Standardized treatment of cholecystitis can be radical,
Guiding opinions:
Comprehensive treatment is needed. In the acute stage, it includes: bed rest, fasting, gastric tube decompression for abdominal distension; Rehydration to correct the imbalance between water, electrolyte and acid-base; Spasm and pain relief; Intravenous combination of effective antibiotics, such as gentamicin, ampicillin, cephalosporin, etc.
Life care:
Give a digestible liquid diet, avoid greasy food and avoid drinking alcohol.
Disease analysis:
In general, it is not easy to go to Gende.
Guiding opinions:
Non-surgical treatment: It can also be used as preoperative preparation, including: a. Bed rest, fasting, gastric tube decompression for patients with abdominal distension; B. rehydration to correct the imbalance between water, electrolyte and acid-base; C. relieving spasm and pain; D. Intravenous combination of effective antibiotics, such as gentamicin, ampicillin, chloramphenicol, cephalosporin, etc. Effective for 80%-85% of early cases.
(2) Surgical treatment
1. Acute cholecystitis: generally speaking, active medical treatment is recommended after12 ~ 24 hours, and surgery is selected after the symptoms are relieved.
2. Chronic cholecystitis: No matter whether there are stones or not, the gallbladder has lost its function and it is an infected focus, so it should be surgically removed.
(3) Diet therapy
In addition to medication and surgical treatment, nutritional therapy plays a certain auxiliary role in cholecystitis and cholelithiasis, especially in the stage of pain relief and postoperative health recovery, the requirements of nutritional therapy and the principles of dietary therapy should not be ignored as follows:
(1) The general purpose of nutritional therapy is to reduce or relieve the pain of patients and prevent the occurrence of stones by controlling the intake of fat. Severe patients in acute attack should fast and be given various nutrients intravenously. When you can eat, you should abstain from fat and irritating food, and eat a liquid diet with high carbohydrate for a short time. With the gradual remission of the disease, you can give soft rice with low fat and semi-liquid or low fat and less residue. You should eat less meals every day, but still limit meat and foods with high fat. Chronic cholecystitis should be given a diet with sufficient calories, high carbohydrate and moderate fat restriction, and be rich in vitamins.
(2) Sufficient heat energy is needed to ensure the patients' needs. If the patients are overweight, they should be given a low-heat diet to reduce their weight. The low-heat diet should also contain less fat to meet the requirements of fat restriction for patients with gallbladder disease. Generally, the daily heat supply is 7531.2 ~ 8368 Joules (1800 ~ 2000 kcal).
(3) For patients with chronic cholecystitis, in order to keep healthy, stimulate appetite, promote gallbladder contraction and facilitate gallbladder emptying, the proportion of protein in diet should be increased as much as possible. The daily protein supply should be L ~1.2g per kg body weight, but excessive cholesterol intake with protein should be avoided.
(4) Fat can cause severe pain due to the contraction of the diseased gallbladder, so it should be strictly limited during the attack. The daily fat supply should be less than 40 grams or fasting, and you can eat in moderation after your condition improves.
(5) When eating carbohydrate liquid diet, the main nutrient is sugar. Adequate carbohydrate can be given, with a daily supply of 300-350g, especially during the attack.
(6) We should supply abundant multivitamins, and pay special attention to supplementing vitamins B and K. 。
(7) Avoid stimulating food and alcohol.
Acute cholecystitis:
General treatment: bed rest, digestible liquid diet, avoiding greasy food, fasting in severe cases, gastrointestinal decompression, intravenous nutrition, water and electrolyte.
1. Spasmodic and analgesic drug therapy: atropine 0.5mg or 654-2 5mg intramuscular injection; Nitroglycerin 0.3-0.6mg, sublingual; Vitamin K38- 16mg, intramuscular injection; Morphine is not suitable for analgesia such as dolantin or isosorbide dinitrate.
13. Antibacterial therapy: ampicillin, ciprofloxacin, metronidazole; Aminoglycosides or cephalosporins can also be selected, and antibiotics should be selected according to the results of bacterial culture and drug sensitivity test.
4. cholagogic: Shudantong, Xiaoyan cholagogic tablets or Qinggan cholagogic oral liquid can be used after the attack is relieved.
⒌ Surgical treatment: Patients with necrosis, suppuration, perforation and incarcerated stones should be treated by surgery in time, and cholecystectomy or cholecystostomy should be performed.
Chronic cholecystitis:
1. Surgical treatment: Cholecystectomy should be performed for patients with chronic cholecystitis accompanied by gallstones. The operation is usually performed two months after the onset of cholecystitis, which can reduce the adhesion around the gallbladder and gallbladder edema.
Comprehensive treatment: low-fat diet, oral cholagogic drugs, such as magnesium sulfate, Xiaoyan cholagogic tablets, Qinggan cholagogic oral liquid, Baodanjinsu, etc. Ursodeoxycholic acid, chenodeoxycholic acid, Xiaoshisun, etc. were used to dissolve the stone. Infected people with parasites should be treated with deworming.
3. Diet therapy: Chinese medicine believes that chronic cholecystitis is mostly caused by stagnation of heat in the liver and gallbladder, which is caused by abnormal drainage. It should be treated by clearing the liver and gallbladder, soothing the liver and activating qi, and regulating qi-flowing. Chinese medicine can generally be divided into the following types according to syndrome differentiation:
Disease analysis:
Hello, there are two kinds of cholecystitis, acute and chronic, which are common in clinic, especially in obese and prolific women aged around 40.
The incidence of acute cholecystitis is closely related to bile stasis and bacterial infection. The main pathogens are gram-negative bacteria such as Escherichia coli (60% ~ 70%), Klebsiella, anaerobic bacteria, etc. Most of them enter the gallbladder retrograde from the intestine through the common bile duct, and a few pass through the portal vein system to the liver, and then flow into the gallbladder with bile.
Part of chronic cholecystitis is caused by acute cholecystitis, but most of them have no history of acute attack in the past. About 70% of patients are accompanied by stones. Due to the stimulation of gallstones and repeated acute attacks on the basis of long-term chronic inflammation, the gallbladder can shrink or the fibrous tissue of the cyst wall proliferate and thicken, and eventually the cystic cavity will shrink and lose its function. If the cystic duct is stone, inflammatory adhesion or scar is completely blocked, bile cannot flow into the gallbladder, but the original bile in the gallbladder can't flow into it. When secondary infection occurs, it develops into gallbladder empyema.
Guiding opinions:
★ Treatment of cholecystitis ★
At present, cholecystectomy is the best treatment for acute and chronic cholecystitis.
(1) Non-surgical therapy: it can also be used as preoperative preparation, including: a. bed rest, fasting, gastric tube decompression for patients with abdominal distension; B. rehydration to correct the imbalance between water, electrolyte and acid-base; C. relieving spasm and pain; D. Intravenous combination of effective antibiotics, such as gentamicin, ampicillin, chloramphenicol, cephalosporin, etc. Effective for 80%-85% of early cases.
(2) Surgical treatment
1. Acute cholecystitis: generally speaking, active medical treatment is recommended after12 ~ 24 hours, and surgery is selected after the symptoms are relieved.
2. Chronic cholecystitis: No matter whether there are stones or not, the gallbladder has lost its function and it is an infected focus, so it should be surgically removed.
(3) Diet therapy
In addition to medication and surgical treatment, nutritional therapy plays a certain auxiliary role in cholecystitis and cholelithiasis, especially in the stage of pain relief and postoperative health recovery, the requirements of nutritional therapy and the principles of dietary therapy should not be ignored as follows:
(1) The general purpose of nutritional therapy is to reduce or relieve the pain of patients and prevent the occurrence of stones by controlling the intake of fat. Severe patients in acute attack should fast and be given various nutrients intravenously. When you can eat, you should abstain from fat and irritating food, and eat a liquid diet with high carbohydrate for a short time. With the gradual remission of the disease, you can give soft rice with low fat and semi-liquid or low fat and less residue. You should eat less meals every day, but still limit meat and foods with high fat. Chronic cholecystitis should be given a diet with sufficient calories, high carbohydrate and moderate fat restriction, and be rich in vitamins.
(2) Sufficient heat energy is needed to ensure the patients' needs. If the patients are overweight, they should be given a low-heat diet to reduce their weight. The low-heat diet should also contain less fat to meet the requirements of fat restriction for patients with gallbladder disease. Generally, the daily heat supply is 7531.2 ~ 8368 Joules (1800 ~ 2000 kcal).
(3) For patients with chronic cholecystitis, in order to keep healthy, stimulate appetite, promote gallbladder contraction and facilitate gallbladder emptying, the proportion of protein in diet should be increased as much as possible. The daily protein supply should be L ~1.2g per kg body weight, but excessive cholesterol intake with protein should be avoided.
(4) Fat can cause severe pain due to the contraction of the diseased gallbladder, so it should be strictly limited during the attack. The daily fat supply should be less than 40 grams or fasting, and you can eat in moderation after your condition improves.
(5) When eating carbohydrate liquid diet, the main nutrient is sugar. Adequate carbohydrate can be given, with a daily supply of 300-350g, especially during the attack.
(6) We should supply abundant multivitamins, and pay special attention to supplementing vitamins B and K. 。
(7) Avoid stimulating food and alcohol.
Disease analysis:
Hello, it is generally difficult to cure.
Guiding opinions:
Cholecystitis 1. Eat less high-fat foods such as pork, beef, mutton, cream, butter, fried food (especially poached eggs), animal viscera, roe, and oily cakes, etc., all of which are high-fat foods. Patients with cholecystitis should eat as little as possible. It stimulates gallbladder contraction and secretes a lot of bile. As a result, gallbladder will contract strongly, which will cause cholecystitis.
2. Appropriate intake of high-quality protein. If a person does not eat animal food for a long time, then the human body will inevitably suffer from malnutrition due to the lack of protein and other nutrients to varying degrees, resulting in decreased resistance, which is more unfavorable to the rehabilitation of cholecystitis patients. Therefore, appropriate intake of high-quality protein is absolutely necessary. Lean meat, chicken and duck meat, fish, eggs and bean products are rich in high-quality protein.
3 Supplementing energy The continuation of life and metabolism need a lot of energy, while rice, noodles and fruits eaten by human beings contain a lot of energy. For patients with cholecystitis, the above foods are unrestricted and can be eaten as needed to meet the needs of the body's metabolism.
4 Avoid irritating foods Patients with cholecystitis should not only pay attention to food that is soft and easy to digest, eat less and eat more meals, but also avoid spicy food, wine and other irritating foods to reduce or avoid irritation to the gallbladder. In short, patients with cholecystitis should not only apply their dietary arrangements to acute attacks, but also to prevent recurrence.
Disease analysis:
Cholecystitis is a kind of cholecystitis disease caused by infection, bile stimulation, pancreatic juice regurgitation to biliary tract, gall bladder cancer and lipid-like metabolism disorder. Cholecystitis can be divided into acute cholecystitis and chronic cholangitis. The typical manifestations of acute cholecystitis are persistent or paroxysmal colic in the right upper abdomen, which can radiate to the right corner, tenderness or rebound pain in the gallbladder area, muscle tension, fever, nausea and vomiting, or jaundice and increased white blood cells. Chronic cholecystitis is characterized by recurrent abdominal distension with different degrees of severity, discomfort or pain in the right upper abdomen and upper abdomen, which often radiates to the right shoulder and back, accompanied by indigestion symptoms such as belching and pantothenic acid, and the symptoms of eating greasy food are aggravated.
Guiding opinions:
Commonly used clinically effective remedies are as follows.
[Formula 1] Fresh and tender wheat straw 1 00g (take the wheat that has been grouted in spring and is not yet mature), and a little white sugar. The wheat straw is boiled in water for about half an hour, and the white sugar is added to make it slightly sweet instead of tea, half a bowl each time,1day for 3 times.
This prescription is suitable for cholecystitis by diminishing inflammation and benefiting gallbladder.
[Formula 2] 500g of Salvia Miltiorrhiza, 250g of Radix Curcumae, 0/00g of Herba Artemisiae Scopariae 1 kg, and appropriate amount of yellow rice wine. Pour Salvia Miltiorrhiza, Radix Curcumae and Herba Artemisiae Scopariae into a large casserole, soak them in cold water for 2 hours, then boil them with medium fire, add 2 tablespoons of yellow rice wine, and slowly fry them with low fire/kloc-0. When about half a bowl of liquid medicine remains, filter out, discard the residue, pour the first juice, second juice and honey into the bowl and basin together, mix well, cover the bowl and basin with strong fire, steam for 2 hours, leave the fire, cool, bottle and cover tightly, twice a day, each time 1-2 spoons, and take it with boiling water after meals, and 3 months is a course of treatment.
Formula 3] Red pulp watermelon 1 4g, frozen powder1.5g, sugar 60g, banana oil1drop, and water 90g. Remove seeds from watermelon pulp, chop, squeeze out watermelon juice, cut frozen powder into inches, and add sugar/.
This prescription is suitable for cholecystitis and cholelithiasis by clearing away heat and toxic materials, promoting gallbladder function and lowering blood pressure.
[Formula 4] Bupleurum 1 2g, Paeonia lactiflora15g, Codonopsis pilosula10g, Atractylodes macrocephala12g, Astragalus membranaceus19g, Coptidis Rhizoma 6g, Pinellia ternata] 0g, Pericarpium Citri Tangerinae, Poria, Alismatis Rhizoma each.
Life care:
Can be eradicated! I suggest that you can even treat the symptoms with anti-inflammatory infusion! Pay attention to diet and don't use spicy food! And greasy food! I wish you a speedy recovery!
Disease analysis:
Hello, the cause of cholecystitis is very complicated and it is a stubborn disease.
Guiding opinions:
Generally, cholecystitis requires surgery sooner or later. If it is mild, you can do anti-inflammatory treatment first, but you have to have surgery in the end.
Disease analysis:
At present, cholecystectomy is the best treatment for acute and chronic cholecystitis.
(1) Non-surgical therapy: it can also be used as preoperative preparation, including: a. bed rest, fasting, gastric tube decompression for patients with abdominal distension; B. rehydration to correct the imbalance between water, electrolyte and acid-base; C. relieving spasm and pain; D. Intravenous combination of effective antibiotics, such as gentamicin, ampicillin, chloramphenicol, cephalosporin, etc. Effective for 80%-85% of early cases.
(2) Surgical treatment
1. Acute cholecystitis: generally speaking, active medical treatment is recommended after12 ~ 24 hours, and surgery is selected after the symptoms are relieved.
2. Chronic cholecystitis: No matter whether there are stones or not, the gallbladder has lost its function and it is an infected focus, so it should be surgically removed.
(3) Diet therapy
In addition to medication and surgical treatment, nutritional therapy plays a certain auxiliary role in cholecystitis and cholelithiasis, especially in the stage of pain relief and postoperative health recovery, the requirements of nutritional therapy and the principles of dietary therapy should not be ignored as follows:
(1) The general purpose of nutritional therapy is to reduce or relieve the pain of patients and prevent the occurrence of stones by controlling the intake of fat. Severe patients in acute attack should fast and be given various nutrients intravenously. When you can eat, you should abstain from fat and irritating food, and eat a liquid diet with high carbohydrate for a short time. With the gradual remission of the disease, you can give soft rice with low fat and semi-liquid or low fat and less residue. You should eat less meals every day, but still limit meat and foods with high fat. Chronic cholecystitis should be given a diet with sufficient calories, high carbohydrate and moderate fat restriction, and be rich in vitamins.
(2) Sufficient heat energy is needed to ensure the patients' needs. If the patients are overweight, they should be given a low-heat diet to reduce their weight. The low-heat diet should also contain less fat to meet the requirements of fat restriction for patients with gallbladder disease. Generally, the daily heat supply is 7531.2 ~ 8368 Joules (1800 ~ 2000 kcal).
(3) For patients with chronic cholecystitis, in order to keep healthy, stimulate appetite, promote gallbladder contraction and facilitate gallbladder emptying, the proportion of protein in diet should be increased as much as possible. The daily protein supply should be L ~1.2g per kg body weight, but excessive cholesterol intake with protein should be avoided.
(4) Fat can cause severe pain due to the contraction of the diseased gallbladder, so it should be strictly limited during the attack. The daily fat supply should be less than 40 grams or fasting, and you can eat in moderation after your condition improves.
(5) When eating carbohydrate liquid diet, the main nutrient is sugar. Adequate carbohydrate can be given, with a daily supply of 300-350g, especially during the attack.
(6) We should supply abundant multivitamins, and pay special attention to supplementing vitamins B and K. 。
(7) Avoid stimulating food and alcohol.
Guiding opinions:
General treatment: bed rest, digestible liquid diet, avoiding greasy food, fasting in severe cases, gastrointestinal decompression, intravenous nutrition, water and electrolyte.
1. Spasmodic and analgesic drug therapy: atropine 0.5mg or 654-2 5mg intramuscular injection; ****0.3-0.6mg, sublingual; Vitamin K38- 16mg, intramuscular injection; Demerol or isosorbide dinitrate should not be used for analgesia.
13. Antibacterial therapy: ampicillin, ciprofloxacin, metronidazole; Aminoglycosides or cephalosporins can also be selected, and antibiotics should be selected according to the results of bacterial culture and drug sensitivity test.
4. cholagogic: Shudantong, Xiaoyan cholagogic tablets or Qinggan cholagogic oral liquid can be used after the attack is relieved.
⒌ Surgical treatment: Patients with necrosis, suppuration, perforation and incarcerated stones should be treated by surgery in time, and cholecystectomy or cholecystostomy should be performed.
Chronic cholecystitis:
1. Surgical treatment: Cholecystectomy should be performed for patients with chronic cholecystitis accompanied by gallstones. The operation is usually performed two months after the onset of cholecystitis, which can reduce the adhesion around the gallbladder and gallbladder edema.
Comprehensive treatment: low-fat diet, oral cholagogic drugs, such as magnesium sulfate, Xiaoyan cholagogic tablets, Qinggan cholagogic oral liquid, Baodanjinsu, etc. Ursodeoxycholic acid, chenodeoxycholic acid, Xiaoshisun, etc. were used to dissolve the stone. Infected people with parasites should be treated with deworming.
3. Diet therapy: Chinese medicine believes that chronic cholecystitis is mostly caused by stagnation of heat in the liver and gallbladder, which is caused by abnormal drainage. It should be treated by clearing the liver and gallbladder, soothing the liver and activating qi, and regulating qi-flowing. Chinese medicine can generally be divided into the following types according to syndrome differentiation:
Diet stagnation type: mainly manifested as hypochondriac pain, epigastric fullness, or nausea and vomiting, unpleasant stool, thick and greasy fur and slippery pulse. When regulating qi and promoting digestion and regulating stomach stagnation are the treatments, the following dietary treatments can be selected.
1. Hawthorn yam cake: hawthorn, yam and white sugar are appropriate. Remove the core of hawthorn, steam it with yam, add white sugar after cooling, stir well, and press it into pancakes. 1 day 1 dose.
2. Dried ginger and pepper Amomum belly: 6 grams of dried ginger, 6 grams of pepper and 6 grams of Amomum villosum, 3 grams of cinnamon and 3 grams of dried tangerine peel, pork belly 1 piece, and appropriate amount of seasoning. Wash the pork belly, wrap all the medicines in cloth, cook with water until the pork belly is cooked thoroughly, remove the dregs and take the juice for drinking, take out the pork belly and slice it, and take it with seasoning on the 2nd.
Type of liver-qi invading the stomach: mainly manifested as hypochondriac pain, fullness in the stomach, pain from attacking and supporting, frequent warming of qi, poor stool, pain attack due to emotional factors, thin and white tongue coating, and thready pulse. When soothing the liver and regulating qi, the following dietary treatments can be selected.
1. Pericarpium Citri Tangerinae and Areca catechu: 20g Pericarpium Citri Tangerinae, 200mg Areca catechu, clove, cardamom and Amomum villosum each10g. Wash all the medicines and put them in a pot. Add appropriate amount of water, boil them with strong fire, and then turn to slow fire. Boil until the liquid medicine is dry, then stop the fire and wait for it to cool. When the liquid medicine is cold, take out the betel nut and chop it into pieces the size of soybeans. Take a little after each meal.
2. Chicken soup for Danshen field: 30g of Danshen, 20g of jujube 1 0g, and 20g of frog. Cover Danshen with cloth, remove the core of jujube, peel and wash the frog. Add water and stew until the frog is cooked, remove the medicine bag, add salt, monosodium glutamate and other ingredients, and take it daily1dose.
Stagnation of heat in the liver and stomach: mainly manifested as hypochondriac pain, fullness and burning pain in the stomach, irritability and irritability, acid and noisy mouth, dry mouth and bitter taste, red tongue with yellow fur, and thready or rapid pulse. When soothing the liver and expelling heat, promoting qi circulation and relieving pain, the following dietary treatments can be selected.
1. Shredded pork with burdock: burdock 1 0g, lean pork150g, shredded carrot100g, and appropriate amount of seasoning. Decoct burdock in water to get juice for later use. Wash and shred pork, and season with burdock decoction and starch. After heating, put vegetable oil in the pot, put it in.
2. Gold coin bamboo leaf porridge: 30g of gold coin grass, 50g of bamboo leaves 1 0g, 50g of rice, and appropriate amount of sugar. Select gold coin grass and bamboo leaves, put them in a pot, add appropriate amount of water, soak them for 5 ~10min, then decoct with water to get juice, and add more rice to cook porridge. When it is ripe, add sugar and boil for two times.
Stagnation of blood stasis: mainly manifested as hypochondriac pain, pain in a fixed place and refusal to press, epigastric fullness and pain, dark purple tongue and unsmooth pulse. When promoting blood circulation to dissipate blood stasis, regulating qi and relieving pain is the treatment, the following dietary treatments can be selected.
1. Hawthorn and Panax notoginseng porridge: Hawthorn 1 0g, Panax notoginseng 3g, rice 50g, and appropriate amount of honey. Grind Panax notoginseng into fine powder, first take Hawthorn and rice to cook porridge, then add Panax notoginseng and honey when it boils, and take it every day1dose and breakfast.
2. Braised pork with figs, fungus and red dates: 250g of lean pork, 60g of figs, 5g of red dates, auricularia auricula15g of seasoning. Wash pork and slice it; Jujube is pitted; Wash the auricularia auricula, put it in the pot with fig, add water to boil, add onion, ginger, pepper, salt, etc. When it is cooked, mix it with monosodium glutamate, daily 1 dose.
3. Cuttlefish with peach kernel: 6g of peach kernel, 0g of Chinese angelica 10, cuttlefish 1 strip, and proper amount of seasoning. Remove the head and bones of cuttlefish, wash it, shred it, wrap it with peach kernel and Chinese angelica, add water and boil it, and then remove the froth. Cook it with slow fire until the cuttlefish is cooked, remove the medicine bag, and season and take it.
A folk prescription:
Syndrome Differentiation: Stagnation of qi in liver and gallbladder, accumulation of damp heat.
Treatment: Soothing the liver, benefiting gallbladder, regulating qi and removing dampness.
Shugan Lidan Decoction.
[Composition] Radix Bupleuri12g, Radix Paeoniae Alba 20g, Fructus Aurantii10g, Radix Aucklandiae10g, Rhizoma Corydalis12g, Fructus Toosendan15g, Herba Artemisiae Scopariae 30g and Radix et Rhizoma Rhei 6g (bottom).
[Usage] Decoct with water, 2 doses a day, twice a day.
Cholecystitis alone is easy to treat if there are no gallstones and polyps. You don't have to take any medicine. Just eat coarse grains instead of flour and rice, fat meat and fried food, eat more fruits and vegetables, and keep your stool unobstructed. It will be almost half a month. But are you at school? There's no place to find cornmeal steamed buns, which is a problem. You can steam them at home during the winter vacation, with 4 portions of cornmeal and one portion of yellow bean, and steam them in a cage for 30 minutes.