Abstract：Traditional Chinese medicine treatment of acute pancreatitis （AP） demonstrates significant advantages in alleviating clinical symptoms and reducing organ damage. Based on HUANG Yuanyu′s theory of one qi circulating in a continuous cycle， our team proposes that AP presents a pathogenic transmission characterized by the central earth collapsing and pivot stagnating，wood and metal contending，water and fire separating and collapsing. Treatment should be guided by the principles of restoring the normal function of central pivot，pacifying wood and descending metal，and clearing the heart and nourishing the kidney， thereby reactivating the qi transformation cycle， restoring the normal state of pivot rotation and wheel circulation， water and fire coordination， and enabling the orderly ascending and descending of the body′s qi movement. This approach aims to provide new insights for the clinical treatment of AP.