Acute Pancreatitis (Acute Phase)
Acute pancreatitis (AP) is an inflammatory response caused by the activation of pancreatic enzymes due to various factors. This leads to autodigestion, edema, hemorrhage, or even necrosis of pancreatic tissue. 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. Severity varies. In mild cases, pancreatic edema predominates; these cases are common, often self-limiting, and generally have a good prognosis. This is known as mild acute pancreatitis (MAP). In a small number of severe cases, pancreatic hemorrhage and necrosis 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 Differentiation and Medication Reference
| Common Symptoms
Clinical description:
Intermittent or shifting pain in the upper and middle abdomen, or pain radiating to the left hypochondrium or left back; abdominal distension that feels relieved after passing gas; fever may be absent; pale-red tongue with a thin white or thin yellow coating; wiry-tight or wiry pulse.
Plain-language explanation:
- There may be intermittent or shifting pain in the upper and middle abdomen. The pain may vary in intensity and cause considerable discomfort.
- The pain may radiate beneath the left ribs or to the left side of the back, and may be more noticeable when turning or when pressure is applied.
- The abdomen may feel full and uncomfortable. Passing gas may bring some relief and reduce the feeling of distension.
- There is generally no obvious fever; some people may have no fever throughout, and their temperature may remain relatively stable.
- The tongue may be pale red with a relatively thin coating, usually white and sometimes yellow.
- The pulse may feel taut and tight, like a drawn string, or have a taut, wiry quality.
| Treatment Approach
Clinical description:
Soothe the Liver, regulate Qi, and unblock the Fu organs.
Plain-language explanation:
- Help soothe constrained Liver Qi and regulate the movement of Qi, easing discomfort such as distension in the chest and flanks, low mood, or difficulty burping.
- Promote the downward movement of Qi and the free flow of the Fu organs, easing symptoms such as upper abdominal fullness, poor appetite, or a feeling of pressure in the abdomen.
- Promote bowel movements to help clear stagnation, easing constipation, abdominal distension and pain, or difficulty passing stool.
| Related Products
The products below are provided for informational reference only and do not constitute medical advice or a prescription. Follow the product packaging and instructions, and use under the guidance of a physician or pharmacist.
| Common Symptoms
Clinical description:
Upper abdominal distending pain with tenderness that resists pressure, or abdominal fullness with flank pain; red tongue with a yellow, greasy coating or a thin yellow coating.
Plain-language explanation:
- The upper abdomen feels distended and painful. Pressing on it may make the discomfort worse, or there may be a feeling of abdominal fullness with pain extending to both flanks.
- The tongue may appear red, with a noticeably red color.
- The tongue coating may look yellow and greasy, thick and heavy, or there may be only a thin yellow coating.
| Treatment Approach
Clinical description:
Clear heat from the Liver and Gallbladder and drain dampness and heat.
Plain-language explanation:
- Help clear constrained heat in the Liver and Gallbladder, easing discomfort such as a bitter taste in the mouth, dry throat, distending pain in the flanks, or yellowing of the eyes and skin.
- Help drain dampness and clear heat, easing symptoms such as a heavy feeling in the body, scant dark urine, or a thick, greasy tongue coating.
| Related Products
The products below are provided for informational reference only and do not constitute medical advice or a prescription. Follow the product packaging and instructions, and use under the guidance of a physician or pharmacist.
| Common Symptoms
Clinical description:
Severe abdominal pain, possibly extending from the epigastrium to the lower abdomen, with marked fullness and tenderness that makes the abdomen difficult to approach; signs of pi, fullness, dryness, excess, and hardness.
Plain-language explanation:
- The abdominal pain may be extremely severe, extending from the upper abdomen all the way to the lower abdomen, with a feeling of distending pressure. Touch or pressure may make it worse and be difficult to tolerate.
- There may be signs described as “pi, fullness, dryness, excess, and hardness”: the abdomen feels blocked and distended, with an internal sense of dryness; it feels firm and tight when pressed and may even seem to contain a hard mass.
| Treatment Approach
Clinical description:
Clear heat and unblock the Fu organs through purgation.
Plain-language explanation:
- Help clear internal heat, easing symptoms such as fever, restlessness, thirst, dry throat, or facial flushing.
- Help unblock the Qi of the Fu organs and promote its downward movement, easing discomfort such as upper abdominal fullness, difficulty burping, or a feeling of pressure in the abdomen.
- Help promote bowel movements through purgation, easing constipation, abdominal distension and pain, or difficulty passing stool.
| Related Products
The products below are provided for informational reference only and do not constitute medical advice or a prescription. Follow the product packaging and instructions, and use under the guidance of a physician or pharmacist.
| Common Symptoms
Clinical description:
Stabbing abdominal pain with tenderness that resists pressure; pain remains in one place; a mass may be palpable; bleeding may occur, with bluish-purple skin and ecchymoses; red tongue, possibly with purple stasis spots; rapid, wiry or choppy pulse.
Plain-language explanation:
- The abdomen may have a stabbing, needle-like pain that worsens with pressure and is difficult to tolerate. The pain remains in one place rather than moving around.
- Sometimes a mass in the abdomen can be felt; it may feel firm and uncomfortable to touch.
- Bleeding may occur, and the skin may appear bluish or purplish with visible bruising.
- The tongue may be red or show dark-purple stasis spots or patches.
- The pulse may feel taut and fast, like a drawn string, or uneven and rough.
| Treatment Approach
Clinical description:
Clear heat and drain fire, dispel blood stasis, and unblock the Fu organs.
Plain-language explanation:
- Help clear internal heat and drain excessive fire, easing discomfort such as fever, restlessness, thirst, dry throat, or facial flushing.
- Help dispel blood stasis and promote the free flow of Qi in the Fu organs, easing symptoms such as fixed stabbing pain, abdominal fullness, or discomfort when pressed.
- Help promote bowel movements to clear stagnation, easing constipation, abdominal distension and pain, or difficulty passing stool.
| Related Products
The products below are provided for informational reference only and do not constitute medical advice or a prescription. Follow the product packaging and instructions, and use under the guidance of a physician or pharmacist.
| Common Symptoms
Clinical description:
Severe pain around the umbilicus; rapid, labored breathing, pale complexion, cold limbs, and convulsions or spasms.
Plain-language explanation:
- There may be severe, difficult-to-tolerate pain around the navel.
- Breathing may become rapid and labored, with a feeling of breathlessness.
- The face may look very pale, with little color.
- The limbs may become cold, with twitching or spasm-like shaking.
| Treatment Approach
Clinical description:
Unblock the Fu organs and dispel blood stasis; restore Yang and rescue from collapse.
Plain-language explanation:
- Help unblock the Qi of the Fu organs and dispel blood stasis, easing symptoms such as abdominal distension and pain, constipation, or discomfort when pressure is applied.
- Help warm and support Yang to counter a tendency toward severe weakness and collapse, easing discomfort such as aversion to cold, cold limbs, pale complexion, or confusion.
| Related Products
The products below are provided for informational reference only and do not constitute medical advice or a prescription. Follow the product packaging and instructions, and use under the guidance of a physician or pharmacist.
References
- Pancreatic Surgery Group, Branch of Surgery, 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 Disease 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 Disease Group, Gastroenterology Branch, Chinese Medical Association; Editorial Board of Chinese Journal of Pancreatology; Editorial Board 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 Advances in Concepts for the Diagnosis and Treatment of Acute Pancreatitis [J]. Chinese Journal of Practical Surgery, 2014, 34(3): 235-239.
- Xu Yiping. Clinical Research on the Adjunctive Use of Chinese Patent Medicines in the Syndrome-Based Treatment of Acute Pancreatitis [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 the Treatment of 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 Renal 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 Chinese Medicine [M]. Beijing: China Press of Traditional Chinese Medicine, 2006: 175-178.