Correlation Between TCM Syndrome Of Acute Appendicitis And Modified Alvarado Score With Pathological Type

ObjectiveAcute appendicitis is the most common acute abdomen in surgery.Traditionally,acute appendicitis requires active surgery after diagnosis.However,in recent years,more and more experts have found that appendix has its own function,and non-surgical treatment of appendicitis is more and more We chose,the premise of non-surgical treatment is that we need to have an accurate assessment of the pathological development of patients with acute appendicitis,so as not to delay the optimal timing of surgery,but also reduce the incidence of non-essential surgery for appendicitis,reduce appendectomy After the complications.In this study,the characteristics of TCM syndrome type,Alvarado score and pathological type of appendectomy after acute appendicitis were analyzed.The syndrome type,Alvarado score and postoperative time were analyzed.The correlation and correspondence of pathological typing provide a reliable and easy method for doctors to evaluate the pathological types of acute appendicitis before surgery.This method has important clinical significance for guiding non-surgical treatment or surgical treatment for appendicitis.Methods151 patients with acute appendicitis who underwent surgery from the Second Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine from May 2018 to March 2019 were enrolled.The clinical data were recorded.Statistical pathological results were collected after surgery.Excel worksheet was prepared.TCM syndrome type judgment table,the syndrome collection of the collected cases,and according to the patient' s clinical symptoms,abdominal signs,laboratory tests,fever or not,according to the modified Alvarado scoring system,the cases were scored and grouped,using a pairwise comparison TCM syndrome type,Alvarado score group,postoperative pathological type were statistically analyzed.Results1.151 cases were collected from the study,according to the syndrome type.The samples of stagnant,damp-heat and heat-toxic type were 29 cases,92 cases and 30 cases respectively.According to the improved Alvarado score grouping method,The low-risk group(0-4 points),the intermediate-risk group(5-6 points),and the high-risk group(7-10 points)were 30 cases,81 cases,and 40 cases respectively.According to the pathological type,simple appendicitis,Suppurative appendicitis and gangrenous perforated appendicitis were 28 cases,88 cases,and 34 cases,respectively.2.Among the counted cases,the proportion of the syndrome type distribution is damp-heat type(60.93%)>heat-toxic type(19.87)>stasis type(19.21%),and the proportion of the modified Alvarado score group is the middle-risk group.(53.64%)>high-risk group(26.50%)>low-risk group(19.87%),postoperative pathological type distribution was suppurative(58.28%)>gangrene perforation(22.52%)>simple(19.21%).3,28 cases of simple appendicitis,from the syndrome type,the proportion of stasis type is up to 20 cases.From the Alvarado score,the lowest proportion of patients with low-risk score is 20 cases;88 cases of acute suppurative appendicitis,damp-heat type The proportion of patients was up to 73,and the distribution of risk scores was also up to 67 cases.In 34 cases of gangrenous perforated appendicitis,the distribution was based on syndrome type and Alvarado score,and the patients with heat-toxic and high-risk scores were the most distributed.21 cases and 24 cases respectively.4.TCM syndrome type,Alvarado score grouping,and pathological type sample size statistics were compared and analyzed.The statistical data of the chi-square test showed that the P value was less than 0.01,indicating that the difference between the two pairs was significant.Conclusions1.The distribution pattern of TCM syndromes of acute appendicitis and Alvarado score group and pathological type after appendectomy is similar.There is a certain corresponding distribution relationship:in the incidence of appendicitis,the patients with damp-heat appendicitis have the most distribution,and the corresponding distribution law is similar.Patients with intermediate-risk scores and patients with acute suppurative appendicitis were the most widely distributed;followed by heat-toxic appendicitis,corresponding to a similar distribution of high-risk scores,acute gangrene perforated appendicitis;and stagnant appendicitis with low-risk scores and simple appendicitis.2.TCM syndrome type,modified Alvarado score,postoperative pathological type distribution,proportion have similar rules,but not one-to-one correspondence,so TCM syndrome type combined with improved Alvarado scoring method can be used as a combination of subjective and quantitative indicators To evaluate the pathological preliminary pathological stage of patients with acute appendicitis who had not undergone surgical resection.