Chronic Pancreatitis
Chronic pancreatitis (CP) is a chronic inflammatory disease characterized by irreversible changes in pancreatic tissue and function caused by various factors. Its pathological features include atrophy and destruction of pancreatic acinar cells and interstitial fibrosis. Clinically, it is mainly characterized by recurrent upper abdominal pain and/or exocrine and endocrine pancreatic insufficiency. It may also involve pancreatic parenchymal calcification, pancreatic duct dilation, pancreatic duct stones, and the formation of pancreatic pseudocysts.
TCM Pattern Differentiation and Medication Guide
| Common Symptoms
Clinical description:
Poor appetite, fatigue and weakness, loose stools, oily droplets in the stool, a pale, swollen tongue, white coating, and a weak pulse.
In plain language:
- You may have a poor appetite and little interest in food.
- You may feel drowsy, low in energy, and physically weak, with everyday tasks feeling difficult.
- Your stools may be loose and poorly formed.
- Your stool may contain oily material that looks like droplets of oil.
- Your tongue may look pale and enlarged.
- Your tongue may have a white coating.
- Your pulse may feel weak on examination.
| Treatment Approach
Clinical description:
Strengthen the spleen, regulate qi, raise the clear yang, and stop diarrhea.
In plain language:
- Use approaches that support the spleen and stomach and regulate qi to promote digestive function and help ease poor appetite, bloating after meals, fatigue, and loose or poorly formed stools.
- Use approaches that raise and stabilize the clear yang and support bowel function to reduce diarrhea and stool frequency, and help with persistent watery stools, abdominal bloating and pain, intestinal rumbling, urgency, or a feeling of downward pressure at the anus.
| Related Formulas
The products below are provided for informational reference only and do not constitute medical advice or a prescription. Refer to the product packaging and instructions, and use under the guidance of a physician or pharmacist.
| Common Symptoms
Clinical description:
Abdominal pain that worsens with pressure, stabbing pain in a fixed location, a palpable mass in the upper abdomen with marked tenderness, a purplish or dark-purple tongue or purple spots, and a deep, choppy pulse.
In plain language:
- You may have abdominal pain that feels like a needle prick, stays in one place, and feels worse when pressed.
- You may be able to feel a lump in the upper abdomen, which may be markedly painful when pressed.
- Your tongue may look purplish or dark, or have spots that resemble bruises.
- Your pulse may feel deep and choppy, with an uneven or rough quality.
| Treatment Approach
Clinical description:
Invigorate blood, dispel blood stasis, regulate qi, and relieve pain.
In plain language:
- Use approaches that promote blood circulation and disperse blood stasis to support the flow of qi and blood and help ease stabbing or fixed-site pain, tenderness, localized hardness, or purplish discoloration and bruising.
- Use approaches that regulate obstructed qi and ease pain to help relieve distending pain, abdominal fullness, upper abdominal pressure or discomfort, belching, acid reflux, hiccups, or nausea.
| Related Formulas
The products below are provided for informational reference only and do not constitute medical advice or a prescription. Refer to the product packaging and instructions, and use under the guidance of a physician or pharmacist.
| Common Symptoms
Clinical description:
Distending pain in the epigastrium and flanks, dry and bitter mouth, feeling hot, poor appetite, weakness, possible jaundice, constipation, scanty dark urine, a thick, greasy yellow tongue coating, and a wiry, rapid pulse.
In plain language:
- You may have a feeling of fullness and distending pain in the upper abdomen and along the sides of the ribs.
- Your mouth may feel dry and taste bitter.
- You may feel hot and uncomfortable.
- You may have a poor appetite and less interest in food, and eat less.
- You may feel weak and lack energy for everyday tasks.
- Your skin and eyes may appear yellow (jaundice).
- You may have constipation, with hard stools that are difficult to pass.
- Your urine may be darker and less abundant than usual.
- Your tongue coating may look yellow, thick, and greasy.
- Your pulse may feel wiry and fast.
| Treatment Approach
Clinical description:
Soothe the liver, promote bile flow, clear heat, and drain dampness.
In plain language:
- Use approaches that help regulate liver qi and promote bile flow to support smooth movement of qi and bile and help ease pain and distension along the ribs, upper-right abdominal discomfort, bitter taste, poor appetite, nausea, acid reflux, or darker urine.
- Use approaches that clear internal heat and excess dampness to help ease a heavy, stuffy feeling, drowsiness, a bitter or sticky taste in the mouth, chest and flank discomfort, a thick, greasy tongue coating, scanty dark urine, or fullness or nausea after eating.
| Related Formulas
The products below are provided for informational reference only and do not constitute medical advice or a prescription. Refer to the product packaging and instructions, and use under the guidance of a physician or pharmacist.
| Common Symptoms
Clinical description:
Distending fullness or shifting pain in the epigastrium and flanks, often triggered by emotional upset; poor appetite, fullness, belching, nausea, vomiting, no relief of distension or pain after vomiting, loose stools, oily droplets in the stool, or difficulty passing stools; a red tongue, white coating, and a wiry pulse.
In plain language:
- You may feel fullness in the upper abdomen and along the sides of the ribs, or pain that seems to move to other areas.
- Symptoms may occur or worsen when you are emotionally upset and may be associated with changes in mood.
- You may have a poor appetite and little interest in food.
- Your abdomen may feel bloated and uncomfortably full.
- You may belch frequently.
- You may feel nauseated or queasy.
- You may vomit stomach contents.
- Bloating and pain may not improve after vomiting.
- Your stools may be loose and poorly formed.
- Your stool may contain oily material that looks like droplets of oil.
- You may have difficulty passing stools.
- Your tongue may look redder than usual.
- Your tongue may have a thin white coating.
- Your pulse may feel tight and wiry.
| Treatment Approach
Clinical description:
Soothe the liver, relieve constraint, regulate qi, and relieve pain.
In plain language:
- Use approaches that help regulate liver qi and ease emotional constraint to promote the smooth flow of qi and help with pain and distension along the ribs, chest tightness, low mood, irritability, or frequent sighing.
- Use approaches that regulate qi and ease pain to help relieve a feeling of blocked distension or pain, upper abdominal pressure and fullness, distending or dull pain, belching, acid reflux, hiccups, or nausea.
| Related Formulas
The products below are provided for informational reference only and do not constitute medical advice or a prescription. Refer to the product packaging and instructions, and use under the guidance of a physician or pharmacist.
| Common Symptoms
Clinical description:
Often seen in people with coexisting diabetes and commonly triggered or worsened by dietary irregularities or overexertion. Symptoms include dull pain around the navel and lower back, abdominal fullness, thirst, frequent urination at night, loose stools, and weight loss; a red, fissured tongue with a slippery white or slightly yellow coating; and a deep, wiry or thin, rapid pulse.
In plain language:
- This pattern is often seen in people who also have diabetes.
- Symptoms may be triggered or worsened by irregular eating or overexertion.
- You may have a persistent dull ache around the navel and lower back.
- Your abdomen may feel full and uncomfortably distended.
- You may feel very thirsty and want to drink water frequently.
- You may urinate more often at night.
- Your stools may be loose and poorly formed.
- You may lose weight and appear thin.
- Your tongue may look redder than usual.
- Your tongue may have small cracks or fissures.
- Your tongue coating may be white and slippery or slightly yellow.
- Your pulse may feel deep and wiry, or thin and rapid.
| Treatment Approach
Clinical description:
Nourish yin, promote the production of body fluids, strengthen the spleen, and transform dampness.
In plain language:
- Use approaches that nourish yin and support the production of body fluids to help keep the body hydrated and ease dry mouth or throat, a dry cough with little phlegm, warmth in the palms and soles, night sweats, or irritability.
- Also use approaches that support the spleen and stomach and help transform dampness to promote digestive function and ease heaviness, drowsiness, poor appetite, bloating after meals, a sticky feeling in the mouth, a thick, greasy tongue coating, or loose stools.
| Related Formulas
The products below are provided for informational reference only and do not constitute medical advice or a prescription. Refer to the product packaging and instructions, and use under the guidance of a physician or pharmacist.
References
- Editorial Board of the Chinese Journal of Pancreatology, Chinese Society of Digestive Endoscopy, Chinese Medical Association. Guidelines for the diagnosis and treatment of chronic pancreatitis[J]. Chinese Journal of Internal Medicine, 2012, 51(11): 922–924.
- Zheng Qinghai, Meng Xiaohong, Yin Jing, et al. Integrated Chinese and Western medicine treatment of 52 cases of chronic pancreatitis[J]. Acta Chinese Medicine and Pharmacology, 2006, 34(3): 55–56.
- Lin Changchun, Yang Shuli, Lin Ruixin, et al. Clinical analysis of 42 cases of chronic pancreatitis treated with Chinese medicine[J]. Jilin Journal of Chinese Medicine, 2003, 23(6): 21.
- Yuan Jianhui, Duanmu Weijia, Xu Xiaomei, et al. Advances in the treatment of chronic pancreatitis with traditional Chinese medicine[J]. Journal of Shaanxi University of Chinese Medicine, 2012, 35(5): 106–108.
- Zhang Xiaoping. Diagnosis and treatment of 34 cases of chronic pancreatitis based on disease-pattern integration[J]. Journal of Anhui College of Traditional Chinese Medicine, 2002, 21(1): 11–13.
- Jin Hua. Treatment of diarrhea in 52 cases of chronic pancreatitis with Shen Ling Bai Zhu San[J]. Journal of Heze Medical College, 2003, 15(2): 68–69.
- Yu Hua, Li Xue. Report on 45 cases of chronic pancreatitis treated with Xue Fu Zhu Yu Capsules[J]. Beijing Journal of Traditional Chinese Medicine, 2005, 24(5): 319.
- Han Jianxiang, Wang Xiaolin. Clinical observation of Da Huang Zhe Chong Wan in the treatment of chronic pancreatitis[J]. Qilu Medical Journal, 2002, 17(3): 191.
- Chinese Pharmacopoeia Commission. Pharmacopoeia of the People’s Republic of China (2015 Edition)[M]. Beijing: China Medical Science Press, 2015.
- Song Minxian, Yang Ming. New Compilation of National Chinese Patent Medicines (2nd Edition)[M]. Beijing: People’s Medical Publishing House, 2011.