Analysis Of Prognostic Factors Of Digestive Tract Perforation And Clinical Retrospective Study Of TCM Intervention

Objective: Through a retrospective analysis of the clinical data of patients with gastrointestinal perforation in General surgery of the first affiliated Hospital of Guangxi University of traditional Chinese Medicine,to explore the factors affecting the prognosis of patients with digestive tract perforation,to discuss the therapeutic effect of traditional Chinese medicine intervention on digestive tract perforation,and to carry out data mining on the relevant experience of doctors in the treatment of digestive tract perforation.To provide new theoretical and clinical basis for clinical treatment of digestive tract perforation,identify the factors related to the prognosis of digestive tract perforation,reduce mortality,accelerate the rehabilitation of patients,and provide new ideas for treatment.Methods: A retrospective study was conducted on the patients with digestive tract perforation diagnosed by the General surgery of the first affiliated Hospital of Guangxi University of traditional Chinese Medicine from January 2017 to September 2022.Through the general data of patients,laboratory tests,treatment,postoperative complications and other clinical data.Analysis of the disease outcome of the patients(general condition,disease outcome 30 days after operation,distribution of perforation site,comparison of laboratory indexes before and after operation,and postoperative use of traditional Chinese medicine in patients with digestive tract perforation).At the same time,the effects of different treatments on postoperative complications were analyzed to explore the related factors affecting the prognosis of digestive tract perforation.Taking "after digestive tract perforation" and including complications "peritonitis" or "abdominal infection","intestinal adhesion","gastrointestinal function",and the treatment method "traditional Chinese medicine" as the search method,we searched the literature collected from the General Database of Chinese knowledge Resources(CNKI)and China academic Journal Database(Wanfang data)up to September 30,2022,through the TCMISSV3.0 version of traditional Chinese medicine inheritance auxiliary platform,using modern information technology and data mining methods.To summarize and discuss the law of drug use and acupoint selection of traditional Chinese medicine.Results:(1)The postoperative cure of digestive tract perforation was negatively correlated with the time from onset to operation.If the time from admission to operation was delayed by 12 hours,the cure rate was 87.25%.When the time from onset to operation was extended to more than 48 hours,the cure rate would be less than 80%.The levels of WBC,Hb,PLT,Alb and Cr in postoperative patients with digestive tract perforation were lower than those before operation,while CRP and ALT increased.(P<0.05)(2)The time from onset to admission,the time from onset to operation,and the preoperative NE%,CRP,Alb,Cr were related to the prognosis of sepsis.Among them,NE%,heart rate at admission and Cr were independent risk factors,while Alb was protective factor.(3)The adjuvant therapy of traditional Chinese medicine after digestive tract perforation was effective.There was significant difference in NE%,Alb,PLT,CRP,ALT and AST between the TCM treatment group and the non-TCM treatment group.(P<0.05)(4)At present,the treatment of traditional Chinese medicine after digestive tract perforation mainly acts on the synergistic treatment of traditional Chinese and western medicine,forming four qi(cold,warm);five flavors(bitterness,bitterness,sweetness);meridian(tonifying deficiency,regulating qi,clearing heat)drug use core,to form rhubarb,Fructus Aurantii,Magnolia officinalis,mirabilite as the core combination of drugs.Postoperative acupoint stimulation treatment took Sanyinjiao and Zusanli as the core combination of acupoints.Conclusion(s): 1.The postoperative cure of gastrointestinal perforation was negatively correlated with the time from onset to operation.WBC,Hb,PLT,Alb and Cr in postoperative patients with digestive tract perforation decreased compared with those before operation,while CRP and ALT showed an upward trend.2.Among the factors affecting the prognosis of patients with digestive tract perforation,NE%,heart rate at admission and Cr were independent risk factors,while Alb was protective factor.3.The synergistic treatment of traditional Chinese and western medicine after digestive tract perforation is effective,with rhubarb,Fructus Aurantii,Magnolia officinalis and mirabilite as the core combination,and Sanyinjiao and Zusanli as the core combination of acupoints.