| Background:Acute pancreatitis is one of the common acute abdomen surgery, incidence of a disease has increased in recent years, the cause, pathogenesis is complex, the conventional foundation treatment is relatively single, if poorly controlled urgent convertible aggravating illness, when converted to mild acute pancreatitis, severe acute pancreatitis case fatality rate doubled, thus increasing the patients’ pain, extended the length of hospital stay, adding to the family and social economic burden. However, after the continuous efforts of numerous Chinese workers, a large number of clinical studies confirmed that combine traditional Chinese and western medicine treatment effect is better than pure western medicine curative effect, can be very good adjuvant therapy of acute pancreatitis, quickly control the condition. Mainly by the therapy of traditional Chinese medicine species diversity, exquisite treatment based on syndrome differentiation, more individualized treatment. The mechanism of moxibustion action research has been mature, efficacy of traditional Chinese medicine can promote tong wen, tong qi and blood stasis; Can bring hot, xie viscera of hot and humid. Western medicine effect can inhibit inflammation is aggravating, increase immune function, protect gastric mucosa, promote gastrointestinal peristalsis, improving pancreas microcirculation, can regulate blood lipid abnormality.Objective:To seek a more effective adjuvant therapy, make Chinese and western combined with better services for patients. Preliminary explore acupoints moxibustion adjuvant therapy for mild acute pancreatitis early abdominal pain relief effect. Preliminary explore acupoints moxibustion adjuvant therapy for mild acute pancreatitis evidence type conversion, the influence of groundwork for later study.Method:Collection of general hospital of Beijing university of Chinese medicine east since December 2014 to January 2016 included in the standard of 70 patients with mild acute pancreatitis, with random indicator method 35 cases were randomly divided into control group and moxibustion group of 35 cases. Control group to give a fast water, inhibition of gastric acid, rehydration, to maintain electrolyte balance, analgesia, inhibit the pancreatic enzyme secretion and activity, resistance to infection and other conventional treatment. Moxibustion group in the control group given on the basis of moxibustion therapy, moxibustion part:chung wan, double parapodum three mile, time:20 minutes each time,2 times/day,7 days of treatment. Using the clinical signs and symptoms scale record the change of the two groups before and after treatment symptoms and signs scores, comprehensive evaluation symptoms improvement; Using visual analogue scale (VAS) record of the two groups before treatment,3,5, and 7 day after the treatment of abdominal pain abdominal distension, assess abdominal pain abdominal distension relief alone; Record for the first time after two groups of patients with this disease treatment time of food intake, exhaust and defecation time assessment for the first time gastrointestinal dysfunction recovery; Records in the two groups before and after treatment B-AMY, the WBC and NEUT% change, the objective evaluation of treatment effect. The syndrome distribution records before and after treatment, a preliminary study of moxibustion on mild acute pancreatitis syndrome outcome of the overall impact.Result:1. The comparable aspects:control group 21 cases of male, female 14 cases; 19 cases moxibustion group of men, women and 16 cases, two groups of gender, P= 0.405> 0.05, there was no statistically significant difference; Age differences between the two groups is not obvious, after comparing P= 0.659> 0.05, there was no statistically significant difference; Two groups of onset time control group was 10.46+/-4.79 on average, moxibustion group was 10.69+/-5.00 on average, P= 0.849> 0.05, there was no statistically significant difference.2. Comprehensive efficiency, two groups of 35 patients after treatment were effective, total effective rate are equal, but the cure rate and efficiency are similar between the two groups, with statistical significance (P= 0.024< 0.05), the control group cure rate (8.6%) is lower than the moxibustion group cure rate (25.7%) and control group efficiency (51.4%) is lower than the moxibustion group, control group efficient (40%) is lower than the moxibustion group (27.1%). Integral aspects.3. The clinical symptoms and signs treatment before the control group, the average score was 30.67+/-4.92, moxibustion group, the average score was 31.89+/-5.13, there was no statistically significant difference (P= 0.322> 0.05). Control group average score 12.11+/-2.32 after treatment, moxibustion group average score 9.26+/-1.76, significant difference was statistically significant (P= 0.00< 0.05).4. Abdominal pain scores:control group in average score before treatment with the median-interquartile range, said both group was 7.00+/-2.00, the two groups before treatment there was no statistically significant difference of abdominal pain score (P= 0.840> 0.05); 3 days after treatment in the control group with an average of 5.00+/-1.00, moxibustion group was 5.00+/-2.00 on average, there was no statistically significant difference (x2= 0.635, P= 0.635).5 days in the two groups after treatment scores were 3.00+ /-1.00, difference obvious, difference was statistically significant (χ2= 10.807, P= 0.001< 0.01), and the mean rank moxibustion group is lower than the control group (28.39< 42.61); 7 days no statistically significant differences between the two groups after treatment (χ2= 1.490, P= 1.490> 0.05).5. Cloth laurel dosage of oxazine (mg):the control group was 200.00+/-116.82 on average, moxibustion group was 111.43+/-83.21 on average, significant difference was statistically significant (P= 0.000< 0.01).6. Abdominal distension scoring:control group scored an average of 5.37+/-1.46 before treatment, moxibustion group scored an average of 5.40+/-1.82, there was no statistically significant difference (P= 0.942> 0.05); Treatment group 3,5, and 7 days after an average of 5.34+/-0.84,3.31,1.310.47 mm,0.63 mm moxibustion groups with an average of 4.06+/-0.69,2.71,0.970.63 mm,0.68 mm is the control group before and after treatment in the group and there was no statistically significant difference for three days, the rest of the group, comparing differences between groups were statistically significant.7. The first time of food intake (d):the control group was 7.22+/-0.53 on average, moxibustion group was 5.49+/-0.34 on average, significant difference was statistically significant (P= 0.000< 0.01).8. The first exhaust and defecation time (h):the control group was 32.29+/-3.36 on average, moxibustion group was 21.94+/-1.89 on average, significant difference was statistically significant (P= 0.000< 0.01).9. The length of time (d):the control group was 11.63+/-2.74 on average, moxibustion group was 9.11+/-2.21 on average, significant difference was statistically significant (P= 0.000< 0.01).10. Objective curative effect evaluation:B-AMY (U/L) in the control group after treatment with an average of 165.5+/-70.9, moxibustion group was 128.7+/-53.5, the difference was statistically significant (P= 0.017< 0.05); In the WBC (x 109/L) in the control group after treatment was 7.19+/-1.56 on average, moxibustion group was 6.27+/-1.36 on average, the difference was statistically significant (P= 0.011< 0.05); NEUT average was 51.54+/-5.90% in control group after treatment, moxibustion group was 50.06+/-9.15 on average, there was no statistically significant difference (P= 0.423> 0.05).Conclusion:Through the integration of the clinical symptoms, abdominal pain, abdominal distension comparison we found that moxibustion group than the control group can obviously relieve symptoms, and in the early treatment of abdominal pain abdominal distension faster than in the control group, moxibustion group so that moxibustion auxiliary treatment can accelerate the patient rehabilitation. By comparing the first exhaust and defecation time, feeding time, for the first time found that moxibustion has obvious advantages in improving gastrointestinal function. Observe two groups of the length of time at the same time, can be concluded that moxibustion adjuvant therapy can shorten the length of hospital stay. Through B-AMY, the WBC and NEUT%, moxibustion group of patients with blood and white blood cell count down starch levels are lower, but the neutrophil percentage decline advantage is not obvious. In short, acupuncture moxibustion auxiliary curative effect is superior to the control group. |
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