Analysis Of Clinical Efficacy Of Combination Of Traditional Chinese And Western Medicine In Minimally Invasive Treatment Of Acute Biliary Pancreatitis Based On SELECT Concept

Objective: By analyzing the general data,serum amylase,lipase,white blood cell count,neutrophil ratio improvement,length of stay and prognosis of patients with acute biliary pancreatitis who were previously treated by the First Affiliated Hospital of Dalian Medical University,To explore the clinical efficacy of the minimally invasive treatment of acute biliary pancreatitis with the combination of traditional Chinese and western medicine under the guidance of the concept of SELECT(Spyglass + ERCP + Laparoscopy + EUS + Choledochoscopy + Traditional Chinese medicine),and to study whether Qingrelidan Keli combined with surgical minimally invasive treatment can improve the clinical treatment effect of acute biliary pancreatitis,and provide help for the follow-up clinical treatment,It also provides reliable experience and scientific basis for the clinical application of SELECT concept.Methods: The clinical data of the patients who met the diagnostic criteria for acute biliary pancreatitis among the patients hospitalized in the General Surgery with integrated traditional Chinese and western medicine Department of the First Affiliated Hospital of Dalian Medical University from January 2010 to December 2021 were collected and sorted out through the Yidu Cloud Database.After screening by the inclusion criteria,they were divided into the treatment group of integrated traditional Chinese and western medicine and the treatment group of western medicine according to their treatment methods.The treatment group of western medicine was treated with surgery combined with conventional western medicine,On this basis,the treatment group of integrated traditional Chinese and western medicine combined with the hospital preparation Qingrelidan Keli for adjuvant treatment.Through the analysis and statistics of the data of the above two groups of patients,the recovery of serum amylase(AMY),lipase(LPS),white blood cell(WBC)and neutrophil ratio(NE%),as well as the hospital stay and recurrence rate of patients between the two groups were compared.Results:From January 2010 to January 2022,a total of 160 patients with acute biliary pancreatitis were admitted to the three departments of general surgery with integrated traditional Chinese and western medicine of our hospital.After screening by the inclusion criteria and exclusion criteria,138 patients were finally included in the study,including 84 patients in the western medicine treatment group and 54 patients in the integrated Chinese and western medicine treatment group.The ratio of male and female in the western medicine treatment group was 0.79:1,and the ratio of male and female in the combined traditional Chinese and western medicine treatment group was 1.35:1(p=0.16);The average age((?)±s)of the western medicine treatment group was 63.8±16.5,and the average age of the western medicine combined treatment group was 67.51±6.0(p=0.19);There was no difference in gender and age between the two groups.The alkaline phosphatase(ALP)of patients in the western medicine treatment group and the integrated traditional Chinese and western medicine treatment group at admission was 159.33±155.56,166.93±82.52 respectively(p=0.74);Alanine aminotransferase(ALT)was 180.67±153.85,233.41±222.41(p=0.10);Total bilirubin(TBIL)was 39.50±39.11umol/L and 44.76±35.50umol/L respectively(p=0.43).There was no significant difference between the two groups in liver function tests at admission.Compared with the western medicine treatment group alone,the recovery of serum lipase(2845.33±2842.43,1548.39±2101.63)U/L and amylase(837.98±481.38,533.56±696.65)U/L.The decrease of neutrophil ratio(15.31±13.30,9.35±16.26)% was statistically significant(p<0.05),but there was no statistically significant difference in the recovery of white blood cells 4.23±2.82×10~9/L,3.24±4.66×10~9/L(p>0.05).The treatment of integrated traditional Chinese and western medicine can significantly improve the recovery of patients laboratory indicators.The auxiliary surgical treatment of Qingrelidan Keli can significantly shorten the hospitalization time of patients(11.67±3.20,14.25±7.26,p=0.015)d;It can also reduce the recurrence rate of patients(5.56%,19.05%,p=0.04).Conclusions:1.Qingrelidan Keli combined with surgical minimally invasive treatment for acute biliary pancreatitis can significantly improve the patients laboratory indicators,effectively promote the recovery of inflammatory indicators and related enzymological indicators,greatly shorten the patients hospitalization time,and significantly reduce the recurrence rate of patients.The efficacy of minimally invasive treatment combined with traditional Chinese and western medicine is superior to that of simple western medicine;2.There was no significant difference in the recovery of white blood cells in patients with acute biliary pancreatitis treated with Qingrelidan Keli;3.SELECT is an advanced concept worthy of clinical application and promotion.