The Study Of Symptomatology Of TCM And The Effects Of Point-injection On Postoperative Nausea And Vomiting After Breast Surgery

Purpose:Postoperative nausea and vomiting (PONV) are commone complications after anaesthesia and surgery. According to the traditional Chinese Medicine (TCM) theory recorded early, nausea and vomiting belong to the category of "throwing" In the TCM today however, there is little systematic research on this kind of nausea and vomiting. In order to find out the rules of PNOV from the point of view of the theory of TCM, we analysed the category of PNOV in female patients undergoing breast surgery. A point-injection therapy was designed based on the category and evaluated its efficiency on the prevention of PONV.Method:1. By reviewing the literatures about nausea and vomiting and using symptomatology of TCM, we classified the syndromic model of PONV based on the patients' manifestation. And the mechanism PONV in TCM were analysised.2. We adopted propofol, fentanyl and remifentanil as anaesthetic in the patients after breast surgery with PCA. Then we record the symptoms in TCM' s theory and the experimental outcomes after surgery 6,12,24hours, the next day and the third day respectively. Finally, we research clinic case stories, then observe and analyse them.3. 100 patients were divided into two groups, with one of them given point-injection of hypertonic glucose 2ml. We evaluated the effects of point-injection by the incident of nausea and vomiting in the two groups respectively. Results:1. This research contains 400 cases, the youngest is 29 years old, the oldest is 65 years old, mainly extend from 35 to 50years old, average 40.20±11.27 years old.2. This disease is mainly result of Incoordination Between Liver and Stomach and Cold of Spleen and Stomach, accompanied by Phlegm block and Stomach-yin deficiency, and Weakness of Spleen and Stomach is throughout.Discovered by statistics:142 out of 300cases throwed; Type of Incoordination Between Liver and Stomach is at a percentage of 39.4%; Type of Cold of Spleen and Stomach is at 30.3%;Type of Phlegm block is at 15.5%; Type of Stomach-yindeficiency is at14.8%o And the symptom of Weakness of Spleen and Stomach is found in most cases, but in different extent.3. Some physic exams may be helpful in the category of PNOV。We found differene types of syndrome may result in difference in the outcomes of pressure, blood electrolyte, platelet and fibrinogen, this difference may be helpful in the category of PNOV。4. PNOV can be prevented by point-injection of hypertonic glucose.According to the analyse before, This disease is mainly result of Incoordination Between Liver and Stomach and Cold of Spleen and Stomach, and Weakness of Spleen and Stomach is throughout. So we adopted injection with hypertonic glucose in the curing group. We found a great difference in incidence of PNOV by the comparison of the two groups. So we believe PNOVcan be prevented by point-injection.Conclusion:1. This disease is mainly result of Incoordination Between Liver and Stomach and Cold of Spleen and Stomach, accompanied by Phlegm block and Stomach-yin deficiency, and Weakness of Spleen and Stomach is throughout.2. Some physic exams may be helpful in the category of PNOV。3. PNOV can be prevented by point injection of hypertonic glucose.4. We have not found relations between blood electrolyte and the category of throwing after breast surgery.