Clinical and Biochemical Characteristics of Traditional Chinese Medicine Syndromes in Acute Pancreatitis: A Two-Center Retrospective Study.

Purpose: This study aimed to investigate the associations between traditional Chinese Medicine (TCM) syndromes of acute pancreatitis (AP) and clinical biomarkers, imaging findings, and severity of AP. Patients and Methods: A two-center retrospective analysis was conducted on 132 AP patients from Guang'anmen Hospital (n = 105) and Shandong University of TCM Hospital (n = 27). TCM syndrome classification of AP was performed according to the consensus of integrative diagnosis and treatment of AP in 2025. The clinical data were obtained from each participant, including clinical, laboratory and radiographic features, and TCM syndrome classification. Results: A total of 132 patients were included from the two centers. No significant differences were observed among the three TCM syndrome groups in sex, age, glucose levels, AP severity, or pleural effusion volume (P > 0.05). Univariable and multivariable analyses yielded consistent results. After adjustment for age, sex, and AP severity, significant overall differences among syndrome groups were observed for C-reactive protein (CRP, P = 0.014), fibrinogen (FIB, P = 0.024), and total bilirubin (TBIL, P = 0.039). Compared with liver and gallbladder dampness-heat syndrome, liver depression and Qi stagnation syndrome was independently associated with elevated CRP (OR = 5.30, 95% CI: 1.73-16.19, P < 0.01), FIB (β = 1.34, 95% CI: 0.37-2.30, P < 0.01), and TBIL (OR = 4.32, 95% CI: 1.14-16.36, P < 0.05), while excess heat accumulation in the viscera syndrome was independently associated with elevated CRP (OR = 3.68, 95% CI: 1.01-13.37, P < 0.05). Conclusion: Although TCM syndromes did not correspond to differences in AP severity, CRP, FIB, and TBIL varied significantly across syndromes. These findings suggest potential biological heterogeneity across TCM syndromes and require further validation.