The diagnosis and treatment of severe acute pancreatitis (SAP) or named acute necrotizing pancreatitis (ANP) has been much improved, but the mortality of the diseaseis still far from satisfactory. One of the reason is that its pathogenetic mechanism is still not clearly elucidated. Though activated pancreatic enzymes in the pancreas still remained to be the core of the pathogenesis of acute pancreatitis, many factors were considered and found to be involved in the initiation and development of the disease, such as inflammatory mediators, vasoactive substances, complements, free radicals,cellular factors, endotoxins, bacterial infections etc. In the early 1980s,we began to tackle this problem with the addition of combination method of Traditional Chinese Medicine (TCM) and Western Medicine (WM). Even though during this time period, we have also got some progress in the early recognition of the disease, its treatment with Somatostatins and especially great advances by our surgeons in the management of this disease. Up to now, we still stick to the route by which we have been much involved in the past nearly 20 years, to study the pathogenesis and treatment of SAP by the combination method of TCM and WM and have got some promising results. In order to facilitate our exchange, we think it might be necessary to talk briefly some basic knowledge of TCM, related to the following contents: 1) What is Traditional Chinese Medicine? 2)Differences in definition of anatomical terms; 3) Traditional medical diagnosis; 4) Traditional diagnosis methods and traditional medical treatment; 5) How to integrate the two different schools of medicine. According to Chinese medical theory, the pathogenesis of acute pancreatitis is "Wetness and heat got stagnant at the mid-focus (epigastrium?). The principle of treatment should be "release liver.adjust gas" ; "clear the heat (fever?), dry up wetnees, getting through and driving down" and "Vitalization of blood (circulation and relieve stasis". The ultimate aim of treatment is "all six organs are communicating and harmony". Based upon these theories, we have carried out a series of researches mainly SAP animal experimentation, with treatment by traditional medicine as the guiding thought. Elucidation of pathogenesis is upon the basis of effective treatment with TCM (mainly) and WM (for comparison).
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