| ObjectiveThe study was to observe and analyze the clinical curative effect of clinical pathway of Traditional Chinese Medicine (TCM) on Functional Abdominal Pain Syndrome (FAPS).By comparing the improvement of clinical symptoms after treatment between treatment group and control group, analyze the clinical curative effect and advantages, and then provide a certain basis and research basis on further optimizing and promoting clinical pathway of TCM on FAPS, meanwhile, standardize the diagnosis and treatment of TCM on FAPS.MethodsBy the method of cohort study, collecting cases and follow-up visiting patients with FAPS in Guangdong Provincial Hospital of Chinese Medicine from March 2014. Patients ware divided into treatment group and control group according to carry out the clinical pathway or not. By looking up medical records or follow-up visiting, fill in abdominal pain symptoms scale at the first visit and after treating 7 days,14 days and 28 days. The abdominal pain symptoms scale includes abdominal pain severity, frequency of onset of abdominal pain, abdominal pain duration of symptom onset, three total score is the abdominal pain total score. According to the percentage of abdominal pain symptoms improvement=(score before treatment-score after treatment)/score before treatment by 100% to calculate, a percentage of 75% or more for the cure, the percentage of 50% to 75% for remarkable curative effect, the percentage of 25% to 50% were effective, the percentage of 25% or less were invalid. Then summarize data input SPSS statistics, using the chi-square test to compare the patients’gender structure、age structure between treatment group and control group, using the t-test to compare course of disease、abdominal pain score at the first visit between the two groups, so that understand the comparability between the groups. Using analysis of variance to compare symptom scores before and after the treatment within each group. Using Mann-Whitney rank sum test to compare the curative effect between the two groups at each time point. Using the t-test to compare average daily cost of TCM. Adopt double side inspection statistical analysis, inspection level α=0.05. P>0.05 was considered that there was no statistically significant difference. P<0.05 was considered difference was statistically significant. Comprehensively analyze and compare the clinical curative effect between treatment group and control group.Results64 patients were included in this study, in which the treatment group was 31 cases, control group was 33 cases, no exclusion cases. In the treatment group, there were 17 male and 14 female, average age was (36.65±11.831) years, average course of disease was (26.81±18.454) months, average abdominal pain score at the first visit was (10.45±1.234). In the control group, there were 18 male and 15 female, average age was (35.30±11.939) years, average course of disease was (25.91±15.749) months, average abdominal pain score at the first visit was (10.58±1.119). Patients with sex structure, age structure between the two groups by chi-square all were worked out P>0.05. Course of disease、abdominal pain score at the first visit between the two groups by t-test both were worked out P>0.05. All were considered that there was no statistically significant difference. These two groups were comparable.In the treatment group, average abdominal pain score after 7 days was (7.45 ±1.457), after 14 days was (6.84±1.530), after 28 days was (6.10±2.166). The score is on the decline. By analysis of variance P<0.05, score decrease was statistically significant. In the control group, average abdominal pain score after 7 days was (8.00±1.696), after 14 days was (7.55±1.348), after 28 days was (7.21±1.816). The score is on the decline. By analysis of variance P<0.05, score decrease was statistically significant. After 7 days, The treatment group total effective rate was 74.19%, the control group total effective rate was 72.73%; After 14 days, The treatment group total effective rate was 90.32%, the control group total effective rate was 60.61%; After 28 days, The treatment group total effective rate was 90.32%, the control group total effective rate was 78.79%. Using Mann-Whitney rank sum test to compare the curative effect between the two groups at each time point. After 7 days, P>0.05, efficacy was no significant difference. After 14 days P<0.05 and 28days P<0.05, too, efficacy difference was statistically significant.In the diagnosis and treatment costs, this study only statistical analysis cost of the Traditional Chinese Medicine decoction pieces in the process of treatment. In the treatment group, minimum daily cost of TCM was 7.52 yuan, maximum was 25.38 yuan, average daily cost of TCM was (17.16±4.91) yuan. In the control group, minimum daily cost of TCM was 8.98 yuan, maximum was 27.67 yuan, average daily cost of TCM was (18.37±4.82) yuan. Compare average daily cost of TCM by t-test, P>0.05, there was no statistically significant difference.ConelusionBoth clinical pathway of TCM on FAPS and conventional treatments can effectively relieve symptoms of abdominal pain. In the full course, clinical curative effect of clinical pathway treatment is better than conventional treatments. And there is no significant difference in cost of TCM between the two treatment. Clinical pathway treatment is feasible. In this study, there was no detailed statistical analysis and comparison to syndrome differentiation. Further research is needed, so that provide a more exact science basis on further optimizing and promoting clinical pathway of TCM on FAPS. |
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