Appendiceal parasitic disease

　　Appendiceal parasites are mainly caused by three kinds of parasites: schistosomes, ascaris, and amebae.

　　1. Schistosomal appendicitis

　　In the chronic inflammatory process, leukocyte infiltration can occur, small ulcerations of the mucosa can form, and over a long period of stimulation, fibrosis, granuloma formation, or mucosal scar stenosis gradually appear. When the perivascular lesions are severe, they can also cause poor blood supply to the appendix. These pathological changes can all become the pathological basis of acute appendicitis.

　　2. Appendiceal ascarid disease

　　Ascaris usually resides in the human ileum. If diarrhea, deworming, pregnancy, etc., cause abnormal peristalsis of the intestines and changes in the intestinal environment, and ascaris also has the habit of drilling, it can窜入cecum and enter the appendix, causing appendiceal ascarid disease. After the ascaris enters the appendix cavity, it can cause obstruction of the appendix cavity, the peristalsis of the ascaris can stimulate the muscle spasm of the appendix wall, and it can cause acute appendicitis.

　　3. Chronic amebic appendicitis

　　Since amebic colitis often occurs in the cecum, there is a higher chance of involving the appendix. In the autopsy of colon amebiasis, it was found that 4.0% to 6.2% had amebic appendicitis, and some formed abscesses or perforations. A simple amebic appendicitis is rare.

　　The secondary infection of appendiceal parasitic disease produces acute appendicitis, which is the inflammatory phase. Subsequently, the pressure inside the appendix cavity increases, the appendix wall becomes ischemic, necrotic, and perforated, and the worms can enter the peritoneal cavity, causing severe purulent peritonitis.

　　According to the main pathogenic parasites causing appendiceal parasitic disease, the clinical manifestations are introduced as follows.

　　1. Schistosomal appendicitis

　　The symptoms of schistosomal appendicitis are similar to those of general acute appendicitis, but the course is rapid, the rate of perforation is high, and there is also a high chance of postoperative residual abscess and intestinal fistula. These characteristics should be paid attention to clinically.

　　2. Appendiceal ascarid disease

　　Abdominal pain is often umbilical paroxysmal colic, much more severe than that of general appendicitis. The onset of migrating right lower quadrant pain is fast, and it is fixed quickly as well. The initial paroxysmal colic has periods of symptom relief, which is called the spasmic obstruction period. If the obstruction is not relieved, the appendix may be damaged; secondary infection may produce acute appendicitis, which is the inflammatory phase. Subsequently, the pressure inside the appendix cavity increases, the appendix wall becomes ischemic, necrotic, and perforated, and the worms can enter the peritoneal cavity, causing severe purulent peritonitis.

　　3. Chronic amebic appendicitis

　　Recurrent right lower quadrant pain, or persistent discomfort in the iliac fossa, may have an acute attack when accompanied by suppurative infection. The symptoms of this disease are similar to those of bacterial appendicitis, and are often discovered only during surgery. The lesion is not limited to the appendix, and the cecum wall also shows thickening and edema.

　　The key to preventing appendiceal parasitic disease is to eliminate the cause of the disease, and the prevention and treatment of parasites are crucial.

　　1. Pay attention to dietary hygiene and do not eat unclean cold foods. Vegetables and fruits that are eaten raw must be washed thoroughly before consumption.

　　2. Develop good hygiene habits and do not defecate anywhere. The transmission route of ascariasis is that the eggs excreted by the worms are excreted with feces, which then contaminates the surrounding environment and can also contaminate vegetables, fruits, and other foods. Once ingested, infection can occur. Make sure to wash hands before and after meals, and often trim your nails. Children should not suck their fingers.

　　3. In the prevention and treatment of ascariasis, it is necessary to carry out health education, cultivate good health habits. The focus of the general survey is on children's collective units (kindergartens, primary schools), conducting general surveys and treatments to ensure children's health. Strengthening fecal management, improving environmental hygiene, and doing a good job in fly control and prevention to prevent the spread of worm eggs.

　　In clinical practice, in addition to the typical symptoms of appendicitis helping with diagnosis, combined with the patient's medical history, ascaris disease in the appendix can be detected through X-ray barium enema, and the diagnosis can be confirmed by colonoscopy, and the worm can be removed.

　　Dietary attention and home prevention after intestinal parasitic infection:
　　1. It is recommended to take oral deworming medicine, preferably on an empty stomach in the morning. After two to three days, parasites can be excreted from the body through feces.
　　2. It is recommended to drink deworming tea water. After one hour of eating, deworming tea can be soaked in boiling water; during the period of drinking deworming tea, the diet should be light, which is helpful for detoxification and killing worms.
　　3. Grind pumpkin seeds into a paste, then add rock sugar or honey and mix with warm water for consumption on an empty stomach. Take twice a day, which can have the effect of expelling worms.
　　4. In daily life, eat more fruits rich in vitamin B and C, such as tomatoes, kiwi, and bananas, which can enhance immunity and prevent intestinal parasitic diseases.

　　In traditional Chinese medicine, acupuncture and moxibustion are commonly used to treat intestinal parasitic diseases.

　　1. Body acupuncture
　　1. Acupoint Selection
　　Main acupoints: Appendicitis point, Zusanli, Ashi point.
　　Auxiliary acupoints: For nausea and vomiting, add Shangwan and Neiguan; for fever, add Quchi and Zhizhu; for abdominal distension, add Dachangshu and Ciliao.
　　Location of the Appendicitis point: About 2 cun below the Stomach 36 (Zusanli) point.
　　Location of the Ashi point: It is the most prominent tender point in the lower right abdomen (Mai's point) (as below).
　　2. Treatment Method
　　Generally, only the main acupoints are used, with 2 to 3 acupoints selected each time. If certain symptoms are prominent, 1 to 2 additional auxiliary acupoints may be added. In terms of operation, for the Zhizhu acupoint, blood-letting with a three-edged needle is used, while the rest of the acupoints are treated with a combination of vigorous twisting and lifting-thrusting technique for 1 to 2 minutes, with strong stimulation. Keep the needle in place for 30 minutes to 1 hour, and twirl the needle once every 5 to 10 minutes. It is also possible to connect a G6805 electroacupuncture instrument, using a sparse-dense wave, with the intensity of the current to be tolerated by the patient. Perform the treatment 1 to 2 times daily.

　　2. Body acupuncture
　　1. Selection of acupoints:
　　Main acupoints: Four knee points, Dachang.
　　Location of the four knee acupoints: 4 cun above the outer margin of the patella.
　　2. Treatment Method
　　All main acupoints are to be used. Instruct the patient to lie on their back with knees bent, and use a 28-gauge 2-inch needle to directly puncture the four knee acupoints. Insert the needle quickly, with the depth determined by the sensation of qi. Use the technique of thumb pushing backward and index finger pushing forward to twist the needle, so that the needle sensation is conducted upwards along the thigh, and it is best to reach the lower abdomen over the inguinal crease. For the Dachang acupoint, puncture downward at a 45-degree angle along the abdomen. Use the technique of thumb pushing forward and index finger pushing backward to twist the needle, to promote the downward conduction of the needle sensation to the inguinal crease, so that the needle sensation on both sides connects. Keep the needle in place for 30 minutes, twisting it once every 10 minutes. Perform the treatment 1 to 2 times daily.

　　Three. Acupoint Injection
　　1. Acupoint Selection
　　Main Acupoints: Anxiacupoint
　　2. Treatment Method
　　Appendicitis Parasitosis Appendicitis Parasitosis Album
　　Medicinal Solution: Normal saline.
　　Anxiacupoint is selected on both sides. For those with strong physique and delayed needle sensation, the needle tip is obliquely inserted upward at a 45-degree angle to the skin, the injection speed is slightly faster, 10 ml per acupoint, finished within 5 minutes; for those with weak physique or strong needle sensation, the needle tip is inserted vertically or downward obliquely, 5 ml per acupoint, slowly pushed in. Once a day, 3-4 times as a course.

　　Four. Auricular Acupuncture
　　1. Acupoint Selection
　　Main Acupoints: New Appendicitis Point.
　　Auxiliary Acupoints: Add Subcortex and Auricle for fever, add Mening root for vomiting.
　　Location of New Appendicitis Point: Located at the edge of the ear cavity of the opposite auricle, between the buttocks and the lumbar spine.
　　2. Treatment Method
　　Main Acupoints, inject about 0.2 ml of normal saline on each side, twice a day, and once a day after the symptoms are relieved. Adjust 1-2 auxiliary acupoints according to the condition. Use needle insertion method, find the sensitive point and quickly insert and twist the needle, the stimulation should be strong, and twist continuously for 2-3 minutes, leave the needle for 30 minutes to 1 hour, and intermittent stimulation can be performed during this period. Once a day to four times a day. Use blood-letting method for auricular points, once a day.

　　Five. Electrical Acupuncture
　　1. Acupoint Selection
　　Main Acupoints: Anxiacupoint, Ashi Point, You Tianshu, Guanyuan, Zhongwan, Qihai, Geshu, Xuehai, Dacangshu.
　　Auxiliary Acupoints: Quchi, Hegu, Neiguan, Neiting, Zhigou, Yanglingquan, Dacangshu.
　　2. Treatment Method
　　The main acupoint, Anxiacupoint, must be selected each time, and 4-5 other main acupoints are selected alternately. The auxiliary acupoints are selected according to the symptoms. The local acupoints are conventionally disinfected. A 1.5-inch needle is used for acupuncture, inserting the needle 5 to 1 cun deep, with the manipulation mainly being twisting and lifting. After getting theQi, connect the G6805 pulse electrical acupuncture treatment instrument, select the waveform as continuous wave, output frequency of 80-120 times/min, and the intensity should be bearable for the patient. At the same time, use a vertical TDP lamp to照射 the abdominal pressure point, leave the needle for 40 minutes, and the pain can be reduced after one treatment in general. Once a day or twice a day, 7 times as a course.