茵连化浊解毒汤联合经内镜逆行性胰胆管造影术治疗胆总管结石的疗效及对胆汁生化指标、肝功能指标、结石复发率的影响  

Curative Effects of Yinlian Huazhuo Jiedu Decoction Combined with ERCP on Choledocholithiasis and Influence on Biliary Biochemical Indexes,Liver Function Indexes and Recurrence Rate of Choledocholithiasis

作　　者：杨铸锋 张玎鑫 段洋洋 龙润[1] Yang Zhufeng;Zhang Dingxin;Duan Yangyang;Long Run(Gastroenterology Department,Hebei Provincial Hospital of Traditional Chinese Medicine,Shijiazhuang 050011,China)

机构地区：[1]河北省中医院消化内科

出　　处：《世界中医药》2019年第7期1793-1796,共4页World Chinese Medicine

基　　金：河北省中医药管理局科研计划项目(2018015)

摘　　要：目的:探讨茵连化浊解毒汤联合经内镜逆行性胰胆管造影术(ERCP)治疗胆总管结石的疗效,评估患者胆汁生化指标、肝功能指标水平及结石复发率。方法:选取2016年9月至2018年7月河北省中医院收治的ERCP治疗的胆总管结石患者100例作为研究对象,按照随机数字表法分为对照组和观察组,每组50例,对照组患者接受ERCP+术后常规干预,观察组患者接受ERCP+术后茵连化浊解毒汤治疗,术后7 d评估疗效。结果:术后7 d,观察组的腹痛、发热、黄疸积分值低于对照组;外周血胆汁生化指标总胆汁酸(TBA)、总胆红素(TBil)、直接胆红素(DBil)、间接胆红素(IBil)水平低于对照组;外周血肝功能指标谷草转氨酶(AST)、谷丙转氨酶(ALT)、γ-谷氨酰转肽酶(γ-GT)的水平低于对照组,差异有统计学意义(P<0.05)。随访期内,2组结石复发率的差异无统计学意义(P>0.05)。结论:ERCP后茵连化浊解毒汤联合治疗胆总管结石,有助于进一步优化患者的近期病情,且具有良好的用药安全性。Objective:To investigate the curative effects of Yinlian Huazhuo Jiedu Decoction combined with ERCP in the treatment of choledocholithiasis,and to evaluate the levels of biliary biochemical indexes,liver function indexes and recurrence rate of stones.Methods:A total of 100 cases of choledocholithiasis patients underwent ERCP treatment in Hebei Provincial Hospital of Traditional Chinese Medicine during September 2016 to July 2018 were chosen as research subjects,and they were divided into a control group(n=50,underwent ERCP+routine intervention after operation),an observation group(n=50,underwent ERCP+Yinlian Huazhuo Jiedu Decoction after operation).The curative effects were evaluated 7 days after operation.Results:On 7th day after operation,the scores of abdominal pain,fever and jaundice in the observation group were decreased than those in the control group;levels of total bile acid(TBA),total bilirubin(TBil),direct bilirubin(DBil)and indirect bilirubin(IBil)in peripheral blood were lower than those in the control group;levels of AST,ALT andγ-GT in peripheral blood were lower than those in the control group(P<0.05).During follow-up period,there was no significant difference in stone recurrence rate between the 2 groups(P>0.05).Conclusion:The combination of Yinlian Huazhuo Jiedu Decoction after ERCP in the treatment of choledocholithiasis is helpful to further optimize the patients′short-term condition and has good medication safety.

关 键 词：胆总管结石 经内镜逆行性胰胆管造影术 茵连化浊解毒汤 胆汁 肝功能 

分 类 号：R289.5[医药卫生—方剂学] R575[医药卫生—中药学]