The Distribution Of TCM Syndromes Of Acute Pancreatitis And The Clinical Research Of TCM Treatment

Objective: To study the distribution of TCM syndromes of acute pancreatitis by retrospectively analyzing the inpatient data of acute pancreatitis,and to provide further reference for TCM syndrome differentiation and treatment of acute pancreatitis.To analyze the current situation of TCM treatment of acute pancreatitis and provide further theoretical basis for TCM treatment of acute pancreatitis.Methods: 210 inpatients with acute pancreatitis who met the inclusion criteria on March 1,2014 and March 31,2019 in the first affiliated hospital of guangxi university of Chinese medicine were selected.A retrospective analysis method was adopted to collect the general data of the patients,such as age and gender,record the causes of the patients,TCM syndromes,scores of all systems,TCM treatment methods,etc.SPSS23.0 software was used for statistical analysis of the collected data.Results:(1)The average age of onset of 210 cases of acute pancreatitis was50.0717.92 years old,and the male to female ratio was 1.6:1.The male patients were mostly young and middle-aged,and the onset age was between31-50 years old,while the female patients were mostly elderly,and the incidence was highest between 71-80 years old.(2)The bmi of patients with acute pancreatitis showed no statistically significant difference with gender(P>0.05).Bmi was mainly distributed in the normal weight group,accounting for 54.3%.There was no statisticallysignificant difference in the distribution of clinical types and sex of acute pancreatitis(P>0.05).The highest incidence was mild acute pancreatitis.The difference between bmi and clinical typing was statistically significant(P<0.05),and the proportion of overweight and obesity in SEVERE acute pancreatitis was higher than that in low weight and normal weight,accounting for 3.3% of the total study population respectively.(3)The pathogeneses of acute pancreatitis were mostly biliary;The etiology distribution and gender difference of acute pancreatitis were statistically significant(P<0.05),and the etiology of male patients was mainly hyperlipidemia.The pathogenesis of female patients is mainly biliary.(4)the TCM syndromes of acute pancreatitis were successively distributed as liver-gallbladder dampness-heat syndrome(40%)> liver-qi stagnation syndrome(31.9%)> visceral heat syndrome(11.4%)> stasis heat(poison)mutual knot syndrome(8.1%)> liver-qi and spleen deficiency syndrome(4.3%)> qi and Yin deficiency syndrome(2.4%)> internal closure and external detachment syndrome(1.9%).The distribution of TCM syndromes in patients with acute pancreatitis was not statistically significant compared with the gender and age of the patients(P > 0.05).(5)the distribution of TCM syndrome types and causes of acute pancreatitis,statistically significant differences(P<0.05),liver depression and qi stagnation syndrome,liver and gallbladder damp heat syndrome causes were the most for gallstone,relieving heat knot of etiology is given priority to with gallstone and diet not festival,the causes of stasis hot alternating knot(drug)are mainly composed of gallstone,shut off the outside the inside causes mainly idiopathic,liver spleen deficiency are mainly composed of gallstone,qi and Yin deficiency syndrome seen in hyperlipidemia and cause more.(6)The difference between TCM syndromes of acute pancreatitis and BODY mass index was statistically significant(P<0.05).The body mass index of liver-qi stagnation syndrome and liver-gallbladder dampness-heat syndrome were mostly in the normal weight group,followed by hyperrecombination.The body mass index(BMI)of blood stasis syndrome was mainly distributed in the obesity group.(7)The difference between the TCM syndromes of acute pancreatitis and the clinical types was statistically significant(P<0.05).Among the TCM syndromes of mild acute pancreatitis,the liver-gallbladder dampness-heat syndrome and liver-qi stagnation syndrome were the most common;Among the TCM syndromes of moderate and severe acute pancreatitis,the syndromes of fu-shi heat,liver-qi and spleen-deficiency,and blood-stasis heat(toxin)are common.Among the TCM syndromes of severe acute pancreatitis,stasis and heat(toxin)were the most common syndromes.(8)The differences between TCM syndromes of acute pancreatitis and BISAP scores were statistically significant(P<0.05).The BISAP scores of visceral heat,stasis heat(toxin)and internal closure and external detachment were mainly ?3 points,and the BISAP scores of patients with liver stagnation and qi stagnation and liver gallbladder dampness-heat were mainly distributed?2points.TCM syndrome compared with APACHEII scores,difference have statistical significance(P<0.05),liver depression and qi stagnation syndrome,liver and gallbladder damp heat syndrome,relieving solid heat knot,liver depression,spleen deficiency of APACHE ? score 8points,main?stasis hot alternating knot(drug)APACHE ? score are mainly composed of eight points or higher.The difference between MCTSI scores of all TCM syndromes and MCTSI was statistically significant(P < 0.05).The MCTSI scores of liver-qi stagnation syndrome and liver-gallbladderdampness-heat syndrome were mainly < 4 points,while the MCTSI scores of blood stasis and heat(poison),fu-substance heat syndrome,and internal closure and external detachment syndrome were mainly ?4 points.(9)The highest utilization rate of TCM treatment was internal treatment(89.0%),followed by enema(76.7%)and abdominal external application(53.3%).Qingyi Decoction(24.1%)was the most commonly used prescription,followed by Dachengqi Decoction(15.5%)and Qingjihua Yingfang(14.4%).The total effective rate of TCM and WESTERN medicine was 93.7%,while that of pure Western medicine was 80.6%.Conclusion:(1)TCM syndromes of acute pancreatitis are mainly liver-gallbladder dampness-heat syndrome.The distribution of TCM syndromes is correlated with body mass index,etiology,clinical classification,BISAP score,APACHEII score and MCTSI score to some extent,and relevant results can be appropriately referenced in TCM differentiation of acute pancreatitis.(2)The traditional Chinese medicine treatment of acute pancreatitis mainly includes traditional Chinese medicine internal treatment,traditional Chinese medicine enema and traditional Chinese medicine external application.Qingyi Decoction,Dacheng Qi decoction and Qingjihua attack prescription are the most commonly used traditional Chinese medicine internal treatment.The combined traditional Chinese and western medicine treatment can significantly improve the total effective rate of acute pancreatitis patients,which is worthy of wide clinical promotion.