清利防石汤干预胆色素结石术后结石复发机制研究  

Mechanism research on “Qingli Fangshi Decoction”for intervention of recurrence of cholochrome cholelith

作　　者：陈佳骏[1] 罗运权[1] 张海阳[1] 曹学冬[1] 冯煜[1] 

机构地区：[1]上海中医药大学附属曙光医院肝胆外科,上海201203

出　　处：《上海中医药杂志》2013年第8期51-53,共3页Shanghai Journal of Traditional Chinese Medicine

基　　金：上海市卫生局青年科研项目(2009Y088)

摘　　要：目的研究清利防石汤干预胆色素结石术后结石复发的机制。方法将125例因肝内外胆管结石行胆总管切开取石+T管引流术患者随机分为清利防石汤组(A组)、胆维他组(B组)及对照组(C组),给予相应干预3个月。检测治疗前后患者胆汁中游离胆红素(UCB)、胆汁酸(TBA)、钙离子(Ca2+)及肝功能变化,测定胆道内压变化,1年后B超随访结石复发情况。结果①治疗后A、B两组肝功能ALT、AST、TBIL的降低幅度均显著大于C组(P<0.05),但两组之间无显著性差异(P>0.05)。②治疗后A、B两组UCB、Ca2+的降低幅度及TBA升高幅度均显著大于C组(P<0.05),但两组之间无显著性差异(P>0.05)。③治疗后,A组胆道内压力降低幅度大于B、C两组(P<0.05),B、C两组之间胆道压力降幅无显著差异(P>0.05)。④A组的复发率低于B、C两组(P<0.05)。结论清利防石汤可改善胆色素结石术后患者肝功能,改变胆汁成分,降低胆道压力以预防结石复发。Objective To observe the mechanism of ＂Qingli Fangshi Decoction＂ in intervening cholochrome cholelith （HCC）. Methods One hundred and twenty-five cases were randomized into ＂Qingli Fangshi Decoction＂ group （group A）, Anethole Trithione group （group B） and control group （group C）, with the course of 3 months. The UCB, TBA, Ca^2＋ , liver function and biliary internal pressure were detected before and after treatment and follow-up visit after one year by B-ultrasonic examination. Results （1） The ALT, AST and TBIL in group A and group B were decreased much more than that of the group C （ P 〈 0.05 ）, without significant difference between the two groups （ P 〉 0.05 ）. （2） After treatment, the decrease of UCB level and Ca^2＋ level and in＇crease of TBA level in group A and group B were much more than that of the group C （ P 〈 0.05 ）, and no significant difference was found between the two groups （ P 〉 0.05 ）. （3） After treatment, the intra-biliary tract pressure in group A was lower than that of the group B and group C （ P 〈 0.05 ）, no significant difference was found between group B and group C （P 〉 0.05 ）. （4） The recurrence rate of group A was lower than group B and group C （P 〈 0.05 ）. Conclusion ＂Qingli Fangshi Decoction＂ can improve the liver function in patients undergo cholochrome cholelith operation, change the bile component and decrease biliary tract pressure.

关 键 词：清利防石汤 胆色素结石 术后 复发 

分 类 号：R657.4[医药卫生—外科学]