Mechanism of Chinese Medicine Against Intestinal Mucosal Barrier Injury in Acute Pancreatitis： A Review / 中国实验方剂学杂志

ABSTRACT

Acute pancreatitis （AP） is one of the most common digestive system diseases in clinic. Its pathogenesis is complex and has not yet been fully clarified. It easily progresses to severe AP if the treatment is not provided in time， and the resulting condition is dangerous with high mortality. Intestinal mucosal barrier （IMB） injury is the key link leading to the aggravation of AP. The IMB injury in the late stage of AP promotes the translocation of harmful intestinal bacteria， the entry of bacteria and the produced endotoxins into blood circulation triggers endotoxemia and enterogenous infection，causing multiple organ failure and even death. Western medicine has limitations in the treatment of IMB injury induced by AP. By contrast， Chinese medicine has been proved effective and reliable in repairing the IMB injury induced by AP through oral administration and external application，and has been widely recognized by physicians and patients. AP falls into the categories of "precordial pain due to spleen disorder"， "thoracic accumulation"， and "pancreas-heat syndrome" in traditional Chinese medicine. The main causes of AP are excessive intake of sweet and greasy food， improper diet， and cholelithiasis， which lead to damp-heat accumulation in the middle energizer， stagnation of spleen and stomach， and obstruction of fu-organ intestine. Therefore， dredging the interior， purging， clearing heat， removing toxin， moving Qi， and activating blood should be emphasized in treatment. According to the related literature both in China and abroad in the past five years， this paper summarized the action mechanisms of Chinese medicine in the treatment of AP-induced IMB injury as follows： It protects the mechanical barrier by improving intestinal microcirculation disorders， relieving intestinal ischemia-reperfusion injury and oxidative stress response， reducing the release of inflammatory mediators and cytokines， and inhibiting the apoptosis of intestinal epithelial cells. It restores the chemical barrier by promoting gastrointestinal functional recovery and shortening enteral nutrition time. It improved the biological barrier by regulating intestinal microecological imbalance. It reinforces the immune barrier by adjusting the level of immune cells. This paper reviewed the characteristics of IMB injury in AP as well as its therapeutic principles and mechanisms with Chinese medicine， aiming to provide a theoretical and scientific basis for the in-depth study and rational application of Chinese medicine for the treatment of IMB injury in AP.