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Objective:To analyze medical records and CT images of two treatment groups with SAP, explore the correlation between TCM Syndrome Differentiation/pre and post treatment and CT images, summarize their regulation, provides the evidence for the TCM Syndrome Differentiation and treatment of SAP.Methods:Medical records and computed tomography (CT) images of 86 patients with severe acute pancreatitis treated between 2009 and 2010 were reviewed.86 patients divided into two groups according to different treatment, the combined treatment of traditional Chinese medicine and western medicine group (Group 1) and conventional western medicine therapy group (Group 2).The TCM Syndrome Differentiation of Group 1 was distributed into 3 types:Stagnation of Liver-qi type (type 1)(0 case), Liver and gallbladder damp-heat type (type 2)(21 cases), Spleen and stomach excessive heat type (type 3)(48 cases).To analyze the CT manifestations of two groups, before and after treatment. Collection of data:age, gender, etiology, APACHE-Ⅱscores within 72h after in hospital, Balthazar CT ratings within 7 days and review, the local complications and system complications.Results:1, after treatment, size of 86 cases pancreas is significantly reducing, blood donation increasing (P< 0.01), the right anterior pararenal space, the right perirenal space, the subphrenic retroperitoneal space, the subperitoneal space and the right pleural effusion absorbed, lobe of lung involvement improved obviously (P< 0.05).2, there’re 69 cases in group 1 and 17 cases in group 2, the mean age of group 1 is 45.91±11.99y, group 2 is 44.65±16.07 y (P>0.05), APACHEⅡscores in groupl (11.93±3.74) is significantly higher than group 2 (9.71±3.37) (P< 0.05), hospitalization days of two groups without difference; After treatment, the absorption of acute exudates and improved of mesenteric infringement in group 1 were better than group 2 (P< 0.05), mainly in peripheral hepatic space and/or recess and under the diaphragm peritoneal fluid absorption differences between obvious (P< 0.05). Pancreatic swelling, blood donation in group1 improved significantly(P<0.01), diameter of pancreatic body and tail, density of pancreatic head by non-contrasted CT in group 2 were changed obviously (P< 0.05), but the comparison between the two groups was not statistically significant; Local complications in two groups of were not statistically significant.3, none of type 1 in group l,the incidence of effusion, which in pelvic extraperitoneal space and perihepatic space and intestinal tube, in type 2 is more than type 3 (P<0.05)Conclusions:1) After treatment,86 patients were improved in the pancreatic size, density and absorption of acute effusion; 2) in similar treatment time, group 1 was superior to absorption effusion around the subphrenic retroperitoneal space and hepatic space and/or recess than group 2; 3) the incidence of effusion, which in pelvic extraperitoneal space and perihepatic space and intestinal tube, in type 2 is more than type 3.
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