ARTICLE
20 December 2025

Advances in Traditional Chinese Medicine for Acute Pancreatitis: A Comprehensive Review

Long Peng1 Shuangmei Zhao* Jiale Ma1 Tianlin Wang1
Show Less
1 Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300143, China
AMCMR 2025 , 1(4), 64–71; https://doi.org/10.61369/AMCMR.202504009
© 2025 by the Author. Licensee Art and Design, USA. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC BY-NC 4.0) ( https://creativecommons.org/licenses/by-nc/4.0/ )
Abstract

Acute pancreatitis (AP) is an acute inflammatory disorder of the pancreas with a significant disease burden and high mortality in its severe form. While modern medicine provides supportive care, it lacks specific pharmacological agents to halt disease progression, highlighting the need for complementary strategies. The integration of Traditional Chinese Medicine (TCM) with conventional Western medicine has emerged as a promising approach for AP management. This review comprehensively summarizes recent advances in the TCM-based understanding and treatment of AP. We elucidate the TCM etiology and pathogenesis, which attribute AP to systemic imbalances such as dampness-heat accumulation and fu-organ obstruction. The review details various TCM treatment modalities, including oral formulations (e.g., Dachengqi Decoction, Qingyi Decoction), external therapies, acupuncture, and moxibustion, all guided by syndrome differentiation. Furthermore, we analyze the clinical efficacy and multi-target mechanisms of TCM interventions, including anti-inflammatory effects, gut barrier protection, microcirculation improvement, and oxidative stress alleviation, supported by both clinical evidence and pharmacological studies. By consolidating this body of evidence, this review aims to provide a robust theoretical and clinical foundation for the integrated treatment of AP, demonstrating its potential to improve patient outcomes and offering a more comprehensive therapeutic strategy.

Keywords
Acute pancreatitis
Traditional Chinese medicine
Integrated medicine
Herbal formulations
Acupuncture
Anti-inflammatory mechanisms
Funding
Traditional Chinese Medicine and Integrated Chinese-Western Medicine Research Project of Tianjin Municipal Health Commission (Project No.: 2025075)
References

[1] Boxhoorn L, Voermans R, Bouwense S, et al., 2020, Acute Pancreatitis. Lancet, 396(10252): 726–734.

[2] Lee P, Papachristou G, 2019, New Insights into Acute Pancreatitis. Nature Reviews Gastroenterology and Hepatology, 16(8): 479–496.

[3] Xiao A, Tan M, Wu L, et al., 2016, Global Incidence and Mortality of Pancreatic Diseases: A Systematic Review, Meta-Analysis, and Meta-Regression of Population-Based Cohort Studies. Lancet Gastroenterology and Hepatology, 1(1): 45–55.

[4] Krishna S, Kamboj A, Hart P, et al., 2017, The Changing Epidemiology of Acute Pancreatitis Hospitalizations: A Decade of Trends and the Impact of Chronic Pancreatitis. Pancreas, 46(4): 482–488.

[5] Tenner S, Baillie J, DeWitt J, et al., 2013, American College of Gastroenterology Guideline: Management of Acute Pancreatitis. American Journal of Gastroenterology, 108(9): 1400–1415.

[6] Bakker O, Van Brunschot S, Van Santvoort H, et al., 2014, Early Versus On-Demand Nasoenteric Tube Feeding in Acute Pancreatitis. New England Journal of Medicine, 371(21): 1983–1993.

[7] Van Santvoort H, Besselink M, Bakker O, et al., 2010, A Step-Up Approach or Open Necrosectomy for Necrotizing Pancreatitis. New England Journal of Medicine, 362(16): 1491–1502.

[8] Li H, Yang Y, Wang T, et al., 2023, Expert Consensus on Traditional Chinese Medicine Diagnosis and Treatment of Acute Pancreatitis. Chinese Journal of Integrated Traditional and Western Medicine on Digestion, 33(3): 303–309.

[9] Chen W, Yang X, Huang L, et al., 2015, Qing-Yi Decoction in Participants with Severe Acute Pancreatitis: A Randomized Controlled Trial. Chinese Medicine, 10: 11.

[10] Cui N, 2024, Wu Xianzhong’s Integrated Traditional Chinese and Western Medicine for Acute Abdominal Conditions, Beijing: People’s Medical Publishing House.

[11] Anonymous, 2008, Huangdi Neijing, Beijing: Ancient Chinese Medical Books Publishing House.

[12] Wang G, Shang D, Zhang G, et al., 2022, Effects of Qingyi Decoction on Inflammatory Markers in Patients with Acute Pancreatitis: A Meta-Analysis. Phytomedicine, 95: 153738.

[13] Li G, 2021, Treatise on Spleen and Stomach. Beijing: Science Press.

[14] China Association of Chinese Medicine, Spleen and Stomach Disease Branch, 2024, Expert Consensus on Traditional Chinese Medicine Diagnosis and Treatment of Acute Pancreatitis (2023). China Journal of Traditional Chinese Medicine and Pharmacy, 39(7): 3549–3557.

[15] Bao M, Chen M, Bao Y, 2024, Research and Prospects on the Etiology, Pathogenesis, and Treatment of Chronic Pancreatitis in Traditional Chinese and Western Medicine. Modern Medicine and Health Research, 8(18): 132–136.

[16] Danpanichkul P, Pang Y, Kim D, et al., 2025, Disproportionately Rising Mortality Rates of Alcohol-Associated Acute Pancreatitis: Analysis from Centers for Disease Control and Prevention Database (2011–2020). Pancreatology, 25(4): 508–515.

[17] Wang Y, Ge P, Chen H, 2025, Induction of Hyperlipidemic Pancreatitis by Different Fatty Acids: A Narrative Review. World Journal of Gastroenterology, 31(22): 106575.

[18] Kamisawa T, Ryu J, Kim M, et al., 2013, Recent Advances in the Diagnosis and Management of Autoimmune Pancreatitis: Similarities and Differences in Japan and Korea. Gut and Liver, 7(4): 394–400.

[19] Zhang J, 2017, Jingyue’s Complete Works [M]. Beijing: People’s Medical Publishing House.

[20] Zhao G, Zhuo Y, Cui L, et al., 2019, Modified Da-Chai-Hu Decoction Regulates the Expression of Occludin and NF-κB to Alleviate Organ Injury in Severe Acute Pancreatitis Rats. Chinese Journal of Natural Medicines, 17(5): 355–362.

[21] Cao Y, Li F, Sun Z, et al., 2024, Regulation of Microtubule Stability in Pulmonary Microvascular Endothelial Cells in Rats with Severe Acute Pancreatitis: Qingyi Decoction Is a Potential CDK5 Inhibitor. Journal of Inflammation Research, 17: 2513–2530.

[22] Ni S, Leng J, 2016, Analysis of Jiawei Shenling Baizhu San in the Treatment of Gastrointestinal Dysfunction in Severe Acute Pancreatitis. Journal of Emergency in Traditional Chinese Medicine, 25(03): 553–555.

[23] Chen Y, Wang C, Pang X, 2012, Clinical Observation of Octreotide Combined With Shenmai Injection and Magnesium Sulfate in the Treatment of Severe Acute Pancreatitis. Clinical Medicine, 32(03): 7–8.

[24] Chen Z, Chen Y, Pan L, et al., 2015, Dachengqi Decoction Attenuates Inflammatory Response via Inhibiting HMGB1-Mediated NF-κB and P38 MAPK Signaling Pathways in Severe Acute Pancreatitis. Cellular Physiology and Biochemistry, 37(4): 1379–1389.

[25] Li H, Zhao Y, Wen Q, et al., 2018, Comparison of Clinical Effects of Electroacupuncture of Abdominal and Limb Acupoints in the Treatment of Acute Pancreatitis. Zhen Ci Yan Jiu, 43(11): 725–729.

[26] Dai R, 2024, Clinical Benefit Analysis of Hot Fomentation with Mirabilite Packs on Shenque Acupoint for the Treatment of Acute Pancreatitis. Modern Medicine and Health Research, 8(01): 78–81.

[27] Liu X, Yuan L, Tang Y, et al., 2023, Da-Cheng-Qi Decoction Improves Severe Acute Pancreatitis–Associated Acute Lung Injury by Interfering with Intestinal Lymphatic Pathway and Reducing HMGB1-Induced Inflammatory Response in Rats. Pharmaceutical Biology, 61(1): 144–154.

[28] Wen Y, Han C, Liu T, et al., 2020, Chaiqin Chengqi Decoction Alleviates Severity of Acute Pancreatitis via Inhibition of TLR4 and NLRP3 Inflammasome. Phytomedicine, 79: 153328.

[29] Cao H, Huang H, Chen Y, et al., 2011, Expression of Zonula Occludens-1 and Mucosal Barrier Injury in Rats with Severe Acute Pancreatitis. Chinese Journal of Bases and Clinics in General Surgery, 18(03): 240–244.

[30] Lv W, Wang T, He S, et al., 2025, Microbiota Regulated by Shenling Baizhu Powder Maintains Intestinal Homeostasis via the Gut–Breast Axis. Phytomedicine, 139: 156528.

[31] Li J, Dai Y, Cao H, et al., 2023, Dachengqi Decoction Reduces Inflammatory Response and Promotes Recovery of Gastrointestinal Function in Patients with Mild Acute Pancreatitis by Regulating the Intestinal Microbiota. Chinese Journal of Critical Care Medicine, 35(2): 170–176.

[32] Li Z, Zheng Y, 2025, Research Progress on Pharmacological Mechanisms of Salviae Miltiorrhizae Radix et Rhizoma and Its Active Components in Modulating Vascular Endothelial Cell Functions. Chinese Traditional and Herbal Drugs, 56(14): 5324–5332.

[33] Zhou Q, Chen S, Li H, et al., 2020, Tetramethylpyrazine Alleviates Iron Overload Damage in Vascular Endothelium via Upregulating DDAHII Expression. Toxicology in Vitro, 65: 104817.

[34] Liu F, Wang M, Feng Y, et al., 2025, Astragalus–Safflower Combination Promotes Vascular Neogenesis in a Rat Model of Ischemic Stroke via Inhibition of MAPK/NF-κB and Activation of VEGF/Notch1 Pathways. Current Pharmaceutical Design.

[35] Zhang H, Zhao B, Wang Y, et al., 2021, Emodin Inhibits Inflammation and Oxidative Stress by Regulating Nrf2/HO-1 and MAPKs. Chinese Journal of Immunology, 37(09): 1063–1068.

[36] Yuan Z, Xiao Y, Liu Z, et al., 2025, Effect of Total Secondary Ginsenosides on Apoptosis and Energy Metabolism of H9c2 Cells Under Hypoxia Based on Mitochondrial Biogenesis. China Journal of Chinese Materia Medica, 50(5): 1255–1266.

[37] Gao J, Han C, Dai N, et al., 2025, Traditional Chinese Medicine Formulas Alleviated Acute Pancreatitis via Improvement of Microcirculation: A Systematic Review and Meta-Analysis. Chinese Herbal Medicine, 17(3): 584–600.

[38] Pi Y, Zhang X, Jiang T, 2018, Meta-Analysis of Randomized Controlled Trials of Qingyi Decoction in Treatment of Acute Pancreatitis. World Chinese Medicine, 13(06): 1546–1552.

[39] Chen J, Jiang M, Ying Y, et al., 2024, Network Pharmacological Mechanism Analysis and Evidence-Based Medical Validation of Dahuang Mudan Decoction in the Treatment of Acute Pancreatitis. Medicine, 103(37): e39679.

Share
Back to top