Objective： TO investigate the changing trends of clinical management for severe acute pancreatitis （SAP） with integrative medicine. Methods： Clinical data of 1 561 patients with SAP from 1980 to 2005 was retrospectively analyzed. The mortality and morbidity of complications were compared. Results： Of the 1 561 patients, 400 patients accepted surgical operation, while the rest were treated conservatively with integrative medicine. There was a change toward conservative management together with Chinese purgative herbal medication use after 1990 （22.4% from 1980-1990 compared with 45.5% from 1991-1993） because of high postoperative mortality. From 1994-2005, the treatment integrating Western medicine with Chinese herbal medications came to be preferred over the classic Westem operation-based method. This change was associated with decreased morbidity （35.4% in 1980-1990 compared with 24.7% in 1991-1993 and 11.0% in 1994-2005, P〈0.05） and lower mortality （40.52% of 1980-1990 compared with 17.17% of 1991- 1993 and 10.25% of 1994-2005, P〈0.05）. Conclusion： The combination of conservative management with Chinese herbal medicines is preferable to classic Western medicine treatment to reduce morbidity and mortality of SAP, while surgery becomes a supplemental option.
Objective： To investigate the effect of prescription compatibility on the pharmacokinetics of components from Dachengqi Decoction （DCQD, 大承气汤） in rats. Methods： Twenty-four male rats were randomly and equally divided into the DCQD group, Dahuang （Radix et Rhizoma Rhei, Polygonaceae） group, Houpo （Magnolia officinalis Rehd., Magnoliaceae） group, and Zhishi （Fructus Aurantii Immaturus, Rutaceae） group. The blood samples were collected before dosing and subsequently at 10, 15, 20, 30, 45 min, 1, 2, 4, 8, and 12 h following gavage. The levels of aloe-emodin, rhein, emodin, chrysophanol, honokiol, magnolol, hesperidin, and naringin in rat serum were quantified using a liquid chromatography tandem mass spectrometry （LC-MS/MS） method for pharmacokinetic study. Results： The area under the curve （AUC）, mean retention time （MRT）, the peak concentration （Cmax） of aloe-emodin, rhein, emodin, and chrysophanol in the DCQD group were significantly different compared with the Dahuang group （P〈0.05, respectively）. The mean plasma concentration, Cmax, and the absorption of Dahuang＇s component in the DCQD group were obviously lower at each time point than those in the Dahuang group, while the elimination process of Dahuang＇s component was obviously delayed （P〈0.05）. Half-lives of aloe-emodin, chrysophanol, and rhein were also extended in the DCQD group （P〈0.05, respectively）. In the DCQD group, the mean plasma concentration, AUC, Cmax and absorption of honokiol, and magnolol were significantly lower （P〈0.01, respectively） at each time point than those in the Houpo group, while the drug distribution half-life time （T1/2α）, the drug eliminated half-life time （T1/2β）, MRT, and time of peak concentration （Tmax） were significantly delayed （P〈0.05, respectively）. Pharmacokinetic parameters of hesperidin and naringin in the Zhishi group were not significantly different as compared with the DCQD group （P〉0.05, respectively）, while the MRT of
