Herbal Medicinal Preparations Research Articles

Suggestion about Modernized Classification of Herbal Medicinal Preparations in Dual Medical Systems

Ji-Hoon Kim, Sun-Young Cho, Sang-Yong Han, Sun-Dong Park, Yun-Kyung Kim Dept. of Herbal Resources, Professional Graduate School of Korean Medicine, Wonkwang University, BK21 Plus Team, Iksan, Republic of Korea KBS Clinic, Seoul, Republic of Korea College of Oriental Medicine, Dongguk Univerisity, Kyungju, Republic of Korea Dept. of Herbal Medicine, College of Pharmacy, Wonkwang University, Iksan, Republic of Korea Wonkwang Oriental Medicines Research Institute, Iksan, Republic of Korea

Safety surveillance of traditional Chinese medicine: current and future.

Herbal medicine, including traditional Chinese medicine, has been used for the prevention, treatment, and cure of disorders or diseases for centuries. In addition to being used directly as therapeutic agents, medicinal plants are also important sources for pharmacological drug research and development. With the increasing consumption of herbal products intended to promote better health, it is extremely important to assure the safety and quality of herbal preparations. However, under current regulation surveillance, herbal preparations may not meet expectations in safety, quality, and efficacy. The challenge is how to assure the safety and quality of herbal products for consumers. It is the responsibility of producers to minimize hazardous contamination and additives during cultivation, harvesting, handling, processing, storage, and distribution. This article reviews the current safety obstacles that have been involved in traditional Chinese herbal medicine preparations with examples of popular herbs. Approaches to improve the safety of traditional Chinese medicine are proposed.

Safety evaluation of chinese medicine injections with a cell imaging-based multiparametric assay revealed a critical involvement of mitochondrial function in hepatotoxicity.

The safety of herbal medicine products has been a widespread concern due to their complex chemical nature and lack of proper evaluation methods. We have adapted a sensitive and reproducible multiparametric cell-based high-content analysis assay to evaluate the hepatic-safety of four Chinese medicine injections and validated it with classical animal-based toxicity assays. Our results suggested that the reported hepatotoxicity by one of the drugs, Fufangkushen injection, could be attributed at least in part to the interference of mitochondrial function in human HepG2 cells by some of its constituents. This method should be useful for both preclinical screen in a drug discovery program and postclinical evaluation of herbal medicine preparations.

Diversity and uses of ethno-medicinal plants associated with traditional agroforestry systems in Kumaun Himalaya

Uttarakhand state is bestowed with great diversity of medicinally important plants which are used frequently by the local people/inhabitants to cure various ailments in their daily life. Traditional agroforestry is a common land use pattern in Uttarakhand which supports various indigenous medicinal plants. The present study provides comprehensive information on the diversity and utilization of medicinally important plants in existing traditional agroforestry systems. The information was gathered using semi-structured questionnaires about the types of ailments treated by the traditional use of medicinal plants, preparation of herbal medicine and formulations. A total of 68 plant species belonging to 38 families and 63 different genera, were reported from agroforestry systems of this region. The families; Rosaceae, Asteraceae, and Verbenaceae were represented by more than 3 species each and dominated the floral composition while remaining 35 families were represented by single species. Different plant parts such as roots/rhizomes/bulbs, leaves, bark, fruits, seeds, flowers, stem and whole plant were used for the treatment of various diseases.

Evaluation of cytotoxic, DNA protecting and LPS induced MMP-9 down regulation activities of Plectranthus amboinicus (Lour) Spreng. essential oil.

Introduction: Plectranthus amboinicus(Lour) Spreng is a known medicinal plant used in Siddha and Ayurveda medicines in India. It has enormous medicinal potential to treat various diseases. Methods: The present study focused on the use of essential oil obtained from the leaves of Plectranthus amboinicus to test cytotoxicity against breast (MCF-7) and colorectal (HT-29) cancer cell lines, to protect DNA from H 2 O 2 induced genotoxicity through comet assay and to treat inflammation in lipopolysaccharide (LPS) induced over expression of matrix metalloproteinase-9 (MMP-9) in human peripheral blood mononuclear cells (PBMCs) by gelatin zymogram and inhibition at transcriptional level confirmed using RT-PCR (reverse transcriptase polymerase chain reaction). Results: Cytotoxicity of essential oil against MCF-7 and HT-29 cancer cell lines revealed the IC50 values of 53±0.01 and 87±0.01µg/mL respectively. At 200µg/mL essential oil protected against 75% of DNA damage in 3T3-L1 fibroblast cells. Essential oil showed significant reduction in production of MMP-9 in a concentration dependent manner. Conclusion: Overall, the results showed that essential oil of P. amboinicus is a potent bioactive substance and it could be used in herbal medicine preparations.

한약제제, 생약제제와 천연물신약의 법규상 개념 및 정의의 문제점과 개선안

Objectives : This study was to analyze definitions of herbal medicinal preparations, crude drug preparations, and new drugs from natural products in the relevant laws and regulations, understand the related problems, and propose directions for improvement. Methods : I analyzed the legal definitions in respect of herbal medicinal preparations, crude drug preparations, and new drugs from natural products in relevant laws and regulations since 1945, explained the problems, and suggested the solution-considering the academic stance of Traditional Korean Medicine and the dualistic medical and pharmaceutical system. Results : Regarding the current laws and regulations that are relevant to herbal medicinal preparations, we should 1) clarify the boundaries between the duty of physicians and that of pharmacists, 2) limit the principles of Korean Medicine as well as the contents of the related textbooks, 3) find a way to protect the intellectual property rights for herbal medicinal preparations, and 4) establish a separate standard for drug classification regarding herbal medicinal preparations. In case of crude drug preparations, we should 1) clarify the meaning and limitations of the phrase, "the point of view of Western medicine," and 2) establish a classification standard for drugs that are used in Korean Medicine and clarify the boundaries between herbal drug preparations and crude drug preparations. Furthermore, laws and regulations apropos of new drugs from natural products do not actually fit the concept of "new drug," and due to subordinate laws, a supplement to a new drug submission is contradictorily misclassified as a new drug from natural products. Conclusions : The problems of legal definitions of herbal medicinal preparations, crude drug preparations, and new drugs from natural products have emerged in the process of giving approval to drugs that are made of herbs and natural products under the dualistic medical and pharmaceutical System. Laws and regulations that differentiate the process of approving herbs that are used in Korean Medicine and the others should be established.

Mathematical exploration of essence of herbal properties based on “Three-Elements” theory

Herbal property theory of traditional Chinese medicines is the theoretical guidance on authentication of medicinal plants, herborization, preparation of herbal medicines for decoction and clinical application, with important theoretical value and prac- tical significance. Our research team proposed the "three-element" theory for herbal properties for the first time, conducted a study by using combined methods of philology, chemistry, pharmacology and mathematics, and then drew the research conclusion that herbal properties are defined as the chemical compositions-based comprehensive expression with complex and multi-level (positive/negative) biological effects in specific organism state. In this paper, researchers made a systematic mathematical analysis in four aspects--the correlation between herbal properties and chemical component factors, the correlation between herbal properties and organism state fac- tor, the correlation between herbal properties and biological effect factor and the integration study of the three elements, proposed future outlook, and provided reference to mathematical studies and mathematical analysis of herbal properties.

Study on the Application of Established Korean Medical Classics in the Korean Pharmaceutical Affairs Act

Purpose: There is an issue in applying various principles introduced in established Korean medical classics to “Pharmaceuticals Approval, Notification and Review” of “herbal medicinal preparations” and “new drugs from natural products” that are used for western forms of medical treatment. Thus, an analysis of the origin, purpose, and application of established Korean medical classics in the Korean Pharmaceutical Affairs Act is essential. Methods: We collected data regarding the origin, purpose, and application of established Korean medical classics in the Korean Pharmaceutical Affairs Act, and classified them by periodical change and subjects. Results: Established Korean medical classics are applied as follows: 1) as criteria for Korean medicine distributors’ sales of mixed herbal drugs (Pharmaceutical Affairs Act; since 1953), 2) as official compendiums for pharmacists’ preparation of Korean medicine (Ministry of Health and Welfare’s authoritative interpretation; from early 1970s to 1993), 3) as standards for oriental pharmacists’ quality measurement of preparations (notification of the Ministry of Health and Welfare; since 1995), 4) as criteria for “Pharmaceuticals Approval, Notification and Review” of herbal medicinal preparations and crude drug preparations (notifications regarding drug approval process by the Ministry of Health and Welfare and the Ministry of Food and Drug Safety; since 1978), and 5) as standards for the quality of materials of health functional food (from 2004 to 2011). Conclusion: The application of Korean medical classics has been closely related with the change of the laws, regulations, and systems that are relevant to Korean medicine, and it seems to be more favorable for pharmacists than oriental pharmacists. Meanwhile, regulations that apply prescriptions that are recorded in Korean medical classics dosage, indications, and preparation methods as criteria for the approval of crude drug preparations for western medical treatment should be abolished.

Acetylcholinesterase inhibitors from galbanum, the oleo gum-resin of Ferula gummosa Boiss.

Due to the correlation of Alzheimer's disease with a cholinergic deficit, acetylcholinesterase (AChE) inhibitors from herbal drugs or herbal medicinal preparations have gained a lot of scientific interest.In a previous study, several substances with AChE inhibitory activity were detected in galbanum by TLC bioautography and two of them were identified as auraptene and farnesiferol A. The aim of present study was the isolation and characterization of the other active compounds in galbanum.In an activity-guided approach, six components were isolated via column chromatography and solid phase extraction. The compounds were identified as deacetylkellerin, kellerin, umbelliferone, 5′-acetoxyauraptene, 5′-hydroxyauraptene and farnesiferol B and their concentrations in galbanum were determined by HPLC analysis with external standardization.Kellerin showed the best AChE inhibition with an IC50 value of 10.6μM which was about one third of the positive control physostigmine (IC50 2.91μM).

Efficacy of Simple Guidelines for Using Acupuncture and Herbal Medicine in General Medical Practice: A Preliminary Observational Report

Abstract Background: The routine integration of traditional Eastern medicine with modern Western medicine can be of great benefit to providers and patients. Practitioners of Western medicine who are unfamiliar with herbal medicine and acupuncture would benefit from a set of simple guidelines for incorporating these techniques in the treatment for a number of common complaints. Materials and Methods: This article introduces a new set of uniquely defined rules (in the form of algorithms) for selection of medicinal herbal preparations and acupoints that can be used by physicians with no prior knowledge of Traditional Chinese Medicine and examines preliminary outcomes in terms of symptom relief after applying these rules for treatment in a group of 987 female patients with headaches, neck/shoulder stiffness, dizziness, low-back pain, or menstrual cramps. Among these patients, 497 were treated with herbal medicine and 490 were treated with acupuncture. Results: Overall, the treatments were considered to be hig...

Review article: Herbal hepatotoxicity--an update on traditional Chinese medicine preparations.

Although evidence for their therapeutic efficacy is limited, herbal traditional Chinese medicine (TCM) preparations increasingly gain popularity. In contrast to other herbal products, adverse effects by herbal TCM including liver toxicity were rarely reported. In recent years, more cases were published, providing new clinical challenges. To summarise comprehensively the literature on herbal TCM hepatotoxicity since 2011. PubMed was searched using key words related to TCM, the results were restricted to full English-language publications and abstracts published since 2011. In addition, the database of the National Institutes of Health (NIH) and LiverTox was accessed under the topic 'Drug record: Chinese and other Asian herbal medicines'. Since 2011, new case reports and case series provided evidence for herbal hepatotoxicity by TCM, focusing on nine TCM herbal mixtures and four individual TCM herbs with potential health hazards. These were the TCM products Ban Tu Wan, Chai Hu, Du Huo, Huang Qin, Jia Wei Xia Yao San, Jiguja, Kamishoyosan, Long Dan Xie Gan Tang, Lu Cha, Polygonum multiflorum products, Shan Chi, 'White flood' containing the herbal TCM Wu Zhu Yu and Qian Ceng Ta, and Xiao Chai Hu Tang. Other developments include the establishment of a new and early diagnostic serum marker for hepatotoxicity caused by pyrrolizidine alkaloids, assessed using ultra performance liquid chromatography-mass spectrometry analysis, and new regulatory details to improve herbal TCM product quality and safety. Stringent evaluation of the risk/benefit ratio is essential to protect traditional Chinese medicines users from health hazards including liver injury.

Formalin-fixed paraffin-embedded tissue as a source for quantitation of carcinogen DNA adducts: aristolochic acid as a prototype carcinogen.

DNA adducts are a measure of internal exposure to genotoxicants. However, the measurement of DNA adducts in molecular epidemiology studies often is precluded by the lack of fresh tissue. In contrast, formalin-fixed paraffin-embedded (FFPE) tissues frequently are accessible, although technical challenges remain in retrieval of high quality DNA suitable for biomonitoring of adducts. Aristolochic acids (AA) are human carcinogens found in Aristolochia plants, some of which have been used in the preparation of traditional Chinese herbal medicines. We previously established a method to measure DNA adducts of AA in FFPE tissue. In this study, we examine additional features of formalin fixation that could impact the quantity and quality of DNA and report on the recovery of AA-DNA adducts in mice exposed to AA. The yield of DNA isolated from tissues fixed with formalin decreased over 1 week; however, the levels of AA-DNA adducts were similar to those in fresh frozen tissue. Moreover, DNA from FFPE tissue served as a template for PCR amplification, yielding sequence data of comparable quality to DNA obtained from fresh frozen tissue. The estimates of AA-DNA adducts measured in freshly frozen tissue and matching FFPE tissue blocks of human kidney stored for 9 years showed good concordance. Thus, DNA isolated from FFPE tissues may be used to biomonitor DNA adducts and to amplify genes used for mutational analysis, providing clues regarding the origin of human cancers for which an environmental cause is suspected.

Phytotherapy of Polish migrants in Misiones, Argentina: Legacy and acquired plant species

Ethnopharmacological relevanceAnalyzing how and why phytotherapeutical practices survive a migratory process is important for understanding migrant health seeking behaviour and health demand. Contrary to most studies, which focus on migrants from warm climates who settle in European and American cities, this study explores continuations in the herbal pharmacopoeia of Eastern European peasants who settled down in rural subtropical areas of Argentina. The study also explores the pharmacopoeia among the descendants of the first generation born in Argentina. Material and methodsPrimary and secondary sources were employed in the study. Data were collected during over 200 interviews (semi-structured, free lists and in-depth) with 94 study participants. Voucher specimens of species mentioned were gathered and identified. Illnesses were reported according to local ethnomedical terminology and classification. Only reports from informants’ own experience were included in the analysis. The unit of analysis was a plant use report (plant species×plant part×ailment×informant). The frequency of mentions was calculated for plant parts used and modes of preparation and administration of herbal medicines, and the Informant Diversity Value was also estimated. Secondary information was obtained from ethnobotanical and ethnomedical literature concerning the whole of Poland. A list was made of medicinal plant species known from Poland available in the study area. Then, the similarity between the available species and those used by Polish migrants was evaluated by applying the Simpson index. ResultsAn exhaustive list of 129 plant species used by the Polish community in Misiones, Argentina, was obtained. Among 37 species known form Poland and available in Misiones, 19 were used by the community. There was low consensus on the treatment of health conditions with legacy plants between Polish migrants and the Polish folk pharmacopoeia. The reasons for the relatively low use of legacy species are explained. More continuation has been observed in forms of application and administration of medicinal plants. Most of the continued species are food plants and are predominantly applied as medicinal food. ConclusionsIn the migratory process, Polish peasants have preserved culturally salient species, which have a wide range of therapeutic applications and are easily accessible. Polish migrants and their descendants have incorporated a great number of local medicinal plant species into their home medicine but at the same time retained traditional ways of administration of herbal medicines. Based on the theory of acculturation, the observed patterns of medicinal plant use in Polish migrant colonies in Misiones indicate good adaptation to the predominant cultural environment.

A Simple Semi‐preparative Reversed‐phase HPLC/PDA Method for Separation and Quantification of Glycyrrhizin in Nine Samples of Glycyrrhiza glabra Root Collected from Different Geographical Origins

Glycyrrhiza glabra L. (Fabaceae), commonly known as 'liquorice', is one of the most popular ingredients in several traditional herbal medicinal preparations, and glycyrrhizin is the major glycoside present in this plant. The content of glycyrrhizin may vary among G. glabra samples collected from various geographical origins, which may affect the therapeutic efficacy. Thus, quantification of glycyrrhizin in G. glabra samples is important. To develop and validate a simple semi-preparative reversed-phase HPLC with photodiode array (PDA) method for separation and quantification of glycyrrhizin in nine samples of G. glabra root collected from various geographical origins. Dried and ground root of G. glabra was Soxhlet-extracted sequentially with n-hexane and methanol (MeOH). The separation and quantification of glycyrrhizin was achieved on a C18 reversed-phase semi-preparative column using a gradient mobile phase, 30-100% solvent B in solvent A in 30 min (solvent A: 0.1% v/v trifluoroacetic acid (TFA) in water and solvent B: 0.1% v/v of TFA in MeOH), at a flow rate of 3.00 mL/min and UV detection at 254 nm. A simple semi-preparative reversed-phase HPLC/PDA method allowing clear separation and quantification of glycyrrhizin content in nine samples has been validated in terms of linearity, selectivity, limits of detection, precision, accuracy and detection. Concentration levels of glycyrrhizin were between 0.177 and 0.688% w/w of dry materials. This method is precise, less time consuming and more cost effective, and can be used for the quality control of any G. glabra sample with regard to its glycyrrhizin contents.

Macroscopial, anatomical and physico-chemical studies on fruits of Coccinia indica Wight & Arn. (Cucurbitaceae)

ObjectiveTo rationalize the macroscopial, anatomical and physico-chemical studies on fruits of Coccinia indica Wight & Arn. (Cucurbitaceae). MethodsThe crude ethanolic extract of fruits of Coccinia indica Wight & Arn. (Cucurbitaceae) was using physico-chemical parameters, fluorescence analysis, and preliminary photochemical investigation (TLC, HPTLC, column chromatography). ResultsAn attempt has been made to highlight this folk herbal medicine through present study which will assist in the identification of fresh as well as dried crude samples of fruits anatomically and physico chemically. TLC fingerprint profiling and fluorescence analysis of powdered fruits were also carried out and the salient qualitative and quantitative parameters are reported. ConclusionsThe present study will provide referential information for correct identification and help in checking adulteration in market samples used in the preparation of various herbal medicines. The present observation will also be helpful in macroscopial, anatomical and physico-chemical studies on fruits of Coccinia indica Wight & Arn. (Cucurbitaceae).

생약제제의 의미 변천과 정책적 문제 검토

Objectives : The aim of this study is reviewing the past legal definition and regulations, to provide basis for the future desirable direction of Korean herbal pharmaceutical industry and national herbal drug policies. Methods : We reviewed how concept of herbal medicinal preparation has been utilized and changed along with various national laws and regulations. And this study also reviewed problems related herbal medicinal preparation policies.

An ethnobotanical study of medicinal plants in Wayu Tuka District, East Welega Zone of Oromia Regional State, West Ethiopia

BackgroundThis paper reports an ethnobotanical study that focused on the traditional medicinal plants used by local communities to treat human and livestock ailments. A cross-sectional study was undertaken from September 2009 to June 2010 in Wayu Tuka District of Oromia Region, Ethiopia. The aim of the study is to document medicinal plants used by local people of the study area and the threats currently affecting medicinal plants.MethodsEthnobotanical data were collected using semi-structured interviews, field observations and group discussion in which 63 (41 men & 22 women) randomly selected informants participated. Of which, 11 (10 male and 1 female) were local healers. Paired comparison method, direct matrix ranking and Informant consensus factors (ICF) were used to analyze the importance of some plant species.ResultsA total of 126 medicinal plant species, distributed in 108 genera and 56 families, were collected together with their medicinal uses. Of the 126 species of medicinal plants collected from the study area, eighty six (68%) were obtained from the wild whereas thirty three (26%) were from homegardens. The Fabaceae came out as a leading family with 15 medicinal species while the Solanaceae followed with eight species. Seventy eight (62%) of the medicinal plants were reported as being used for treating human ailments, 23 (18.2%) for the treatment of livestock ailments and 25 (20%) for both. The most frequently used plant parts were leaves (43%), followed by roots (18.5%) while crushing, which accounted for (29%) and powdering (28%) were the widely used methods of preparation of traditional herbal medicines.ConclusionThe number of reported medicinal plants and their uses by the local people of the District indicate the depth of the local indigenous knowledge on medicinal plants and their application. The documented medicinal plants can serve as a basis for future investigation of modern drug.

Effects of Shengmai Injection on multiple organ failure in post cardiopulmonary resuscitation rabbits

Objective To observe the effect of Shengmai Injection (a Chinese herbal medicine preparation) on the serum levels of TNF-α used as indicators of organ function in post cardiopulmonary resuscitation rabbits.Methods Rabbit cardiac arrest model was made with asphyxia by clamping the trachea of rabbit.A total of 30 rabbits were randomly (random number) divided into two groups,namely the normal saline group (n =15) and the Shengmai injection group (n =15).Rabbits in Shengmai injection group were injected with 2 ml/kg Shengmai Injection immediately at the beginning of cardiopulmonary resuscitation (CPR),and the same dose of Shengmai injection given 10 min after CPR.Rabbits in saline group were injected with the same volume of physiological saline instead at the same intervals as previous group.The rate of restoration of spontaneous circulation (ROSC) and survival rates at 6,12,24 and 48 h after ROSC were observed.The serum levels of TNF-α were measured by enzyme-linked immunosorbent assay (ELISA).Biochemical methods were used to detect myocardial MB-isoenzyme of creatine kinase (CK-MB),alanine aminotransferase (ALT),creatinine (Cr),glucose (Glu) and arterial partial pressure of oxygen (PaO2) before resuscitation and 12,24 and 48 h after ROSC simultaneously in the two groups.Results There was no statistically significant difference in the ROSC rate and survival rate after resuscitation between the two groups (P ＞ 0.05).Before asphyxia,there was no significant difference in the level of TNF-α found between the two groups (P ＞ 0.05),but at 12,24 and 48 h after ROSC,the levels of TNF-α in Shengmai group were much lower than those in Saline group (P ＜ 0.05).At 24 h after ROSC,the levels of serum CK-MB,ALT,and Cr in Shengmai group were much lower than those in Saline group (P ＜0.05).Furthermore,at 48 h after ROSC,the levels of CK-MB and ALT in Shengmai group were still lower than those in Saline group (P ＜ 0.05),but there was no significant difference in the level of Cr between the two groups (P ＞ 0.05).There was also no significant difference in the blood glucose and arterial partial pressure of oxygen between the two groups (P ＞ 0.05).Conclusions Shengmai Injection has significant inhibiting effect on the serum level of TNF-α in post cardiopulmonary resuscitation rabbits,and it also has more or less some degrees of protective effect on organ function of heart,liver and kidney in rabbits after ROSC. Key words: Cardiac arrest; Cardiopulmonary resuscitation; Tumor necrosis factor-α; Shengmai Injection; Systemic inflammatory response syndrome; Multiple organ dysfunction syndrome

PCR–RFLP to distinguish three Phyllanthus sp., commonly used in herbal medicines

The herbs Phyllanthus amarus, P. fraternus and P. urinaria, are known for their use in preparation of herbal medicines. These herbs grow together and are morphologically indistinguishable. Hence, collections of these herbs for raw drug trade, frequently contain mixture of the three species. Such mixing can result in preparation of herbal drugs with altered efficacy. To prevent this, it is essential to develop reliable methods/markers for accurate identification of species. Keeping this in view, PCR–RFLP (Polymerase Chain Reaction–Restriction Fragment Length Polymorphism) of chloroplast genome regions was carried out, using six pairs of universal primers of chloroplast DNA for amplification, followed by restriction with HinfI and TaqI in P. amarus, P. fraternus and P. urinaria. Distinct restriction patterns for the three species were obtained in all primer pair-restriction enzyme combinations. Since the primers used are conserved over a wide range of plant taxa, PCR–RFLP technique using universal cpDNA primers may be applied to other medicinal/economically important plants, posed with similar problems of identification.

Clinical efficacy of Qingyi decoction combined with DAR for the treatment of acute pancreatitis

Objective To explore the clinical efficacy of Qingyi decoction (a preparation of Chinese herbal medicine) combined with DAR (combined use of dexamethasone,anisodamine and rhubarb) for the treatment of acute pancreatitis.Methods A total of 387 eligible patients met the criteria of acute pancreatitis were enrolled from January 2005 to April 2012 for prospective study.All patients,mild acute pancreatitis (MAP) or severe acute pancreatitis (SAP),were divided (random niumber) into four groups,namely conventional therapy (T),DAR therapy (DAR),Qingyi decoction therapy (Q) and Qingyi decoction combined with DAR therapy (Q + DAR).Outcome,fasting time,serum amylase,abdominal pain relief time,pancreatic or peri-pancreatic complications and average hospital-stay were analvzed with SPSS 13.0 statistic software.P ＜ 0.05 was considered statistically significant.Results None of MAP patients died.Of SAP patients,there was no difference in mortality among different groups (P ＞ 0.05).length of fasting time,tine elapsed for abdominal pain relief,time required for normalized serum amylase level and length of hospital stay in MAP patients were significantly shorter than those in SAP patients regardless of different therapies (P ＜ 0.05).Either patients of SAP or MAP treated with Q + DAR or DAR suffered shorter length of time than those treated with T or Q in respect of fasting,abdominal paiu relief,serum amylase level normalization and hospital stay (P ＜ 0.05).For SAP or MAP patients,there was no difference in abdominal pain relief time between receiving DAR and Q + DAR treatment (P ＞ 0.05),but the fasting time in Q + DAR was shorter than that in DAR (P ＜ 0.05).Patients with SAP were more likely to suffer pancreatic or per-pancreatic complications than those with MAP,but there was no difference for SAP or MAP with different treatments.Conclusions DAR or Q + DAR was an alternative to conventional treatment for MAP or SAP,and they were both superior to conventional treatment.And Q + DAR was more advantageous than DAR when fasting time,hospital-stay time and cost were considered. Key words: Acute pancreatitis; DAR; Qingyi decoction; Comprehensive treatment