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ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 40 Issue 6
Jun.  2024
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Article Contents

Guidelines for integrated traditional Chinese and Western medicine diagnosis and treatment of severe acute pancreatitis

DOI: 10.12449/JCH240608
Research funding:

Tianjin Science and Technology Project in Key Areas of Traditional Chinese Medicine (2022005);

Tianjin Natural Science Foundation Key Project (21JCZDJC00550);

Tianjin Municipal Health Commission Key Project of Combined Traditional Chinese and Western Medicine Subjects (2021006);

Tianjin 131 Innovative Talent Team Project (201938)

  • Received Date: 2024-04-08
  • Accepted Date: 2024-04-23
  • Published Date: 2024-06-25
  • Severe acute pancreatitis (SAP) is characterized by rapid onset and progression, complex clinicopathological changes, and a mortality rate of as high as 20%‍ ‍—‍ ‍30%. Long-term clinical practice and basic research have shown that relying solely on Western medicine for the treatment of SAP may not achieve satisfactory outcomes, and integrated traditional Chinese and Western medicine therapy has a marked clinical effect and significant advantages. Based on evidence-based medicine and with reference to related guidelines and clinical practice in China and globally, these guidelines summarize 28 clinical questions after widely soliciting opinions and suggestions from experts. This document specifically elaborates on the etiology, pathogenesis, and diagnostic criteria of SAP, as well as the key points of integrated traditional Chinese and Western medicine typing, disease staging, treatment methods, and therapies, so as to standardize the integrated traditional Chinese and Western medicine diagnostic criteria and treatment principles of SAP.

     

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  • [1]
    CUI NQ, QI QH, KONG D, et al. Treatment of severe acute pancreatitis with integrated traditional Chinese and western medicine: A report of 145 cases[J]. Chin J Surg Integr Tradit West Med, 1999, 5( 3): 129- 132.

    崔乃强, 齐清会, 孔棣, 等. 重型急性胰腺炎的中西医结合治疗——附145例报告[J]. 中国中西医结合外科杂志, 1999, 5( 3): 129- 132.
    [2]
    XIA Q, HUANG ZW, JIANG JM, et al.“Yi-Huo-Qing-Xia” method as the main therapy in integrated traditional Chinese and western medicine on severe acute pancreatitis: A report of 1 161 cases[J]. Chin J Integr Tradit West Med Intensive Crit Care, 2006, 13( 3): 131- 134. DOI: 10.3321/j.issn: 1008-9691.2006.03.001.

    夏庆, 黄宗文, 蒋俊明, 等. 以“益活清下”为主的中西医结合综合疗法治疗重症急性胰腺炎1 161例疗效报告[J]. 中国中西医结合急救杂志, 2006, 13( 3): 131- 134. DOI: 10.3321/j.issn: 1008-9691.2006.03.001.
    [3]
    HU Y, JIANG X, LI CY, et al. Outcomes from different minimally invasive approaches for infected necrotizing pancreatitis[J]. Medicine, 2019, 98( 24): e16111. DOI: 10.1097/MD.0000000000016111.
    [4]
    LIU XY, CUI YF. Individualized surgical intervention in severe acute pancreatitis[J]. J Hepatobiliary Surg, 2019, 27( 6): 474- 478. DOI: 10.3969/j.issn.1006-4761.2019.06.022.

    刘翔宇, 崔云峰. 重症急性胰腺炎的个体化外科干预[J]. 肝胆外科杂志, 2019, 27( 6): 474- 478. DOI: 10.3969/j.issn.1006-4761.2019.06.022.
    [5]
    CUI YF, QU ZL, QI QH, et al. Guidelines for diagnosis and treatment of severe acute pancreatitis with integrated traditional Chinese and western medicine(Tianjin, 2014)[J]. Chin J Surg Integr Tradit West Med, 2014, 20( 4): 460- 464. DOI: 10.3969/j.issn.1007-6948.2014.04.049.

    崔云峰, 屈振亮, 齐清会, 等. 重症急性胰腺炎中西医结合诊治指南(2014年, 天津)[J]. 中国中西医结合外科杂志, 2014, 20( 4): 460- 464. DOI: 10.3969/j.issn.1007-6948.2014.04.049.
    [6]
    BANKS PA, BOLLEN TL, DERVENIS C, et al. Classification of acute pancreatitis: 2012: Revision of the Atlanta classification and definitions by international consensus[J]. Gut, 2013, 62( 1): 102- 111. DOI: 10.1136/gutjnl-2012-302779.
    [7]
    ZHANG SS, LI HZ. Consensus opinion of TCM diagnosis and treatment experts on acute pancreatitis(2017)[J]. China J Tradit Chin Med Pharm, 2017, 32( 9): 4085- 4088.

    张声生, 李慧臻. 急性胰腺炎中医诊疗专家共识意见(2017)[J]. 中华中医药杂志, 2017, 32( 9): 4085- 4088.
    [8]
    Digestive System Disease Committee of Chinese Association of Integrative Medicine. Consensus on diagnosis and treatment of acute pancreatitis with integrated traditional Chinese and western medicine(2017)[J]. Chin J Integr Tradit West Med Dig, 2017, 25( 12): 901- 909. DOI: 10.3969/j.issn.1671-038X.2017.12.03.

    中国中西医结合学会消化系统疾病专业委员会. 急性胰腺炎中西医结合诊疗共识意见(2017年)[J]. 中国中西医结合消化杂志, 2017, 25( 12): 901- 909. DOI: 10.3969/j.issn.1671-038X.2017.12.03.
    [9]
    BOXHOORN L, VOERMANS RP, BOUWENSE SA, et al. Acute pancreatitis[J]. Lancet, 2020, 396( 10252): 726- 734. DOI: 10.1016/s0140-6736(20)31310-6.
    [10]
    DELLINGER EP, FORSMARK CE, LAYER P, et al. Determinant-based classification of acute pancreatitis severity: An international multidisciplinary consultation[J]. Ann Surg, 2012, 256( 6): 875- 880. DOI: 10.1097/SLA.0b013e318256f778.
    [11]
    van DIJK SM, HALLENSLEBEN NDL, van SANTVOORT HC, et al. Acute pancreatitis: Recent advances through randomised trials[J]. Gut, 2017, 66( 11): 2024- 2032. DOI: 10.1136/gutjnl-2016-313595.
    [12]
    YOKOE M, TAKADA T, MAYUMI T, et al. Japanese guidelines for the management of acute pancreatitis: Japanese Guidelines 2015[J]. J Hepatobiliary Pancreat Sci, 2015, 22( 6): 405- 432. DOI: 10.1002/jhbp.259.
    [13]
    STAUBLI SM, OERTLI D, NEBIKER CA. Laboratory markers predicting severity of acute pancreatitis[J]. Crit Rev Clin Lab Sci, 2015, 52( 6): 273- 283. DOI: 10.3109/10408363.2015.1051659.
    [14]
    CHO JH, KIM TN, CHUNG HH, et al. Comparison of scoring systems in predicting the severity of acute pancreatitis[J]. World J Gastroenterol, 2015, 21( 8): 2387- 2394. DOI: 10.3748/wjg.v21.i8.2387.
    [15]
    HINES OJ, PANDOL SJ. Management of severe acute pancreatitis[J]. BMJ, 2019, 367: l6227. DOI: 10.1136/bmj.l6227.
    [16]
    WU XZ, WANG PZ. Practice of abdominal surgery[M]. Beijing: People’s Medical Publishing House, 2017.

    吴咸中, 王鹏志. 腹部外科实践[M]. 北京: 人民卫生出版社, 2017.
    [17]
    LEPPÄNIEMI A, TOLONEN M, TARASCONI A, et al. 2019 WSES guidelines for the management of severe acute pancreatitis[J]. World J Emerg Surg, 2019, 14: 27. DOI: 10.1186/s13017-019-0247-0.
    [18]
    TENNER S, BAILLIE J, DEWITT J, et al. American College of Gastroenterology guideline: Management of acute pancreatitis[J]. Am J Gastroenterol, 2013, 108( 9): 1400- 1415, 1416. DOI: 10.1038/ajg.2013.218.
    [19]
    HOWARD TJ, PATEL JB, ZYROMSKI N, et al. Declining morbidity and mortality rates in the surgical management of pancreatic necrosis[J]. J Gastrointest Surg, 2007, 11( 1): 43- 49. DOI: 10.1007/s11605-007-0112-4.
    [20]
    YANG AL, MCNABB-BALTAR J. Hypertriglyceridemia and acute pancreatitis[J]. Pancreatology, 2020, 20( 5): 795- 800. DOI: 10.1016/j.pan.2020.06.005.
    [21]
    DUBINA ED, DE VIRGILIO C, SIMMS ER, et al. Association of early vs delayed cholecystectomy for mild gallstone pancreatitis with perioperative outcomes[J]. JAMA Surg, 2018, 153( 11): 1057- 1059. DOI: 10.1001/jamasurg.2018.2614.
    [22]
    Working Party of the Australasian Pancreatic Club, Smith RC, Smith SF, et al. Summary and recommendations from the Australasian guidelines for the management of pancreatic exocrine insufficiency[J]. Pancreatology, 2016, 16( 2): 164- 180. DOI: 10.1016/j.pan.2015.12.006.
    [23]
    HOLLEMANS RA, HALLENSLEBEN NDL, MAGER DJ, et al. Pancreatic exocrine insufficiency following acute pancreatitis: Systematic review and study level meta-analysis[J]. Pancreatology, 2018, 18( 3): 253- 262. DOI: 10.1016/j.pan.2018.02.009.
    [24]
    DAS SLM, SINGH PP, PHILLIPS ARJ, et al. Newly diagnosed diabetes mellitus after acute pancreatitis: A systematic review and meta-analysis[J]. Gut, 2014, 63( 5): 818- 831. DOI: 10.1136/gutjnl-2013-305062.
    [25]
    IQBAL U, ANWAR H, SCRIBANI M. Ringer’s lactate versus normal saline in acute pancreatitis: A systematic review and meta-analysis[J]. J Dig Dis, 2018, 19( 6): 335- 341. DOI: 10.1111/1751-2980.12606.
    [26]
    CROCKETT SD, WANI S, GARDNER TB, et al. American gastroenterological association institute guideline on initial management of acute pancreatitis[J]. Gastroenterology, 2018, 154( 4): 1096- 1101. DOI: 10.1053/j.gastro.2018.01.032.
    [27]
    LIPINSKI M, RYDZEWSKA-ROSOLOWSKA A, RYDZEWSKI A, et al. Fluid resuscitation in acute pancreatitis: Normal saline or lactated Ringer’s solution?[J]. World J Gastroenterol, 2015, 21( 31): 9367- 9372. DOI: 10.3748/wjg.v21.i31.9367.
    [28]
    YI FM, GE LQ, ZHAO J, et al. Meta-analysis: Total parenteral nutrition versus total enteral nutrition in predicted severe acute pancreatitis[J]. Intern Med, 2012, 51( 6): 523- 530. DOI: 10.2169/internalmedicine.51.6685.
    [29]
    STIGLIANO S, STERNBY H, DE MADARIA E, et al. Early management of acute pancreatitis: A review of the best evidence[J]. Dig Liver Dis, 2017, 49( 6): 585- 594. DOI: 10.1016/j.dld.2017.01.168.
    [30]
    ADIAMAH A, PSALTIS E, CROOK M, et al. A systematic review of the epidemiology, pathophysiology and current management of hyperlipidaemic pancreatitis[J]. Clin Nutr, 2018, 37( 6 Pt A): 1810- 1822. DOI: 10.1016/j.clnu.2017.09.028.
    [31]
    CHRISTIAN JB, ARONDEKAR B, BUYSMAN EK, et al. Clinical and economic benefits observed when follow-up triglyceride levels are less than 500 mg/dL in patients with severe hypertriglyceridemia[J]. J Clin Lipidol, 2012, 6( 5): 450- 461. DOI: 10.1016/j.jacl.2012.08.007.
    [32]
    WU XZ. Academician wu Xianzhong’s collection[M]. Beijing: People’s Military Medical Press, 2014.

    吴咸中. 吴咸中院士集[M]. 北京: 人民军医出版社, 2014.
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