疏肝利胆冲剂在肝内外胆管结石术后应用研究  

Application of Shugan Lidan Granules in Postoperative Patients with Intrahepatic and Extrahepatic Bile Duct Stone

作　　者：于庆生[1] 汪晓明[1] 帅剑锋[1] 张琦[1] 刘书先[1] 

机构地区：[1]安徽中医学院第一附属医院普外科,安徽合肥230031

出　　处：《安徽中医学院学报》2010年第2期10-13,共4页Journal of Anhui Traditional Chinese Medical College

摘　　要：目的观察疏肝利胆冲剂治疗肝内外胆管结石的临床疗效及其作用机制。方法将31例肝内外胆管结石术后患者随机分为研究组和对照组,研究组16例,对照组15例,研究组在常规补液、抗感染治疗基础上,给予疏肝利胆冲剂口服,1包/次,每日3次,疗程7 d;对照组只给予常规补液、抗感染处理。分别观察两组治疗前后临床症状体征、血常规、肝功能、血清胆汁生化指标、T管引流液胆汁生化指标和胆汁引流量变化。结果两组治疗前和治疗后临床症状、体征和血常规改变的差异无显著性(P>0.05);两组治疗后丙氨酸转移酶、天冬氨酸转氨酶、血清前清蛋白水平比较,差异有显著性(P<0.05,或P<0.01)。两组治疗后总胆汁酸(total acid bile,TAB)、总胆红素(total bilirubin,TB)和结合胆红素比较,差异有显著性(P<0.05,或P<0.01)。两组治疗后T管引流液胆汁TAB、TB、非结合胆红素、总胆固醇和钙离子水平比较,差异有显著性(P<0.05,或P<0.01)。两组治疗后平均每日T管胆汁引流量比较,差异有非常显著性(P<0.01)。结论疏肝利胆冲剂通过促进术后肝功能早日恢复、调节致石性胆汁成分、增加胆汁分泌量,达到促进手术后残余结石的排出和防治术后结石再生的作用。Objeetive To observe the clinical effects of Shugan Lidan （SHLD） Granules, a traditional Chinese prescription for soothing liver-qi and promoting bile excretion, in treating intrahepatic and extrahepatic bile duct stone, and explore its mechanism of action. Methods Thirty-one postoperative patients with intrahepatic and extrahepatic bile duct stone were randomly divided into treatment group（n=16） and control group （n = 15）. Based on routine treatment such as water electrolyte balance maintaining and anti-infective therapy, patients in the treatment group were treated with SGLD granules for 7 days, 1 pocket per time, 3 times daily, from the 1st day after operation; while patients in control group were only treated with routine treatment. Before and after treatment, the clinical symptoms and signs, the blood routine, the liver function, the serum bile biochemical index, the T-tube bile biochemical index and the bile drainage volume in treatment and control groups were observed, respectively. Results There were no statistical difference in clinical symptoms and signs and the blood routine between two groups before and after treatment（P〉0.05）. There were statistical difference in serum levels of alamine aminotransferase, aspartate aminotransferase, total acid bile （TAB）, total bilirubin （TB） and conjugated bilirubin between two groups after treatment（P〈0.05, or P〈0.01）. There were statistical difference in levels of TAB, TB, unconjugated bilirubin and calcium ion in the T tube drainage fluid between two groups after treatment （P〈0.05, or P〈0.01）. The mean volume of bile drainage per day in treatment group was significantly higher than that in control group after treatment （P〈0.01）. Conclusion SGLD Granules might promote the discharge of residue stones and prevent the regeneration of postoperative stones by the pathway of promoting an early recovery of liver function, regulating stone-inducing components in the bile and increasing the volume of bile excretion.

关 键 词：肝内外胆管结石 疏肝利胆冲剂 肝功能 胆汁生化 作用机制 

分 类 号：R575.62[医药卫生—消化系统]