加减化石利胆汤预防胆总管结石ERCP术后复发的临床研究  

Study of the Prevention of Recurrence of Common Duct Stones after ERCP/EST by Jiajian Huashi Lidan Decoction

作　　者：田金沙[1] 林一帆[1] 巩阳[1] 刘杨[1] 陆宇平[1] 高文艳[1] 季芳[1] 雷春红[1] 李昊燃[1] 盛天骄[1] 王长洪[1] 

机构地区：[1]沈阳军区总医院中医科,国家中西医结合消化病重点学科,辽宁沈阳110016

出　　处：《中华中医药学刊》2013年第1期204-205,共2页Chinese Archives of Traditional Chinese Medicine

摘　　要：目的:观察加减化石利胆汤辨证施治预防胆总管结石患者ERCP术后复发的疗效。方法:将2003年1月—2009年1月,经腹部B超、CT、MRCP检查,ERCP乳头切开取石,最终确诊为胆总管结石的患者600例,随机分为两组,实验组300例,取石术成功后,给予中药"加减化石利胆汤"100 mL,2次/d,口服,每月服用不少于6～7剂,每年服药不少于70剂,对照组300例,未服中药及其他相关药物,同时进行随访,随访时间6～60个月,平均48个月;患者每半年或出现腹痛症状时复查腹部B超、CT、MRCP检查。结果:实验组有19例复发,对照组有33例复发,两组术后结石累计复发概率分别是6.3%和11%,两组比较,差异有统计学意义(x^2=4.361,P=0.037)。结论:加减化石利胆汤辨证施治可有效预防ERCP取石术后患者的胆石症复发。Objective：To observe the recurrence prevention of common duct stones in patients with post-ERCP/EST by Jiajian Huashi Lidan decoction（JHD）.Method：1133 patients in the department of TCM and the Endoscope Department at the General Hospital of Shenyang Military Area From Jan 2003 to Jan 2011,were diagnosed as choledocholith by ultrasound,CT,MRCP,EST,calculus were removed with mechanical lithotripsy and reticular basket.After the treatment, they were randomly divided into two groups,experimental group（n =300）was given JHD 100 mL twice a day;the control group（n = 300 ） was given nothing.All of them were followed-up for 6 to 60 months（average of 48 months）,and abdominal B ultrasound,CT,MRCP were reviewed every six months.Results：19 cases of recurrence were found in the experimental group,however,33 cases in control group,the probability of postoperative stone cumulative recurrence rates were 6.3%and 11%respectively,there was statistically significant difference between two groups（χ~2 =4.361,P =0.037）. Conclusion：JHD can be effective on preventing recurrence after ERCP/EST stone extraction in patients with common duct stones.

关 键 词：胆总管结石 预防 化石利胆汤 

分 类 号：R364.25[医药卫生—病理学]