A Clinical Study On The Treatment Of Abscess Around The Appendix Based On The Theory Of Collaterals

Acute appendicitis is the most common acute abdomen in surgery,and the periappendiceal abscess is the result of its loss of treatment and mistreatment,which is a complication in the later period of acute appendicitis.As we all know,western medicine is more inclined to choose a conservative treatment with a high success rate and a low complication risk.However,it is insufficient to accelerate abscess dissipation,reduce recurrence rate,and improve the success rate of elective surgical resection.Some scholars are still controversial and the related report is rare,and the large RCT research is lack of to confirms.Therefore,more and more scholars at home and abroad are paying more attention to the combination of traditional Chinese and Western medicine with periappendiceal abscess,especially the successful treatment of classical prescription.However,the current theoretical system of TCM is not comprehensive in understanding the abscess around the appendix,especially in the case of TCM pathogenesis lacks the detailed clinical research support.Through clinical practice and from the angle of collateral disease theorythe,we observed the evolution law of recurrent periappendicural absecess,considering its possible pathogenesis:the periappendicular abscess is long,upright has been empty and inability to transport,Xie and Ql-blood fighting in the intestine,bowel qi stagnation,Ql-blood of intestinal collaterals is stasis,resistance lower abdomen and form mass.Therefore,through this research based on classical Fuziyiyibaijiangsan's add and subtract,with "blood stasis"legislation,wentong dissipation,removing stasis poison,reuse of promoting blood circulation to remove blood stasis,cold blood stasis drugs.We can observe the clinical symptoms and the long-term recurrence by Fuzihuayutang,and accordingly explore the feasibility of treatment of periappendicural absecess from stasis pathogenesis of meaning,and through reasonable and effective clinical observation we can confirm our scientific hypothesis.PurposeThe current periappendicural absecess status quo analysis of Chinese and western medicine treatment,combined with collateral disease theorythe,the stasis treatment clinical curative effect of observation,the feasibility of clear from stasis treatment and its significance in the pathogenesis of related to clear the disease "Xie and QI-blood fighting in the intestine in course of time,bowel qi stagnation,QI-blood of intestinal collaterals is stasis,resistance lower abdomen and form mass" pathogenesis can provide objective and scientific empirical support.MethodsA retrospective cohort study was conducted to collect 60 cases of periappendiceal abscess which met the inclusion criteria.They were divided into the control group(Western Medicine)and the experimental group(Chinese Medicine).The control group gives the conventional western medicine treatment and the experimental group gives the conventional western medicine treatment as well as Fuzihuayutang with 7 days for a period of treatment.After 14 days,we observe the clinical symptoms of the two groups of patients including the lately-admitted patients.The observation includes the degree of the abdominal pain and the recovery time of the bowel sounds after 24,48,72 hours,compared with the lately-admitted patients' clinical symptoms.After the medicine was taken 48 hours,72 hours,7 days,14 days of blood routine,we should observe the recovery of the liver and kidney function as well as the CRP index.Through the recordintg of the abdomen discharge ultrasound results of patients with abdominal mass dispelpatients when they are admitted to hospital,7 days,14 days,1 month and 3 months later after they've taken the medicine.At the same time,we should record the transfer cases,the recurrence rate within 3 months after discharge,the success rate of elective surgical procedures after 3 months in the two groups.Results1,After the comparison of the control group and experimental group in gender,age,basic vital signs,onset time,diagnostic information as well as the statistics analysis,there is no significant difference(P>0.05)and the two groups are comparable.2,In the experimental group,the score of abdominal pain,the recovery time of the bowel sound and the reduction of the package are all shorter than the control group,with statistically significant differences(P<0.05).3,The control group and experimental group in reducing on admission,48 hours,72 hours after the white blood cells,neutrophils,lymphocytes and c-reactive protein treatment,after statistics processing,there was no significant difference(P>0.05);Compared with the control group,the experimental group decreased white blood cells,neutrophils,lymphocytes and c-reactive protein after 7 days and 14 days.Statistically significant differences were observed(P<0.05).4,The control group and experimental group in the treatment of patients with aspertate aminotransferase,alanine aminotransferase,serum creatinine,blood urea nitrogen treatment,after statistics processing,there was no significant difference(P is greater than 0.05).5,There was no difference in the transfer operative rate between the two groups.The recurrence rate within 3 months after discharge was significantly lower in the experimental group than in the control group.The recurrence rate in the experimental group was lower than that in the control group,compared with the two groups.Conclusion1,based on collateral disease theory,the conventional western medicine treatment with Fuzihuayutang can significantly improve the patient's clinical curative effect,reduce the degree of patients with abdominal pain,bowel sounds promote patients recovery,routine blood and CRP laboratory indexes such as lower.2,the treatment of periappendiceal abscess from stasis can help to promote the dissipation of the appendix,reduce the recurrence rate.3,based on collateral disease theory,discuss the pathogenesis of periappendicural absecess:the periappendicular abscess is long,upright has been empty and inability to transport,Xie and Ql-blood fighting in the intestine,bowel qi stagnation,Ql-blood of intestinal collaterals is stasis,resistance lower abdomen and form mass.