Clinical Study Of Xiao Chaihu Decoction Combined With Diclofenac Sodium Suppository In Treatment Of Partial Splenic Artery Embolism Syndrome

Objective: In recent years,Partial Splenic Embolization(PSE)has gradually become the commonly used treatment for hypersplenism in cirrhosis,while there are no clear treatment guidelines for postoperative syndroms such as fever,abdominal pain,nausea and vomiting caused by PSE,and no complete consensus has been reached in academic circles.Diclofenac sodium suppository,with its antipyretic and analgesic functions,has dual central and peripheral effects,and is not easy to damage gastric mucosa as suppository,so it is commonly used in clinical and postoperative patients with high fever.However,long-term clinical practice has proved that the use of diclofenac sodium suppository in postoperative patients is not effective,especially for patients with non-high fever,resulting in generally poor acceptance of PSE.Xiao Chaihu decoction originated from Zhong Jing’s Treatise on Typhoid and Miscellaneous Diseases.It is widely used in clinical practice.Its compatibility has the characteristics of combining cold and heat,attack and tonic.Modern medical research has confirmed that Xiao Chaihu decoction has anti-inflammatory,antipyretic and other effects,and is widely used in clinic for fever and other symptoms caused by various causes.In this paper,by observing the clinical efficacy of small bupleurum decoction combined with diclofenac sodium supposit in the treatment of patients with PSE postoperative syndrome,we explore the best treatment plan that can effectively relieve PSE postoperative syndrome.Methods: Sixty patients with cirrhosis and hypersplenism who met the inclusion criteria and were admitted to the Gastroenterology Department of the Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine from March 2021 to January 2023 were randomly divided into two groups after partial splenic artery embolization in the same intervention room according to the same team,the same standard and the same operation process.For the two groups of patients,one group was the control group with 30 cases each: on the basis of routine liver protection,anti-infection,anticoagulation and other treatments,patients below38.5℃ were given physical cooling,above 38.5℃ combined with diclofenac sodium supposit treatment;The other group was the experimental group of30 patients: on the basis of routine liver protection,anti-infection,anticoagulation and other treatments,all patients were treated with Xiao Chaihu decoction on the day after surgery.One dose of Xiao Chaihu decoction was taken warm every day,once in the morning and once in the evening,a total of seven doses were taken.Patients with more than 38.5℃were treated with diclofenac sodium suppositories.Liver function indexes of patients were recorded before,after and after treatment,including alanine aminotransferase(ALT),aspartate aminotransferase(AST)and albumin(ALB).Blood routine indicators,including: white blood cell(WBC),platelet count(PLT).Daily changes in temperature,abdominal pain,nausea and vomiting were recorded by the observer.After data collection,statistical tool SPSS24.0 software was used to analyze and process the data,and the therapeutic effect of Xiao Chaihu decoction combined with diclofenac sodium supposit in the treatment of partial splenic artery embolization syndrome was evaluated.Results:(1)Before PSE patients are treated,the age,the gender,the liver function grading and other basic conditions of the two groups are basically consistent,there was no statistical difference in this data;(2)As to the levels of ALT and AST in patients,There was no statistical difference in this data of both groups increased to a certain extent after surgery,then the level of ALT and AST basically recovered compare with to the preoperative level after treatment;However,After treatment,the AST level of experimental group was significantly lower than that of control group,with statistical significance.For the level of ALB in patients,the postoperative level of patients in both groups decreased to a certain extent.After treatment,ALB level of patients in the two groups recovered to a certain extent,but there was no statistical difference in ALB level compared with that of patients before surgery.For the levels of WBC and PLT in peripheral blood cells of patients in the two groups,the average course of postoperative and post-treatment patients in the two groups increased,and there was no difference in the increase level between the two groups.(3)As for the symptoms of fever in patients with PSE postoperative syndrome,compared with the control group,the number of postoperative fever in the experimental group is significantly reduced,the peak value of fever is significantly decreased,and the number of days of fever is significantly decreased.(4)For the symptoms of abdominal pain in PSE postoperative syndrome patients,compared with the control group,the number of patients with abdominal pain in the experimental group is significantly reduced,and the number of days of abdominal pain is significantly reduced.(5)As for the symptoms of nausea and vomiting in patients with PSE postoperative syndrome,the number of patients in experimental group is significantly lower than that in control group;Conclusions:(1)Xiao Chaihu decoction combined with diclofenac sodium suppository can effectively reduce the incidence of fever,abdominal pain,nausea and vomiting after PSE,improve the damage of liver function,and improve the clinical safety of PSE to a certain extent.(2)Xiao Chaihu decoction can effectively prevent the occurrence of syndrome after PSE,and has good clinical application value.