With Clinical Investigation of 522 Cases and Preliminary Consideration of Features of Stone-Excretion
Group for Treating Cholelithiasis with Needling, Department of Surgery, Wendeng Central Hospital, Shandong
This paper presents and analyses the therapeutic effect of 522 patients with cholelithiasis treated in the interval from 1975 to november, 1978.
1. Criteria of Diagnosis
History: All the cases had a history of recurrent upper right abdominal pain, fever and jaundice, or a history of cholelithotomy.
Signs: Body temperature around 38.5ºC, scleral jaundice, pain on percussion in the liver field and the distension of the gall bladder. (Marked tenderness also remains on the upper right abdomen even if the gall bladder had been removed.)
Laboratory findings: Blood studies show an increased white count, increased icterus index, with direct reaction to Van Den Bergh Test and increased serum transaminase. Nothing abnormal in other liver function test.
Most of patients had not received cholangiography prior to stone excretion because of acute episode on admission.
2. Method of Treatment
The right Qimen and Rique should be regarded as the main acupuncture points. In case of severe pain and gall bladder distension, point Danshu should be needled in addition, and a 6 cun needle should also be prepared to insert obliquely the midpoint of the line linking Juque and right Fuai points. The needle of 6 cun in length travels in the direction of the central part of the distended gall bladder and reaches underneath the external oblique muscle.
G 6805 Appartus were connected to the needles sticking in Qimen and Riyue points. Electric current of sparse and dense waves were given. The intensity of current should be within patients' tolerance. Draw the needles after 60 minutes' making of the circuit, then 40 ml of 50% magnesium sulfate was ordered orally once a day for ten days which was regarded as a course of treatment.
3. Results of Treatment
The 522 patients treated by electric needling are divided into three types (the stable type, the acute onset type and the shock type). Stone excretion rate is 35% in stable type, 89.7% in acute onset type, and 50% in shock type. The total stone excretion rate is 78.4%.
4. 73 cases of acute onset type with the same diagnostic criteria as before were selected as control group. 40ml of 50% magnesium sulfate were taken orally immediately after admission. Then took the same dose every day around 9 o'clock in the morning. The stone excretion rate was 27.4% in this group. In comparison with the acute onset type of the electric needling group and control group, there is a significant difference (P<0.01). The stone excretion rate in the former is markedly higher than that in the latter.
5. 360 cases out of 522 patients (69%) in electric needling group excreted gall stones within 1 to 5 days, while only 15 cases out of 73 patients (20.5%) in the control group excreted gall stones within the same pariod. The results of both groups are greatly different from each other (P<0.001).
6. Since 1978, 61 consecutive cases who received electric needling treatment and excretion stones had been examined cholangiographically. The result was satisfactory, 23 cases (37.7%) are free from gall stones.
7. Relationship Between the Stone-excretion and the Course of Disease
Stone-excretion rate is high in case of the short course of disease than in case of the longer course of disease. The stone-excretion rate is higher in young patients than in elders. Statistics shows a marked difference (P<0.01).
8. Anti-shock managements such as antibiotic administration and fluid infusion should not be omitted in the course of electric needling in case of acute attack and shock patients.
If there is no improvement after 6 to 8 hours' first-aid treatment, it may be the case of stricture of bile duct complicating severe infection and shock, surgical intervention then should be considered.
9. There were 25 cases who failed to excrete stones after the electric needling treatment. It shows that satisfactory results may not be obtained in cases of edema and thickening of the bile duct, pyocele of the bile duct, peripheral fibrosis, stricture, scars, or diverticula of lower segment of the common bile duct, as well as big stones.
As for the needling treatment of cholicystolithiasis, we have experienced only a few cases, so further investigation is necessary.
Group for Treating Cholelithiasis with Needling, Department of Surgery, Wendeng Central Hospital, Shandong
This paper presents and analyses the therapeutic effect of 522 patients with cholelithiasis treated in the interval from 1975 to november, 1978.
1. Criteria of Diagnosis
History: All the cases had a history of recurrent upper right abdominal pain, fever and jaundice, or a history of cholelithotomy.
Signs: Body temperature around 38.5ºC, scleral jaundice, pain on percussion in the liver field and the distension of the gall bladder. (Marked tenderness also remains on the upper right abdomen even if the gall bladder had been removed.)
Laboratory findings: Blood studies show an increased white count, increased icterus index, with direct reaction to Van Den Bergh Test and increased serum transaminase. Nothing abnormal in other liver function test.
Most of patients had not received cholangiography prior to stone excretion because of acute episode on admission.
2. Method of Treatment
The right Qimen and Rique should be regarded as the main acupuncture points. In case of severe pain and gall bladder distension, point Danshu should be needled in addition, and a 6 cun needle should also be prepared to insert obliquely the midpoint of the line linking Juque and right Fuai points. The needle of 6 cun in length travels in the direction of the central part of the distended gall bladder and reaches underneath the external oblique muscle.
G 6805 Appartus were connected to the needles sticking in Qimen and Riyue points. Electric current of sparse and dense waves were given. The intensity of current should be within patients' tolerance. Draw the needles after 60 minutes' making of the circuit, then 40 ml of 50% magnesium sulfate was ordered orally once a day for ten days which was regarded as a course of treatment.
3. Results of Treatment
The 522 patients treated by electric needling are divided into three types (the stable type, the acute onset type and the shock type). Stone excretion rate is 35% in stable type, 89.7% in acute onset type, and 50% in shock type. The total stone excretion rate is 78.4%.
4. 73 cases of acute onset type with the same diagnostic criteria as before were selected as control group. 40ml of 50% magnesium sulfate were taken orally immediately after admission. Then took the same dose every day around 9 o'clock in the morning. The stone excretion rate was 27.4% in this group. In comparison with the acute onset type of the electric needling group and control group, there is a significant difference (P<0.01). The stone excretion rate in the former is markedly higher than that in the latter.
5. 360 cases out of 522 patients (69%) in electric needling group excreted gall stones within 1 to 5 days, while only 15 cases out of 73 patients (20.5%) in the control group excreted gall stones within the same pariod. The results of both groups are greatly different from each other (P<0.001).
6. Since 1978, 61 consecutive cases who received electric needling treatment and excretion stones had been examined cholangiographically. The result was satisfactory, 23 cases (37.7%) are free from gall stones.
7. Relationship Between the Stone-excretion and the Course of Disease
Stone-excretion rate is high in case of the short course of disease than in case of the longer course of disease. The stone-excretion rate is higher in young patients than in elders. Statistics shows a marked difference (P<0.01).
8. Anti-shock managements such as antibiotic administration and fluid infusion should not be omitted in the course of electric needling in case of acute attack and shock patients.
If there is no improvement after 6 to 8 hours' first-aid treatment, it may be the case of stricture of bile duct complicating severe infection and shock, surgical intervention then should be considered.
9. There were 25 cases who failed to excrete stones after the electric needling treatment. It shows that satisfactory results may not be obtained in cases of edema and thickening of the bile duct, pyocele of the bile duct, peripheral fibrosis, stricture, scars, or diverticula of lower segment of the common bile duct, as well as big stones.
As for the needling treatment of cholicystolithiasis, we have experienced only a few cases, so further investigation is necessary.
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