[Clinical manifestations] Typical acute appendicitis is characterized by sudden upper abdominal or periumbilical pain, followed by short-term nausea and vomiting. After a few hours, the pain shifted to the right lower abdomen. There may be tenderness and rebound pain in the right lower abdomen, localized pain and low fever when coughing. [Diagnosis]1.The diagnosis of this disease must be based on clinical examination. The typical clinical features are metastatic right lower abdominal pain, fever, gastrointestinal symptoms and positive Maxwell's sign. In severe cases, there may be reflex pain, abdominal muscle tension, positive psoas major test, positive obturator internus test, tenderness in the right upper right corner of rectal digital diagnosis and positive colon inflation test. If an inflammatory mass or abscess has been formed, a tender mass can be touched. 2. Blood routine: the total number of white chest and the classification of neutrophils increased. 3. In the early stage of appendicitis, X-ray, ultrasound or ct examination can hardly provide diagnostic help, and barium enema is dangerous. In the late stage of the disease, the examination of ultrasound and bite is very helpful for the diagnosis of abscess, and the pelvic cavity and subphrenic area can be examined by laparoscopy. 4. Pay attention to distinguish it from other acute abdomen in pelvic cavity, colon and digestive tract.
[Treatment] 1. Western medicine treatment (1) The main treatment of acute appendicitis is surgical removal of the appendix. Pericolonic abscess has formed, and inflammatory bowel disease involving cecum can be treated by non-surgery, and appendectomy can be performed after inflammation disappears. (2) Antibiotic therapy: Gentamicin 80,000 U intramuscular injection twice a day, or kanamycin o．5g intramuscular injection twice a day; Or cephalosporin antibiotics, such as cefotaxime sodium 1 .0/g1time, every 12 hours1time, which can be injected intramuscularly, intravenously or intravenously; Xianfeng Bisu 1-2g/time, 12 hours1time, which can be injected intramuscularly, intravenously or intravenously. Severe infection can be increased to 8-12g/day. Metronidazole can be added. (3) Maintain the balance of water and electrolyte.
2. Stagnation period of TCM treatment (1): pain in the right lower abdomen, paroxysmal aggravation, localized pain, fever, nausea and vomiting, abdominal distension and constipation, thin yellow tongue coating and rapid pulse. Treatment: attack from the interior, detoxify and remove stasis. Prescription: 9 g of raw rhubarb (lower back), 9 g of peony bark 12 g, 9 g of mirabilite (washed), 9 g of raw coix seed 15 g, 9 g of peach kernel, 30 g of wax gourd seed, 0/5 g of Patrinia/kloc-,0/5 g of red vine/kloc-,and dandelion. (2) Stagnation of heat: severe abdominal pain in the right lower abdomen, less abdominal fullness and refusal to press, palpable mass, constipation due to strong heat, nausea and abdominal distension, red tongue, yellow and thick fur, and rapid pulse. Treatment: dredge the fu-organs to relieve heat, detoxify and penetrate pus. Prescription: Viola yedoensis15g, Flos Lonicerae15g, Caulis Sargentodoxae15g, Olibanum 9g, Semen Benincasae 20g, Myrrha 9g, Radix et Rhizoma Rhei 9g, Radix Paeoniae Rubra12g, Rhizoma Corydalis 9g and Fructus Forsythiae/kloc-0. (3) Toxic heat stage: severe abdominal pain, abdominal muscle stiffness, lump refusal, constipation, intense heat and irritability, crimson tongue, brown fur, and slippery pulse. Treatment: dredging fu organs and discharging pus, nourishing yin and clearing heat. Prescription: 9 grams of raw rhubarb (below), 9 grams of mirabilite (washed), 9 grams of immature bitter orange, 9 grams of Polygonum cuspidatum 10, 9 grams of magnolia officinalis, 0/2 grams of Radix Scrophulariae 12 grams of Radix Rehmanniae, 0/2 grams of Cortex Moutan 10 grams of raw Coicis Semen.
[Prevention and nursed back to health] Eat well, avoid overeating or strenuous exercise after eating, strengthen physical exercise, enhance physical fitness, and prevent intestinal parasite infection.