II. Differential Diagnosis

II. Differential Diagnosis

Acute cholecystitis needs to be differentiated from biliary ascariasis, perforated gastric or duodenal ulcers, and acute pancreatitis; chronic cholecystitis needs to be differentiated from chronic gastritis, peptic ulcer disease, gastric ptosis, gastric neurosis, and chronic pancreatitis (see relevant chapters).

Section 3: Integrated Chinese and Western Medicine Treatment

Integrated Chinese and Western medicine treatment for cholecystitis and cholelithiasis is one of the earliest fields to be developed since the founding of the People's Republic of China, with Tianjin Nankai Hospital as a representative, collaborating with medical institutions across the country to conduct joint research and achieve a series of major breakthroughs. Effective prescriptions with confirmed clinical efficacy, such as Compound Da Chai Hu Tang and Bile Duct Stone-Expelling Soup, have been developed, opening up broad avenues for non-surgical treatment of this disease. In the study of cholelithiasis, methods such as comprehensive stone-expelling, infusion, and oral litholysis have been adopted, establishing therapies that soothe the liver and promote bile flow, while also clearing the bowels and attacking the root cause. Over the past decade, research achievements have manifested in new changes in strategies, methods, and principles for preventing and treating biliary diseases with traditional Chinese medicine. First, it is now recognized that this disease is a long-term process from static to dynamic, combining both aspects—that is, the disease has a recurrent nature and a long course, so treatment should be based on the principle of long-term stability. Therefore, the previous strategy of aggressive attack, rapid descent, and all-out assault has gradually shifted to gradual transformation, slow dissolution, and simultaneous stone expulsion and litholysis. Second, treatment methods are becoming more diversified, with integrated therapy as the main approach. For example, ear acupressure, magnetic therapy, instruments, and external treatments are all emerging therapies in recent years, and there are even more emerging therapies formed by the organic combination of various methods. Third, there is a new understanding of the disease's pathogenesis, leading to new breakthroughs in treatment principles. For instance, it is now recognized that in addition to liver-gallbladder damp-heat, phlegm accumulation turning into stone, and yang deficiency-cold condensation turning into stone, prolonged stagnation can also lead to stone formation—these pathological factors should not be overlooked. In terms of treatment methods, the previous focus on "clearing, dispersing, and attacking" has evolved to incorporate the use of cold and heat simultaneously, balancing tonification and elimination, and combining ascending and descending approaches, resulting in the creation of many effective "new prescriptions."