| Objective To explore the pathogenesis and staged treatment of pancreatic exocrine-endocrine comorbidity based on the six-stagnation theory of Danxi Xinfa. Methods The theoretical evolution from the five-stagnation theory in Huangdi Neijing to Zhu Danxi"s six stagnations and Dai Sigong"s “dysfunction of transmission-transformation” was reviewed, and pancreatic exocrine and endocrine functions were corresponded to “transmission” and “transformation” of the middle jiao, respectively. The staging scheme was formulated according to fecal elastase-1 (FE-1), blood glucose, glycated hemoglobin (HbA1c) and imaging findings. Results For the acute exacerbation phase, purging the fu-organs, clearing heat and moving qi are applied, with Qingyi Decoction or Dachaihu Decoction; for the early, middle and late stages of the remission phase, Yueju Wan combined with Pingwei Powder, Huanglian Wendan Decoction, or Liujunzi Decoction plus blood-activating herbs is used, respectively. One representative case is reported. Conclusion The dynamic progression of the six stagnations constitutes the core pathogenesis whereby exocrine injury extends to involve endocrine function. The staged treatment provides a reference for early prevention and treatment, while its cutoff values and correspondence with patterns await validation in large-sample prospective clinical studies. |