AIM:To evaluate the therapeutic mechanism of Yinchenhao Chengqi (YCHCQ) decoction (containing mainly Herba Artemisia capillaris) combined with endoscopic sphincterotomy (EST) for endotoxemia (ETM) in acute cholangitis.METHODS:Twenty-one cases of acute cholangitis with ETM were divided randomly into two groups: group A, 10 patients treated with YCHCQ decoction combined with EST, group B,11 patients treated with EST. The incidence rate of ETM, plasmic ET, serum superoxide dismutase (SOD) activity, malonyldialdehyde (MDA), complement C(3) and C-reactive protein (CRP) were studied respectively.RESULTS:The ET level of group A (35.92ng/L ± 8.30ng/L) was significantly reduced after 7 days of treatment (P < 0.05) in contrast to that of group B (47.8ng/L ± 11.62ng/L), so did the level of MDA and CRP. But the SOD activity and C(3) level in group A increased significantly (P < 0.05).CONCLUSION:YCHCQ decoction combined with EST had a beneficial effect for ETM in acute cholangitis.