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The description by evidence-based medicine (EBM) principles and methods was used to analyze the literature of using Chinese traditional medicine (TCM) for treatment of Choleycystits ( ZY, D., GL, W., X, L., J, L., DZ, Z., & CQ, L. , (n.d.).).
Eight medical research databases were searched including Chinese Clinical Registry Center, MEDLINE, Cochrane Central (CCTR), Database of Chinese Science and Technology Periodicals, EMbase, Chinese National Knowledge Infrastructure Database, Database of Chinese Ministry of Science and Technology) and Database of Chinese Ministry of Science and Technology), were searched ( ZY, D., GL, W., X, L., J, L., DZ, Z., & CQ, L. , (n.d.).).
Articles based on TCM treatment of Choleycystits were sorted out, grouped according to the design of study, authors hospital type, the strength of the provided evidence, and analyzed statistically ( ZY, D., GL, W., X, L., J, L., DZ, Z., & CQ, L. , (n.d.).). Surprisingly, out of the total 1477 articles of the subject matter, none of them was found having level 1 category of evidence. Only 9% of the articles were found to be within the level II evidence bracket ( Bloom, A. A. , (n.d.).)
In, addition, majority of these articles were written by authors from level-3 hospitals which is the highest level in china based on the academic level ( ZY, D., GL, W., X, L., J, L., DZ, Z., & CQ, L. , (n.d.).). Cognitive medicine may be used as the best alternative or framework for the evaluation as compared to use of traditional medicines ( ZY, D., GL, W., X, L., J, L., DZ, Z., & CQ, L. , (n.d.).). Emphysematous Choleycystits is a complex acute case of cholecystitis whose characteristics are the presence of pericholecystic tissue and the presence of gas in the gallbladder wall ( Martinez, S. R., Monica, S., Hourani, H. S., Sorrento, J. J., & Mohan, E. P. , (n.d.).).The most types of bacteria in relation to the subject matter includes Clostridia welchii being the most common, followed by E.coli, which is the second in according to the number of frequency amongst most cases ( Martinez, S. R., Monica, S., Hourani, H. S., Sorrento, J. J., & Mohan, E. P. , (n.d.).). Immediate diagnosis and medicinal attention (treatment) is significantly essential as far as this disease is concerned ( Bloom, A. A. , (n.d.).)
The accurate mortality rate for acute emphysematous cholecystitis is 15 to 20% which is relatively higher compared to the uncomplicated acute cholecystitis whose accurate mortality rate is 15% to 20% as a result of perforation in these patients and severe huge mass of gallbladder wall gangrene ( Martinez, S. R., Monica, S., Hourani, H. S., Sorrento, J. J., & Mohan, E. P. , (n.d.).).
The use of wide spectrum antibiotic is encouraged until the particular patient is diagnosed without leukocytosis ( Martinez, S. R., Monica, S., Hourani, H. S., Sorrento, J. J., & Mohan, E. P. , (n.d.).).This is as a result of both gram negative aerobes and gram positive anaerobes organisms being commonly present in patients with emphysematous cholecystitis ( Emphysematous Cholecystitis: A Case Report and Literature Review ISPUB , (n.d.).).
According to available data, making decisive recommendation for treating acute cholecystitis for critically ill patients is not possible through use of cholecystectomy in elderly people or PC ( Winbladh, A., Gullstrand, P., Svanvik, J., & Sandström, P. , (n.d.).). In addition, using Cholecystectomy in critically ill patients or/and elderly people for treating cholecystitis is better and the preferred method of treatment than PC ( Winbladh, A., Gullstrand, P., Svanvik, J., & Sandström, P. , (n.d.).).
It is time to open an RCT to address the issue of the fact that elderly mortality rate is significantly low according to recent years reports after a Cholecystectomy session for patients with acute cholecystitis ( Winbladh, A., Gullstrand, P., Svanvik, J., & Sandström, P. , (n.d.).). These reports have a good data set that can be analyzed for proper decision making in addressing the mortality rates in relation to other modes of treatment for the other age groups.
References
Martinez, S. R., Monica, S., Hourani, H. S., Sorrento, J. J., & Mohan, E. P. (n.d.). Emphysematous Cholecystitis: A Case Report and Literature Review ISPUB. Internet Scientific Publications, LLC.. Web.
Bloom, A. A. (n.d.). Medscape: Medscape Access. Medscape: Medscape Access. Web.
Metastatic breast carcinoma initially p& [Eur J Gynaecol Oncol. 2008] PubMed NCBI. (n.d.). National Center for Biotechnology Information. Web.
Winbladh, A., Gullstrand, P., Svanvik, J., & Sandström, P. (n.d.). National Center for Biotechnology Information. Systematic review of cholecystostomy as a treatment option in acute cholecystitis. Web.
ZY, D., GL, W., X, L., J, L., DZ, Z., & CQ, L. (n.d.). Treatment of cholecystitis with Chines& [World J Gastroenterol. 2012] PubMed NCBI. National Center for Biotechnology Information. Web.
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