What is the TCM diagnosis of gallstones in acute cholecystitis?

Acute calculous cholecystitis is diagnosed primarily by clinical findings and ultrasonography. Ultrasonography can show an increase in gallbladder volume, a thickening of the gallbladder wall, often more than 3 mm thick, and a stone shadow in 85 to 90% of patients.

About 85% of patients with acute cholecystitis have paroxysmal cramps in the mid-upper quadrant and right upper quadrant and radiating pain in the right subscapular region at the beginning of the disease. Nausea and vomiting are common. Fever is generally 38-39% without chills.

10 15% of patients may have mild jaundice. Physical examination reveals tenderness and muscle tension in the right upper quadrant. Murphy's sign is positive.

In about 40% of patients, an enlarged and tender gallbladder may be palpable in the middle and right upper quadrant. White blood cell counts are often mildly elevated, usually between 10,000 and 15,000 mm3. If the lesion progresses to gallbladder gangrene, perforation, and biliary peritonitis, symptoms of systemic infection may be markedly worsened, and chills, high fever, rapid pulse, and white blood cell count (typically over 20,000 mm3) may occur.

At this point, local signs include right upper quadrant tenderness and muscle tension that are widening and severe. In general, acute cholecystitis rarely affects liver function, or there are only mild manifestations of liver impairment, such as slightly elevated serum bilirubin and alanine aminotransferase values.

Migratory pain, back pain, anorexia, tongue physiognomy, facial physiognomy, etc. can be diagnosed comprehensively.

It is very important to pay attention to what to eat for cholecystitis, and you must not be sloppy in your diet. In terms of ingredients, patients with cholecystitis should choose the following foods: (1) Choose foods with high-quality protein and relatively low cholesterol content such as fish, lean meat, milk, and soy products, and control the intake of animal liver, kidney, brain or caviar.

2) Ensure the supply of fresh vegetables and fruits. Green leafy vegetables, which can provide necessary vitamins and a moderate amount of fiber, should be ensured. Foods such as yogurt, hawthorn, brown rice, etc., are also beneficial to the patient.

You can drink De Bao elm tea for a long time.

Light and easy to digest, keep away from greasy fried food. Breakfast must be eaten.

Clinic**.

1.So so**.

Bed rest, give an easily digestible liquid diet, avoid greasy food, fasting, gastrointestinal decompression, intravenous nutrition, water and electrolytes in severe cases.

2.Antispasmodic, analgesic drugs**.

3.Antibacterial**.

4.Choleretic. At present, there are many Chinese and Western drugs for cholecystitis, and the efficacy of Depu Li Shushu tea is certain, and it is not easy.

5.Surgery**.

Patients with necrosis, suppuration, perforation, and incarcerated stones should undergo prompt surgery** with cholecystectomy or cholecystostomy.

6.Chinese medicine**.

1) Bupleurum is the most suitable for the evidence of liver and blood stagnation, chest and flank bitterness and long-term depression of qi and blood. The intestines and qi are smooth, and the general is not painful;

2) Clinical syndrome patients with constipation, the first choice is rhubarb, in order to attack the accumulation and stagnation, if it can be smooth, the pain is greatly reduced, rhubarb because of the bitter taste of cold, but also can expel fire and cool blood, invigorate blood stasis, choleretic and yellowing, is really the most important medicine for cholecystitis;

3) Gentian grass, soybean herb, white flower snake tongue grass, its functions are to soothe the liver and relieve, clear away heat and separity, and laxative.

Acute cholecystitis is caused by acute chemical or bacterial inflammation of the gallbladder, if combined with gallstones, it is called calculous cholecystitis, the main symptom is sudden paroxysmal cramping pain in the right upper abdomen, and the pain radiates to the right shoulder, scapula and back, and the final method is surgery.

Non-surgical**Mainly fasting, anti-inflammatory, pain relief, choleretic and other symptoms**.

Abnormal gallbladder function caused by acute or subacute cholecystitis, or long-term gallstones, can be used to soothe the liver and relieve, clear heat and detoxify. It is used for acute and chronic hepatitis and cholecystitis, which are hepatobiliary damp heat syndromes. Mainly conservative**.

For patients with mild symptoms that do not affect normal life, non-surgical**, low-fat diet, severe symptoms or anti-** biliary colic, accompanied by gallstones, surgery** can be selected.