Cholecystitis heat

　　This condition is often caused by internal injury of the seven emotions and external attack of the six pathogenic factors, leading to stagnation of heat in the gallbladder or heat transformation from qi stagnation, and adverse function of the Shaoyang pivot, which belongs to a实证. The disease location is in the gallbladder, often involving the liver, spleen, stomach, and other viscera. Due to internal disturbance of fire and heat, gallbladder qi is not at ease, with common symptoms such as irritability, easy anger,胁胀 mouth bitterness, or ear fullness, earache, tinnitus, or unilateral headache, insomnia, and dreams, red tongue with yellow fur, and wiry and rapid pulse.

　　1. Acute emphysematous cholecystitis:This is a special type of cholecystitis, mainly caused by anaerobic bacteria, such as Clostridium perfringens, leading to infection, often accompanied by mixed infection caused by Streptococcus, Escherichia coli, and other bacteria. The clinical manifestations of patients are similar to acute severe cholangitis, and sometimes patients may experience jaundice and dark stools. On an abdominal X-ray film, gallbladder wall thickening and air accumulation can be seen 24-48 hours after onset.

　　2. Perforation of the gallbladder:Perforation of acute cholecystitis can have various clinical manifestations: (1) bile entering the peritoneal cavity causes cholestatic peritonitis; (2) secondary liver abscess formation; (3) adhesion with surrounding tissues, eventually forming a cholecystitis abscess; (4) formation of internal fistulas with adjacent tissues and organs.

　　3, Gallbladder fistula:Gallbladder fistula is mainly manifested as cholecystitis and gallstone disease. Due to the different locations of the fistula, there are different clinical manifestations. The following clinical manifestations should be considered as possible gallbladder fistula: (1) Sudden attack of biliary colic, accompanied by fever, chills, and jaundice, symptoms relieved spontaneously or after treatment with anti-inflammatory drugs; (2) Chronic diarrhea, especially after eating greasy food; (3) Hiccups, vomiting bile; (4) Biliary bleeding; (5) Intestinal obstruction.

　　Symptoms include right or bilateral rib pain, jaundice, short yellow urine, bitter and dry throat, alternating chills and fever, or nausea and vomiting, loss of appetite and abdominal distension, or headache and dizziness, irritability, deafness, and turbid nasal discharge, red tongue with yellow fur, wiry and rapid pulse.

　　1, Food should be light and delicious.

　　2, Food should be limited to low-fat, low-protein, small, easily digestible liquid or semi-liquid food, and as the symptoms subside, a small amount of fat and protein can be gradually added, such as lean meat, fish, eggs, milk, and fruits and fresh vegetables.

　　3, Eat more radish, green vegetables, beans, soy milk, etc. as side dishes.

　　4, Drink more water.

　　5, Avoid fried and fried foods, avoid eggs, meat soup, and alcohol.

　　6, Eat less greasy and fried foods.

　　7, Do not eat animal brain, kidney, egg yolk, etc.

　　8, Avoid spicy foods.

　　At the time of diagnosis, in addition to relying on clinical manifestations, auxiliary examinations are also needed. This disease includes gallbladder and bile duct ultrasound examination, intravenous cholecystography, fecal bilirubin, routine urine, blood routine, stool routine, duodenal drainage, and general physical examination.

　　Firstly, Diet

　　1, Dietetic therapy for heat in the gallbladder (the following information is for reference only, detailed consultation with a doctor is required)

　　(1) Orange peel 3 grams, a small handful of glutinous rice, decocted in water, served with ginger juice, for vomiting.

　　(2) Water spinach 250 grams, wash and chop, water chestnut 10 peeled and washed, placed in a pot, add an appropriate amount of water, boil for half an hour, add an appropriate amount of rock sugar before serving, eat the vegetables and water chestnuts, drink the soup. Suitable for bitter taste in the mouth, chest fullness, etc.

　　(3) White radish 1, ginger 10 grams, pounded and squeezed, add brown sugar and boiling water to serve, suitable for severe vomiting.

　　(4) Potato 100 grams, ginger 10 grams, wash and chop separately, orange 1 peeled and pitted, squeeze the juice with clean gauze, take 1 tablespoon before eating, suitable for bitter taste in the mouth, chest fullness, nausea, loss of appetite.

　　(5) Corn silk 33 grams, dandelion and artemisia 15 grams each, decocted in water, suitable for jaundice.

　　Secondly, what are the good foods to eat for heat in the gallbladder?

　　You can choose foods that clear heat and relieve fire, and benefit the gallbladder.

　　1, Aquatic products:Crab, clam, seaweed, jellyfish, algae, etc.

　　2, Fruits:Pear, loquat, sugarcane, persimmon, watermelon, peach, banana, mulberry, etc.

　　3, Vegetables:Eggplant, radish, winter melon, luffa, green vegetables, spinach, celery, potato, bitter melon, lotus root, amaranth, tomato, bamboo shoots, cucumber, water chestnut, mushrooms, lily, etc.

　　4. Cereal category:Barley, wheat, mung beans, soy products, soy sauce, etc.

　　5. Other:Tea, lotus seed, chrysanthemum, maxima, honey, etc.

　　Treatment Principles:Clear heat and purge the gallbladder.

　　Firstly, traditional Chinese medicine treatment: oral medicine

　　1. Basic Prescription:Aofen Qingdan Decoction with modification: Qinghao 12 grams, Zhuru 15 grams, Banxia 10 grams, Chishifuling 12 grams, Huangqin 10 grams, Zhishen 10 grams, Chenpi 10 grams, Biyu San 20 grams (enclosed), Dahuang 10 grams. This formula is suitable for syndromes with severe less Yang heat and phlegm-dampness. Take the above medicine, decoct, take 300 milliliters of juice, take 2-3 times a day, once a day.

　　2. Modification and Change:For those with acid regurgitation, add 3-5 grams of Left Golden Pill three times a day; for those with limb pain, add 12 grams of Sangzhi, 15 grams of Yiyiren, and 10 grams of Luffa; for those with damp-heat jaundice, with heat heavier than dampness, remove Chenpi and Banxia, and add 25 grams of Yinchen; for those with chest and hypochondriac distension, add 10 grams of Chuanlianzi and 10 grams of Foshou.

　　Secondly, other treatments in traditional Chinese medicine

　　1. External Medication:(1) Zhuru, ginger in appropriate amounts, squeeze juice, cotton dipped and wiped on the chest, used for acid regurgitation. (2) Qingpi 15 grams, ground into powder, stir-fried with vinegar and applied to the sides, used for chest and hypochondriac distension. (3) Nansheng pounded, placed in a cup, placed on the navel, blisters picked to release fluid, used for jaundice.

　　2. Enema Therapy:(1) Raw Dahuang 25 grams, decoct to get 150 milliliters of juice, retain enema for 30 minutes. (2) Raw Dahuang 20 grams, Qinghao 15 grams, Huangqin 15 grams, Chenpi 10 grams, decoct to get 150 milliliters of juice, retain enema for 30 minutes.

　　Key Points of Treatment:

　　1. This syndrome is a syndrome of excessive heat in the less Yang gallbladder meridian, with heat depression in the less Yang half of the exterior and interior, leading to unfavorable opportunities, and it is necessary to use clearing gallbladder herbs to expel the heat and benefit the pivot.

　　2. Gallbladder diseases affect the spleen and stomach, transform into damp-heat phlegm and turbidity, and the decline of the less Yang fire is prone to symptoms such as nausea and acid regurgitation; damp-heat lingering easily causes jaundice, and it is necessary to complement or strengthen the use of acrid and bitter herbs that open the chest, reduce the interior, and promote diuresis to reduce jaundice. Because gallbladder heat often reverses to the stomach, forming the syndrome of disharmony between the gallbladder and the stomach, attention should be paid to treating both the gallbladder and the stomach to improve the efficacy, and attention should be paid to maintaining the stomach Qi at all times, and should not be used excessively bitter and cold, so as not to injure the stomach.