): 683–685.
- Li Qiangou. Guidelines for the Diagnosis and Treatment of Digestive Diseases in Traditional Chinese Medicine[M]. Beijing: China Press of Traditional Chinese Medicine, 2006: 175–178.