Analysis Of Curative Effect Of Traditional Chinese Medicine Combined With Acupuncture On Moderate Severe Acute Pancreatitis

Objective(s):To analyze the curative effect of traditional Chinese medicine combined with acupuncture on moderate severe acute pancreatitis.Methods: The clinical data of 150 patients with moderate severe acute pancreatitis(MSAP)admitted in our hospital during the four-year period from June2018 to June 2022 were included and analyzed retrospectively.It was divided into group A(n=50),group B(n=50),and group C(n=50).Group A was treated with gastrointestinal decompression,fasting,oxygen inhalation,nutritional support,adequate fluid resuscitation,maintenance of respiratory and circulatory stability,inhibition of pancreatic secretion(using somatostatin combined with proton pump inhibitors),prevention of infection,monitoring and control of blood glucose levels,maintenance of water,salt,electrolyte and acid-base balance and other treatments;group B was treated with traditional Chinese medicine on the basis of this;group C was treated with traditional Chinese medicine combined with acupuncture on the basis of group A.Compare the demographics(including gender,age,time from onset to hospital admission,and BMI)and etiology of the three groups of patients;compare the relief of abdominal pain and abdominal distension,the recovery time of bowel sounds,the cost of hospitalization,the opening time of enteral nutrition and the duration of hospitalization among the three groups;APACHE II and MCTSI scores were compared among the three groups before and after treatment;the total number of white blood cells,percentage of neutrophils,hematocrit,blood calcium,heart rate,respiratory rate,partial pressure of carbon dioxide and oxygen saturation were compared among the three groups before and after treatment.The infection indexes(including CRP,TNF-α,IL-6)and liver function indexes [ALT,AST,TBIL,ALB,PA]were compared among the three groups before and after treatment;finally,the incidence of adverse events and complications of the three groups were compared.Incidence rates,including comparisons of rates of gastrointestinal bleeding,acute peripancreatic fluid accumulation(APFC),Infected pancreatic necrosis(IPN),pancreatic pseudocyst(PPC),intra-abdominal hypertension(IAH),or abdominal compartment syndrome(ACS).Results: 1.There was no statistically significant difference in the general information(including gender,age,time from onset to admission,and BMI)and etiology among the three groups of patients included in this study(P>0.05).2.Before treatment,there was no significant difference in abdominal pain score and abdominal distension score among the three groups of patients(P>0.05);after treatment,compared with before treatment,the scores of the three groups were significantly lower(P<0.05).And the three groups of patients After treatment,there were significant differences in abdominal pain scores,abdominal distension scores,bowel sounds recovery time,and enteral nutrition opening time after pairwise comparison(P<0.05).The abdominal pain,abdominal distension scores were the highest in group A after treatment.And the recovery time of bowel sounds,the opening time of enteral nutrition were the longest in group A.In group C,the scores of abdominal pain and abdominal distension were the lowest,and the recovery time of bowel sounds and the opening time of enteral nutrition were the shortest.There was no significant difference in hospitalization expenses among the three groups(P>0.05).In terms of hospitalization time,there were significant differences between group B and group A,group C and group A(P<0.05),but there was no significant difference between group B and group C(P>0.05).3.Before treatment,there was no significant differences in APACHEⅡ score and MCTSI score among the three groups(P>0.05);after treatment,compared with before treatment,the scores of the three groups were significantly lower(P<0.05).After treatment,the three groups,After pairwise comparison,there were significant differences between group B and group A,group C and group A(P<0.05)in APACHEⅡ score and MCTSI score,but there was no significant difference between group B and group C(P>0.05).4.There were no significant differences in the total number of white blood cells,percentage of neutrophils granulocyte,hematocrit,blood calcium,heart rate,respiratory rate,partial pressure of carbon dioxide,and oxygen saturation among the three groups before treatment(P>0.05).Compared before treatment,the values of the three groups were significantly lower than those before treatment(P<0.05).After treatment,there were significant differences in the total number of white blood cells and the percentage of neutrophils in the three groups after pairwise comparison,(P<0.05);And the value of group A is the largest,the value of group C is the smallest.After the treatment of hematocrit,there were significant differences between group B and group A,group C and group A(P<0.05);and there was no significant difference between group B and group C(P>0.05).There were no significant differences among the three groups after treatment in blood calcium,heart rate,respiratory rate,partial pressure of carbon dioxide,and oxygen saturation(P>0.05).5.There was no significant difference in infection indexes(including CRP,TNF-α,IL-6)among the three groups of patients before treatment(P>0.05);after treatment,the values were significantly lower than those before treatment(P<0.05).After the treatment of the three groups of patients,after pairwise comparison,there were significant differences in infection indicators(including CRP,TNF-α,IL-6)among the three groups(P<0.05),and the values were the highest in group A,the lowest in group C.6.There was no statistically significant difference in liver function(including AST,ALT,TBIL,ALB,PA)among the three groups before treatment(P>0.05);after treatment,the difference was statistically significant(P<0.05).After the treatment of the three groups of patients,after pairwise comparison,there were significant differences in AST,ALT,TBIL and ALB between group B and group A,group C and group A(P<0.05),there was no significant difference between group B and group C(P>0.05).After treatment,there was no significant difference in PA among the three groups(P>0.05).7.There were no significant differences in the incidence of adverse events(gastrointestinal bleeding,acute peripancreatic fluid accumulation,Infected pancreatic necrosis,pancreatic pseudocyst,intra-abdominal hypertension or abdominal compartment syndrome)among the three groups(P>0.05).Conclusion(s): 1.Traditional Chinese medicine combined with acupuncture in the treatment of moderate severe acute pancreatitis has a significant effect in improving the symptoms of abdominal pain and abdominal distension,promoting the recovery of intestinal sound and shortening the opening time of enteral nutrition.The hospitalization time was also significantly shorter than that of the routine treatment group,which was similar to that of the combined traditional Chinese medicine treatment group.2.The scores of APACHE II and MCTSI in the treatment of moderate severe acute pancreatitis with traditional Chinese medicine combined with acupuncture were improved,which was superior to the conventional treatment group and had the same curative effect as the treatment group with traditional Chinese medicine.3.In terms of the total number of white blood cells and the percentage changes of blood neutrophils,the treatment group of Chinese medicine combined with acupuncture has a significant effect;in hematocrit,the treatment group of Chinese medicine combined with acupuncture is better than the conventional treatment group,similar to the combination of traditional Chinese medicine treatment group.Traditional Chinese medicine combined with acupuncture in the treatment of moderate severe acute pancreatitis systemic inflammatory response syndrome(SIRS)improved most significantly in the three groups.4.Traditional Chinese medicine combined with acupuncture can reduce the level of inflammatory factors in the treatment of moderate severe acute pancreatitis.5.In improving liver function,the traditional Chinese medicine combined with acupuncture treatment group is better than the conventional treatment group,and the curative effect is remarkable,which is equivalent to that of the combined traditional Chinese medicine treatment group.6.There was no significant improvement in the incidence of adverse events of moderate severe acute pancreatitis in the Chinese medicine combined with acupuncture treatment group.