Clinical Observation On Treatment Of Acute Biliary Pancreatitis With Liver Gallbladder And Dampness By Chinese Medicine

Objective:To evaluate the clinical efficacy of conventional Western medicine in the treatment of hepatobiliary damp-heat type acute gallstone pancreatitis on the basis of oral administration and abdominal external application.To explore the therapeutic effect of western medicine on the basis of the addition of self-made medicinal herbs for oral administration and abdominal external application for hepatobiliary hot and humid type Whether the curative effect of acute gallstone pancreatitis is better than conventional western medicine treatment,explore new approaches for clinical treatment of acute gallstone pancreatitis with hepatobiliary heat and heat type.Methods:Fifty-six patients with hepatobiliary hygropyretic acute biliary pancreatitis who were admitted to the general surgical ward of Dongzhimen Hospital from September 2015 to January 2018 were randomly selected into the control group and the observation group.For example,in the observation process,the control group was removed in 3 cases,the observation group was removed in 1 case,and 2 cases were detached on their own.50 cases were clinically observed,25 cases in the control group and 25 cases in the observation group.The control group was treated with fasting,gastro-intestinal decompression,early fluid resuscitation,nutritional support,inhibition of pancreatic secretion,acid suppression,anti-infection,and symptomatic treatment,and western medicine routine treatment.The observation group was prepared on the basis of western medicine routine treatment.The soup is taken internally,and the homemade Chinese medicine is applied on the abdomen at the same time for 7 consecutive days.Observe the white blood cell count and serum amylase value on the day of admission and on the 3rd,5th and 7th day of hospital admission,and the abdominal pain,abdominal distention disappearance time,bowel sound recovery time,first bowel movement time,and TCM syndrome score.And APACHEII scores and other clinical indicators,and statistical analysis of the data.Result:(1)General InformationThere was no significant difference in gender and age between the two groups(P>0.05)and they were comparable.(2)Laboratory indicatorsThere was no significant difference in the white blood cell count between the two groups on the day of admission(P>0.05),and they were comparable.Repeated measurement analysis of variance was used to compare the white blood cell counts on the 1st,3rd,5th,and 7th days after admission between the two groups of patients.There was no statistically significant difference between the two groups(P=0.059),indicating that there was no significant difference in white blood cell counts during admission between the two groups;multivariate test(F=6.03,P<0.05)and intrabody testing(F=10.83,P<0.05).There was an interaction between display time and group,indicating that the white blood cell count in the observation group decreased faster than the control group.There was no significant difference in serum amylase levels between the two groups on the day of admission(P>0.05),and they were comparable.Repeated-measures analysis of variance was used to compare serum amylase levels on the 1st,3rd,5th,and 7th days after admission in the two groups.There was a statistically significant difference between the main effects(F=5.25,P<0.05),indicating that the serum amylase concentration in the observation group was lower than that in the control group;the multivariate test(F=40.60,P<0.05)and the in-subject effect test(F=5.23,P<0.05)The results showed that there was an interaction between time and group,indicating that the serum amylase concentration in the observation group decreased faster than that in the control group.(3)Clinical indicatorsThe time of disappearance of abdominal pain,disappearance of abdominal distension,and bowel sound recovery time in the two groups were shorter than those in the control group.(4)Imaging examination There was no significant difference in Balthazar CT grading scores before treatment(P>0.05).There was no significant difference between Balthazar CT grading in the observation group and the control group(P>0.05).(5)Rating ScaleThere was no significant difference in TCM syndrome scores and APACHEII score scale scores before treatment(P>0.05).The TCM syndrome scores in the observation group after treatment were significantly lower than those in the control group(P<0.05).After treatment,there was no significant difference between the observation group’s APACHEII score scale score and the control group(P>0.05).(6)Efficacy evaluationAccording to the evaluation criteria of efficacy,4 cases were cured in the control group after treatment,8 cases were cured in the observation group,the cure rate was 16%in the control group,and 32%in the observation group.The cure rate in the observation group was higher than that in the control group.(7)Safety evaluation before and after treatmentAccording to data statistics,the safety evaluation after treatment included 23 cases of grade 1,2 cases of grade 2 and high safety.Conclusion:Self-made oral administration of Qingyi Tongyu Decoction and external application of traditional Chinese medicine combined with basic western medicine can accelerate the regression of inflammation in the treatment of hepatobiliary damp-heat type acute gallstone pancreatitis,control infection faster,promote pancreatic repair,and quickly relieve clinical symptoms.,To improve the cure rate,that is,the short-term effect is better than the Western medicine treatment group.This provides a new idea for clinical treatment of hepatobiliary heat-type ABP,and provides scientific basis for further improving the clinical diagnosis and treatment level.