自拟胰腺清治疗急性胰腺炎36例

目的 :探讨胰腺清治疗急性胰腺炎的疗效 ,方法 :采用自拟“胰腺清”方 (苍术、柴胡、半夏、黄芩、黄连 )治疗本病 3 6例 ,并设对照组。结果 :两组总有效率无明显差异 ( P>0 .0 5)。但在缓解、消除临床症状 ,缩短病程方面 ,治疗组优于对照组 ( P<0 .0 5)。提示 :本方有清热祛湿、消食导滞、理气化瘀、泄热解毒功效。对清除中焦湿热壅聚有良好效果。

芒硝及清胰汤联合西药治疗急性重症胰腺炎的护理

急性胰腺炎是常见急腹症之一,是由胰酶激活后引起胰腺组织自身消化所致的急性化学性炎症,其病情程度轻重不一,主要表现为急性腹痛、恶心、呕吐,病情严重者重者可致胰腺出血、坏死并发休克或多器官功能衰竭的综合症候群,重症急性胰腺炎约占急性胰腺炎的5%-16%,死亡率较高.笔者统计自2014年1月至2016年6月,我科共23例急性重症胰腺炎患者采用了芒硝外敷与清胰汤联合西药非手术治疗,取得满意的效果,现将护理体会报道如下.

坏死性胰腺炎术后影响切口疝发生的因素分析

目的坏死性胰腺炎(NP)患者经常需要胰腺清创,并且有发生切口疝(IH)的风险。然而,目前尚未见关于坏死性胰腺炎中切口疝发生率的相关报道。我们研究的目的是明确其发病率,并且确定胰腺清创后IH发生的危险因素。方法通过临床查体及病人访谈确定IH的存在。技术及临床方面的数据包括:切口类型,关腹方式,缝线材料,年龄,身体质量指数(BMI),糖尿病(DM),术前白蛋白水平及手术次数。结果 149例胰腺清创患者中63例(42%)发生了IH,且IH患者多为老年(P<0.05)。在外科手术方式或临床危险因素方面组间未见差异。结论需要手术清创的NP患者IH的发病率要显著高于常规剖腹探查者。具有创新性的筋膜关闭技术,如非合成补片进行初次手术筋膜支撑,应予关注。

闭合性胰腺损伤17例诊治体会

目的 交流闭合性胰腺损伤的诊治经验 ,以提高治愈率和减少并发症。方法 回顾性分析 17例闭合性胰腺损伤患者的病情资料。结果 本组 17例 ,治愈 15例 ,死亡 2例。并发胰瘘 2例 ,创伤性胰腺炎 2例 ,胰腺假性囊肿 1例。结论 闭合性胰腺损伤诊断主要依靠 CT及血和腹腔穿刺液淀粉酶测定。选择合适的术式 ,术后予以积极的支持 ,抑胰酶 ,抗感染 ,保持通畅引流等综合治疗措施 ,可提高治愈率 ,减少并发症的发生。

胰腺创伤的诊断与治疗

胰腺解剖位置深在,创伤机会较为少见,但随着现代交通、建筑及工业的迅速发展,胰腺损伤日渐增多,一旦发生,常合并其它脏器伤,病情重,并发症多,死亡率高。为提高胰腺创伤的诊断水平及治疗效果,我院总结1981—1997年间腹部创伤病人868例。

感染性胰腺坏死组织清创术后患者皮肤管理的效果分析

目的探讨感染性胰腺坏死组织清创术后引流管周围刺激性皮炎护理效果。方法选取2018年3月至2019年3月收治在首都医科大学宣武医院行感染性胰腺坏死组织清创术后引流患者108例,按照入院时间分为试验组54例和对照组54例,对照组给予常规护理,试验组给予阶梯式皮肤护理,包括教育培训、评估、皮肤准备、皮肤保护剂以及一次性泌尿造口袋的使用等内容,并进行效果评价。结果试验组刺激性皮炎的发生率为20.4%(22/54),对照组40.7%(11/54),2组比较差异有统计学意义(χ^2值为5.280,P<0.05);试验组治愈4例占36.36%,Ⅰ级5例占45.45%,Ⅱ级2例占18.18%,Ⅲ级0,对照组分别为0,13例占59.09%,8例占36.36%,1例占4.54%,2组严重程度比较差异有统计学意义(χ^2值为8.353,P<0.05);试验组住院期间皮炎的发生时间和总护理时长分别为(18.00±2.25)d、(12.69±1.96)h,对照组分别为(12.13±5.84)d、(15.29±2.09)h,2组比较差异具有统计学意义(t值为29.167、-2.791,均P<0.05);试验组总护理费用(570.38±88.01)元,对照组(448.79±59.44)元,2组比较差异无统计学意义(t值为-0.372,P>0.05)。结论阶梯式皮肤护理方案降低了感染性胰腺坏死组织清创术后引流患者刺激性皮炎的发生率、严重程度,延长了刺激性皮炎的发生时间,提高了护理人员的工作效率。

Pancreatic cancer with a high serum IgG4 concentration

Differentiation between autoimmune pancreatitis and pancreatic cancer is sometimes difficult. It has been reported that serum IgG4 concentrations are significantly elevated and particularly high (>135 mg/dL) in autoimmune pancreatitis. Measurement of serum IgG4 has become a useful tool for differentiating between autoimmune pancreatitis and pancreatic cancer. However, we present a 74-year-old female with a markedly elevated serum IgG4 (433 mg/dL) who underwent pancreaticoduodenectomy for pancreatic cancer. Elevated serum IgG4 levels continued after the resection. On histology, adenocarcinoma of the pancreas accompanied with moderate lymphoplasmacytic infiltration infiltrated the lower bile duct and duodenum, but there were no findings of autoimmune pancreatitis. Although a small metastasis was detected in one parapancreatic lymph node, regional lymph nodes were swollen. Abundant IgG4-positive plasma cells infiltrated the cancerous areas of the pancreas, but only a few IgG4-positive plasma cells were detected in the noncancerous areas. Pancreatic cancer cells were not immunoreactive for IgG4. An abundant infiltration of IgG4-positive plasma cells was detected in the swollen regional lymph nodes and in the duodenal mucosa. We believe that the serum IgG4 level was elevated in this patient with pancreatic cancer as the result of an IgG4-related systemic disease that had no clinical manifestations other than lymphadenopathy.

Breviscapine attenuates acute pancreatitis by inhibiting expression of PKCα and NF-κB in pancreas

AIM:To study the effect of breviscapine (Bre) on activity of protein kinase Cα (PKCα) and nuclear factor (NF)-κB in pancreas,and the mechanism of Bre attenuating acute pancreatitis (AP). METHODS:One hundred and eight rats were randomly divided into acute necrotizing pancreatitis (ANP) group,Bre group (ANP + Bre group) and sham operation (SO) group,36 rats in each group. ANP model was induced by a retrograde injection of 4% sodium deoxycholate into the bilio-pancreatic duct. Fifteen minutes after the ANP model was induced,the rats in Bre group were intraperitoneally injected with Bre (0.4 mg/100 g body weight or 0.1 mL/100 g body weight). Survival time and mortality of rats were calculated. Serum amylase and malondialdehyde levels were measured,volume of ascites was recorded and morphology of pancreas and lung was evaluated at 1,5 and 10 h,after the ANP model was induced,respectively. Expressions of PKCα and subunit p65 of NF-κB in pancreas were detected by immunohistochemistry and Western blotting. RESULTS:The life span of rats was longer and the mortality was lower in Bre group than in ANP group 13.51 ± 5.46 vs 25.36 ± 8.11 (P < 0.05). The amylase and MDA levels as well as the volume of ascites were lower and the pathological changes in pancreas and lung were less in Bre group than ANP group (P < 0.05),indicating that the pancreatitis is less severe in Bre group than ANP group. The activation of PKCα and NF-κB p65 in pancreas was induced rapidly and reached their peak at 1 h or 5 h after ANP,but their activity in Bre group was significantly inhibited. CONCLUSION:Bre exerts its therapeutic effect on AP by inhibiting the activation of PKCα and NF-κB p65 in pancreas.

Effect of melatonin on the severity of L-arginine-induced experimental acute pancreatitis in rats

AIM： To determine the effect of melatonin pre- and post-treatment on the severity of L-arginine （L-Arg） -induced experimental pancreatitis in rats. METHODS： Male Wistar rats （25） were divided into five groups. Those in group A received two injections of 3.2 g/kg body weight L-Arg i.p. at an interval of 1 h. In group MA, the rats were treated with 50 mg/kg body weight melatonin i.p. 30 min prior to L-Arg administration. In group AM, the rats received the same dose of melatonin 1 h after L-Arg was given. In group M, a single dose of melatonin was administered as described previously. In group C the control animals received physiological saline injections i.p. All rats were exsanguinated 24 h after the second L-Arg injection. RESULTS： L-Arg administration caused severe necrotizing pancreatitis confirmed by the significant elevations in the serum amylase level, the pancreatic weight/body weight ratio （pw/bw）, the pancreatic IL-6 content and the myeloperoxidase activity, relative to the control values. Elevation of the serum amylase level was significantly reduced in rats given melatonin following L-Arg compared to rats injected with L-Arg only. The activities of the pancreatic antioxidant enzymes （Cu/Zn-superoxide dismutase （CulZn-SOD） and catalase （CAT）） were significantly increased 24 h after pancreatitis induction. Melatonin given in advance of L-Arg significantly reduced the pancreatic CAT activity relative to that in the rats treated with L-Arg alone. In the liver, L-Arg significantly increased the lipid peroxidation level, and the glutathione peroxidase and Cu/Zn-SOD activities, whereas the Mn-SOD activity was reduced as compared to the control rats. Melatonin pre-treatment prevented these changes. CONCLUSION： Melatonin is an antioxidant that is able to counteract some of the L-Arg-induced changes during acute pancreatitis, and may therefore be helpful in the supportive therapy of patients with acute necrotizing pancreatitis.

Delayed ethyl pyruvate therapy attenuates experimental severe acute pancreatitis via reduced serum high mobility group box 1 levels in rats

AIM： To investigate the effect of delayed ethyl pyruvate （EP） delivery on distant organ injury, survival time and serum high mobility group box 1 （HMGB1） levels in rats with experimental severe acute pancreatitis （SAP）. METHODS： A SAP model was induced by retrograde injection of artificial bile into the pancreatic ducts of rats. Animals were divided randomly into three groups （n = 32 in each group）： sham group, SAP group and delayed EP treatment group. The rats in the delayed EP treatment group received EP （30 mg/kg） at 12 h, 18 h and 30 h after induction of SAP. Animals were sacrificed, and samples were obtained at 24 h and 48 h after induction of SAP. Serum HMGB1, aspartate arninotransferase （AST）, alanine arninotransferase （ALT）, blood urea nitrogen （BUN）, and creatinine （Cr） levels were measured. Lung wet-to-dry-weight （W/D） ratios and histological scores were calculated to evaluate lung injury. Additional experiments were performed between SAP and delayed EP treatment groups to study the influence of EP on survival times of SAP rats. RESULTS： Delayed EP treatment significantly reduced serum HMGB1 levels, and protected against liver, renal and lung injury with reduced lung W/D ratios （8.22 ±0.42 vs 9.76 ± 0.45, P 〈 0.01）, pulmonary histological scores （7.1 ± 0.7 vs 8.4 ± 1.1, P 〈 0.01）, serum AST （667 ± 103 vs 1 368 ± 271, P 〈 0.01）, ALT （446 ± 91 vs 653 ± 98, P 〈 0.01） and Cr （1.2 ± 0.3 vs 1.8 ± 0.3, P 〈 0.01） levels. SAP rats had a median survival time of 44 h. Delayed EP treatment significantly prolonged median survival time to 72 h （P 〈 0.01）. CONCLUSION： Delayed EP therapy protects against distant organ injury and prolongs survival time via reduced serum HMGBllevels in rats with experimental SAP. EP may potentially serve as an effective new therapeutic option against the inflammatory response and multiple organ dysfunction syndrome （MODS） in SAP patients.

An autopsy case of acute pancreatitis with a high serum IgG4 complicated by amyloidosis and rheumatoid arthritis

We report an autopsy case of acute pancreatitis with a high serum IgG4 concentration complicated by systemic amyloid A amyloidosis and rheumatoid arthritis (RA). The patient was a 42-year-old Japanese female with a 22-year history of rheumatoid arthritis. She was diagnosed with myasthenia gravis when she was 31-year old. At the onset of pancreatitis, the patient was anti-nudear antibody-positive, and had high serum gamma globulin and IgG4 levels. Dexamethasone and conventional therapy induced clinical remission and significantly decreased the serum IgG4 and gamma globulin. However, despite the decreased disease parameters, the patient developed a bleeding pseudocyst and died of cardiac failure. In the autopsy examination, it was determined that pancreatitis was probably caused by ischemia due to vascular obstruction caused by amyloid deposition in the pancreas. Even though acute pancreatitis is a rare complication in RA patients, we speculate that an autoimmune pancreatitis-related mechanism and ischemia due to vascular obstruction by amyloid deposition might be attributable to a single source that leads to acute pancreatitis in our particular case.

Association between autoimmune pancreatitis and systemic autoimmune diseases

AIM: To investigate the association between autoimmune pancreatitis (AIP) and systemic autoimmune diseases (SAIDs) by measurement of serum immunoglobulin G4 (IgG4). METHODS: The serum level of IgG4 was measured in 61 patients with SAIDs of different types who had not yet participated in glucocorticosteroid treatment. Patients with an elevated IgG4 level were examined by abdominal ultrasonography (US) and, in some cases, by computer tomography (CT). RESULTS: Elevated serum IgG4 levels (919 ± 996 mg/L) were detected in 17 (28%) of the 61 SAID patients. 10 patients had Sj gren's syndrome (SS) (IgG4: 590 ± 232 mg/L), 2 of them in association with Hashimoto's thyroiditis, and 7 patients (IgG4: 1388 ± 985.5 mg/L) had systemic lupus erythematosus (SLE). The IgG4 level in the SLE patients and that in patients with SS were not significantly different from that in AIP patients (783 ± 522 mg/L). Abdominal US and CT did not reveal any characteristic features of AIP among the SAID patients with an elevated IgG4 level. CONCLUSION: The serum IgG4 level may be elevated in SAIDs without the presence of AIP. The determination of serum IgG4 does not seem to be suitable for the differentiation between IgG4-related diseases and SAIDs.

Induction of pancreatic duct cells of neonatal rats into insulin-producing cells with fetal bovine serum: A natural protocol and its use for patch clamp experiments

AIM： To induce the pancreatic duct cells into endocrine cells with a new natural protocol for electrophysiological study. METHODS： The pancreatic duct cells of neonatal rats were isolated, cultured and induced into endocrine ceils with 15% fetal bovine serum for a period of 20 d. During this period, insulin secretion, MTT value, and morphological change of neonatal and adult pancreatic islet cells were comparatively investigated. Pancreatic β-cells were identified by morphological and electrophysiological characteristics, while ATP sensitive potassium channels （KATP）, voltage-dependent potassium channels （Kv）, and voltage-dependent calcium channels （KcA） in β-cells were identified by patch clamp technique. RESULTS： After incubation with fetal bovine serum, the neonatal duct cells budded out, changed from duct-like cells into islet clusters. In the first 4 d, MTT value and insulin secretion increased slowly （MTT value from 0.024 ±0.003 to 3.028±0.003, insulin secretion from 2.6±0.6 to 3.1±0.8 mIU/L）. Then MTT value and insulin secretion increased quickly from d 5 to d 10 （MTT value from 0.028 ±0.003 to 0.052±0.008, insulin secretion from 3.1±0.8 to 18.3±2.6 mIU/L）, then reached high plateau （MTT value 〉0.052±0.008, insulin secretion 〉18.3±2.6 mIU/L）. In contrast, for the isolated adult pancreatic islet cells, both insulin release and MTT value were stable in the first 4 d （MTT value from 0.029±0.01 to 0.031±0.011, insulin secretion from 13.9±3.1 to 14.3±3.3 mIU/L）, but afterwards they reduced gradually （MTT value 〈0.031 ±0.011, insulin secretion 〈8.2±1.5 mIU/L）, and the pancreatic islet cells became dispersed, broken or atrophied correspondingly. The differentiated neonatal cells were identified as pancreatic islet cells by dithizone staining method, and pancreatic β-cells were further identified by both morphological features and electrophysiological characteristics, i.e. the existence of recording currents from KATP, Kv, and KCA. CONCLUSION： Islet cells differentiated from neonatal pancreatic duct cells with the new natural protocol are more advantageous in performing patch clamp study over the isolated adult pancreatic islet cells.

Perforated appendicitis masquerading as acute pancreatitis in a morbidly obese patient

Diagnosis and treatment of common conditions in morbidly obese patients still pose a challenge to physicians and surgeons.Sometimes too much reliance is put on investigations that can lead to a misdiagnosis.This case demonstrates an obese woman admitted under the medical team with a presumed diagnosis of pneumonia, who was later found to have an acute abdomen and raised amylase,which led to an assumed diagnosis of pancreatitis.She died within 24 h of admission and post mortem confirmed the cause of death as systemic sepsis due to perforated appendicitis,with no evidence of pancreatitis.Significantly elevated serum amylase level may occur in non-pancreatitic acute abdomen.

Acute pancreatitis caused by leptospirosis: Report of two cases

Two cases of acute pancreatitis with leptospirosis are reported in this article. Case 1: A 68-year-old woman,presented initially with abdominal pain, nausea, vomiting,and jaundice. She was in poor general condition, and had acute abdominal signs and symptoms on physical examination. Emergency laparotomy was performed, acute pancreatitis and leptospirosis were diagnosed on the basis of surgical findings and serological tests. The patient died on postoperative d 6. Case 2: A 62-year-old man, presented with fever, jaundice, nausea, vomiting, and malaise. Acute pancreatitis associated with leptospirosis was diagnosed,according to abdominal CT scanning and serological tests.The patient recovered fully with antibiotic treatment and nutritional support within 19 d.

Effect of double-balloon enteroscopy on pancreas:An experimental porcine model

AIM： To evaluate the effect of double-balloon enteros- copy （DBE） on pancreas histology and levels of pancre- atic enzymes. METHODS： Conventional upper gastrointestinal endos- copy was performed on five control pigs. Oral DBE was performed with an EN-450T5 enteroscope on 20 pigs. Two experimental groups （10 pigs each） were defined according to DBE duration： 90 rain for Group 1 and 140 min for Group 2. During oral insertion, the balloons were not inflated in the descending part of the duodenum to avoid the minor duodenal papilla. Serum amy- lase, lipase and C-reactive protein （CRP） levels were monitored before the procedure and repeated every 30 min until the exploration was finished, as well as 24 h and 7 d after. After the procedure and for a total of 7 d, the pigs were observed twice a day for signs of de- creased activity, irritability, vomiting or anorexia. Gross and microscopic examination of the pancreas was per- formed on day 7. RESULTS： All animals tolerated DBE without clini- cal manifestations of acute pancreatitis. Experimental groups had higher levels of enzymes than the control group at 24 h. Throughout the exploration, the amylase levels increased significantly above the baseline 24 h after DBE, although the increase was not statistically significant and did not reach 20% of the baseline. An increase in lipase and CRP was observed at 24 h after the procedure, although by day 7, all enzymatic lev- els had returned to baseline. No differences between Groups 1 and 2 were found for any enzyme and sam- pling site during and after the procedure. Similarly, no correlation between insertion depth and enzyme levels was observed. Direct in situ and post-removal inspec- tion of the pancreas did not show any evidence of fluid collection, abscesses or hemorrhage. Histological examination of the pancreas from Groups 1 and 2 re- vealed the existence of focal areas （0.14-0.26 mm2） of ischemic necrosis in 47.4% of the animals. In the pigs with damaged pancreas, the left lobe （tail） was always affected. However, this only happened in 83.3% of the samples from the right lobe （head） and in 33.3% of the samples from the body of the pancreas. Significant differences were found between the left lobe （tail） and the body for the percentage of affected pancreas. Both the size of the lesions and the percentage of affected pancreas were higher in the left pancreatic lobe （tail）. The presence of the lesions was not related to the ex- ploration length.CONCLUSION： The increase in pancreatic enzymes after DBE could be related to focal points of pancreatic ischemic necrosis due to mechanical stress.

Serum inter-cellular adhesion molecule 1 is an early marker of diagnosis and prediction of severe acute pancreatitis

AIM:To determine if serum inter-cellular adhesion molecule 1(ICAM-1)is an early marker of the diagnosis and prediction of severe acute pancreatitis(SAP) within 24 h of onset of pain,and to compare the sensitivity,specificity and prognostic value of this test with those of acute physiology and chronic health evaluation(APACHE)Ⅱscore and interleukin-6(IL-6). METHODS:Patients with acute pancreatitis(AP)were divided into two groups according to the Ranson's criteria:mild acute pancreatitis(MAP)group and SAP group.Serum ICAM-1,APACHEⅡand IL-6 levels were detected in all the patients.The sensitivity,specificity and prognostic value of the ICAM-1,APACHEⅡscore and IL-6 were evaluated. RESULTS:The ICAM-1 level in 36 patients with SAP within 24 h of onset of pain was increased and was significantly higher than that in the 50 patients with MAP and the 15 healthy volunteers(P<0.01).The ICAM-1 level(25 ng/mL)was chosen as the optimum cutoff to distinguish SAP from MAP,and the sensitivity,specificity,positive predictive value,negative predictive value(NPV),positive likelihood ratio and negative likelihood ratio were 61.11%,71.42%,0.6111,0.7142, 2.1382 and 0.5445,respectively.The area under the curve demonstrated that the prognostic accuracy of ICAM-1(0.712)was similar to the APACHE-Ⅱscoring system(0.770)and superior to IL-6(0.508)in distinguishing SAP from MAP. CONCLUSION:ICAM-1 test is a simple,rapid and reliable method in clinical practice.It is an early marker of diagnosis and prediction of SAP within the first 24 h after onset of pain or on admission.As it has a relatively low NPV and does not allow it to be a stand-alone test for the diagnosis of AP,other conventional diagnostic tests are required.

重症急性胆石性胰腺炎57例临床分析

目的总结重症急性胆石性胰腺炎(SAGP)的治疗方法及手术时机.方法选取大理大学第一附属医院2011年7月至2018年7月收治的SAGP患者57例,男22例,女35例,年龄18~75岁.57例中行早期(72 h内)手术或急诊手术26例,行非手术治疗及延期手术31例.结果早期手术或急诊手术26例中,治愈22例,占84.6%(22/26),好转2例,死亡2例,分别为:死于急性呼吸窘迫综合征1例、多器官功能衰竭1例.非手术治疗31例中,治愈26例,占83.9%(26/31),病情好转并发胰腺囊肿2例,死亡2例,分别为:死于胰性脑病1例、急性肾功能衰竭1例、不可逆感染中毒性休克1例.总有效率为91.2%(52/57).结论依据SAGP患者胆道梗阻及胆胰系统感染情况,合理选择治疗方案及手术时机,可提高疗效,减少相关并发症.

中西药联合治疗重症急性胰腺炎疗效观察

目的观察中西药联合治疗重症急性胰腺炎的临床疗效。方法64例重症胰腺炎患者随机分为治疗组（34例）和对照组（30例），两组均采用胰腺炎常规治疗，治疗组加用复方清胰汤或清胰陷胸汤治疗，观察比较两组临床疗效、平均住院时间及并发症发生情况。结果治疗组非手术治愈28例（82．4％），好转4例，死亡2例，平均住院时间（15．5±5．2）d，发生并发症5例（14．7％）；对照组非手术治愈19例（63．3％），好转7例，死亡4例，平均住院时间（19．6±5．2）d，发生并发症9例（30．0％）。两组治愈率、平均住院时间、并发症发生率等差异均有统计学意义（x^2=9．81，t=3．27、x^2=8．13，均P〈0．05）。结论中西药联合治疗重症急性胰腺炎能明显提高治愈率，减少并发症的发生，缩短住院时间。

Synergetic Effect of Yihuo Qingyi Decoction (益活凊胰汤) and Recombinant Staphylokinase in Treatment of Severe Acute Pancreatitis of Rats

Objective: To investigate the effect of recombinant staphylokinase (r-Sak) and the Chinese medicine Yihuo Qingyi Decoction (益活凊胰汤 Herbal decoction for severe acute pancreatitis) in the treatment of the severe acute pancreatitis (SAP) in rats, and to observe the synergistic effect of the two. Methods: One hundred and sixty-two adult male SD rats with the body mass of 250–280 g were randomly divided into the following 5 groups: sham operation group (n=18), control group (n=36), Yihuo Qingyi Decoction treatment group (n=36), r-Sak treatment group (n=36), and Yihuo Qingyi Decoction plus r-Sak treatment group (n=36). The SAP ratmodel was prepared by retrograde injection of 5% sodium taurocholate into the cholangiopancreatic duct. Two days before modeling, Yihuo Qingyi Decoction was intragastrically administrated, and r-Sak was intraperitoneally injected. The survival rate within 18 h after modeling was determined. The pancreatic blood flow, the weight of ascites, and the serum amylase and lipase were investigated at 6 h, 12 h, and 18kh after modeling, and the pancreatic tissue was examined under light microscopy to see its pathological change. Results: The 18 h survival count of group A,B,C,D and E rats was 9,2,6,7 and 8 respectively. After r-Sak and Yihuo Qingyi Decoction intervention, the serum amylase and lipase and the weight of ascites were significantly decreased, especially in group E.18 h after modeling, the level of the serum amylase and lipase and the weight of ascites in group E was 1 100±118 U·L-1,1 000±150 U·L-1 and 13.40±1.80 g respectively, obviously lower than that of group B (P<0.05).After SAP was induced, the pancreatic blood flow showed a tendency to decrease, but the decrease extent in the treatment groups was smaller than that in the control group.18h after modeling, the pancreatic blood flow in group B and group E was 30.16±8.96 mL·100 g-1·min-1,and 129.10±42.58 mL·100 g-1·min-1 respectively, there was significant difference (P<0.05). The pathological change of the pancreatic tissue was alleviated in the treatment groups. Conclusion: Both r-Sak and Yihuo Qingyi Decoction play a beneficial role in the treatment of rat SAP and there is a synergistic effect between the two.