穴位辨病辅助诊治急腹症在急诊科及基层卫生院的应用

Application of Acupoint Disease Differentiation in the Diagnosis and Treatment of Acute Abdomen in Emergency Department and Grass-Roots Health Center

目的探讨穴位辨病辅助诊治急腹症在急诊科及基层卫生院中的临床应用价值。方法选择2019年8月至2020年2月柳州市柳铁中心医院急诊科及所属卫生院收治的103例急腹症患者作为研究对象。按照随机数表法分为中西医诊治组(52例)和西医诊治组(51例)。西医诊治组接受常规西医诊治方案;中西医诊治组在常规问诊、查体后辅以穴位按压辨病,再完成辅助检查等后续诊治。观察两组病例初诊正确率、初诊误诊率、医疗资源占用、医疗费用,症状改善情况、就医体验性等。结果中西医结合诊治组的初诊正确率高于西医诊治组,误诊率、医疗资源占用、医疗费用、症状改善优于西医诊治组,差异有统计学意义(P<0.05)。中西医结合诊治组的就医体验优秀率高于西医诊治组,但差异无统计学意义(P>0.05);两组均存在急诊诊断不明病例,差异无统计学意义(P>0.05)。结论穴位辨病辅助诊治急腹症,可提高初诊正确率,降低初诊误诊率,窄化鉴别诊断范围,减少医疗费用,改善就医体验。

Objective To explore the clinical value of acupoint disease differentiation in the diagnosis and treatment of acute abdomen in emergency department and grass-roots health center.Methods A total of 103 patients with acute abdomen treated in the emergency department and affiliated health centers of Liuzhou Liutie Central Hospital from August 2019 to February 2020 were selected as the research objects.According to the random number table method,they were divided into traditional Chinese and Western medicine diagnosis and treatment group(52 cases)and Western medicine diagnosis and treatment group(51 cases).The correct rate of initial diagnosis,misdiagnosis rate of initial diagnosis,occupation of medical resources,medical expenses,symptom improvement and medical experience were observed.Results The correct rate of initial diagnosis in the integrated traditional Chinese and Western medicine group was higher than that in the Western medicine group,and the misdiagnosis rate,occupation of medical resources,medical expenses and improvement of symptoms were better than those in the Western medicine group(P<0.05).The excellent rate of medical experience in the integrated traditional Chinese and Western medicine group was higher than that in the Western medicine group,but the difference was not statistically significant(P>0.05).There were cases with unknown emergency diagnosis in both groups,but the difference was not statistically significant(P>0.05).Conclusion Acupoint disease differentiation assisted diagnosis and treatment of acute abdomen can improve the accuracy of initial diagnosis,reduce the misdiagnosis rate of initial diagnosis,narrow the scope of differential diagnosis,reduce medical expenses and improve medical experience.