腹腔镜胆囊切除术联合茵陈蒿汤对急性结石性胆囊炎患者炎性反应递质及血清淀粉酶水平的影响  

Effects of Laparoscopic Cholecystectomy Combined with Yinchenhao Decoction on the Levels of Serum Inflammatory Factor and Amylase in Patients with Acute Calculous Cholecystitis

作　　者：谢刚[1] 岳雁鸿[1] 韩波 陈云 Xie Gang;Yue Yanhong;Han bo;Chen Yun(Department of General Surgery,Meishan Traditional Chinese Medicine Hospital,Meishan 620010,China)

机构地区：[1]四川省眉山市中医医院普外科

出　　处：《世界中医药》2019年第6期1556-1559,共4页World Chinese Medicine

基　　金：眉山市科技委员会项目(2017-4-206)

摘　　要：目的:探讨腹腔镜胆囊切除术联合茵陈蒿汤对急性结石性胆囊炎患者炎性反应递质及血清淀粉酶水平的影响。方法:选取2015年6月至2017年1月眉山市中医医院收治的急性结石性胆囊炎患者112例作为研究对象,随机分为对照组和观察组,每组56例。2组患者均行腹腔镜胆囊切除术治疗,对照组术后进行常规西药治疗,观察组在对照组的基础上联合茵陈蒿汤治疗,连续治疗15d。统计2组临床疗效;统计2组患者相关临床指标及中医证候积分变化;检测并比较治疗前后2组患者血清炎性反应递质和淀粉酶水平变化;比较2组患者术后相关并发症发生情况。结果:治疗后观察组总有效率91.07%,较对照组的76.79%显著升高,差异有统计学意义(P<0.05);治疗后观察组患者肛门排气时间、下床活动时间、发热缓解时间、疼痛缓解时间及住院时间均较对照组显著缩短,差异有统计学意义(P<0.05);与治疗前比较,治疗后2组中医证候积分显著降低,且观察组显著低于对照组,差异有统计学意义(P<0.05);与治疗前比较,治疗后2组血清C反应蛋白(CRP)、白细胞介素-8(IL-8)及肿瘤坏死因子-α(TNF-α)及淀粉酶水平均显著降低,且观察组显著低于对照组,差异有统计学意义(P<0.05);观察组及对照组并发症总发生率分别为8.9%及28.6%,观察组显著低于对照组,差异有统计学意义(P<0.05)。结论:腹腔镜胆囊切除术联合茵陈蒿汤治疗急性结石性胆囊炎可有效缓解患者临床症状,降低术后炎性反应及血清淀粉酶水平,具有较高的安全性,临床疗效显著优于术后常规治疗。Objective: To explore the effects of laparoscopic cholecystectomy combined with Yinchenhao Decoction on the levels of serum inflammatory factor and amylase in patients with acute calculous cholecystitis. Methods: A total of 112 cases of acute calculous cholecystitis patients in Meishan Traditional Chinese Medicine Hospital from June 2015 to January 2017 were selected and randomly divided into a control group and an observation group,with 65 cases in each group.The 2 groups were treated with laparoscopic cholecystectomy.The control group was treated with conventional western medicine treatment,and observation group was treated combined with Yinchenhao Decoction on the basis of control group,for 15 days continuously.The clinical efficacy and the changes of related clinical indexes and TCM syndrome integral were statisticsed;the changes of the levels of serum inflammatory factor and amylase of 2 groups were detected and compared.The occurrence of postoperation related complications of 2 groups was compared. Results: The total effective rate of the observation group was 91.07%,which was higher than that 76.79% of the control group ( P <0.05);the anus exhaust time,off-bed activity time,alleviated fever time,pain relief time and hospitalization time were shorter than those of the control group ( P <0.01).Compared with before treatment,the TCM syndrome integrals of the 2 groups decreased significantly,and the observation group was significantly lower than control group ( P <0.01).The serum CRP,IL-8,TNF-α and amylase levels of the 2 groups after treatment decreased significantly,and the observation group was significantly lower than the control group ( P <0.01);The total occurrence rates of complications in the control group and the observation group were 8.9% and 28.6% respectively,and observation group was significantly lower than the control group ( P <0.01). Conclusion: Laparoscopic cholecystectomy combined with Yinchenhao Decoction can alleviate the clinical symptoms,reduce the postoperative inflammatory response a

关 键 词：急性结石性胆囊炎 腹腔镜 胆囊切除术 茵陈蒿汤 炎性反应递质 淀粉酶 

分 类 号：R289.5[医药卫生—方剂学] R605[医药卫生—中药学]