疏肝利胆排石汤对胆结石合并慢性胆囊炎患者胃肠功能、应激反应及血清CEA、CA19-9表达影响  

Effect of Shugan Lidan Paishi Decoction on Gastrointestinal Function,Stress Response and Serum CEA,CA19-9 Expression in Patients with Gallstone Complicated with Chronic Cholecystitis

作　　者：王思玉[1] 邓晋妹[1] 彭美哲[1] 赵凯声[1] WANG Siyu;DENG Jinmei;PENG Meizhe;ZHAO Kaisheng(Beijing Hospital of Traditional Chinese Medicine,Capital Medical University,Beijing 100010,China)

机构地区：[1]首都医科大学附属北京中医医院,北京100010

出　　处：《辽宁中医药大学学报》2020年第6期95-98,共4页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：北京市医管局2020年度“培育计划”(PZ2020011)。

摘　　要：目的研究疏肝利胆排石汤治疗胆结石合并慢性胆囊炎的效果,以及对患者胃肠功能、应激反应、癌胚抗原(CEA)和糖类抗原19-9(CA19-9)的影响。方法选择我院2016年10月—2019年2月期间收治胆结石合并慢性胆囊炎患者160例,按照随机数字表法分为对照组和观察组,每组80例。对照组接受熊去氧胆酸片、金胆片治疗;观察组在对照组的基础上联用疏肝利胆排石汤。4周为1个疗程,两组患者均连续治疗3个疗程。分别在治疗前后记录两组患者中医证候评分、胆囊结石直径、胆囊壁厚度、总胆红素(TBIL)、总胆汁酸(TBA)、总胆固醇(TC)、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、CEA、CA19-9、胃泌素(GAS)、血管活性肠肽(VIP)和胃动素(MOT)、丙二醛(MDA)、超氧化物歧化酶(SOD)的水平,并比较疗效。结果治疗后,观察组患者血清TBIL、TBA、TC、ALT、AST水平低于对照组(P<0.05);观察组患者血清GAS、MOT水平高于对照组,血清VIP水平低于对照组(P<0.05);观察组患者血清MDA水平低于对照组,血清SOD水平高于对照组(P<0.05);观察组患者血清CEA、CA19-9水平低于对照组(P<0.05);观察组患者结石直径与胆囊壁厚度小于对照组(P<0.05);观察组患者中医证候评分低于对照组(P<0.05);观察组总有效率为93.75%高于对照组的82.50%(P<0.05)。结论采用疏肝利胆排石汤治疗胆结石合并慢性胆囊炎能够有效改善病情,抑制应激反应,下调血清CEA、CA19-9表达水平,提高胃肠功能,疗效显著。Objective To study the effect of Shugan Lidan Paishi Decoction on chronic cholecystitis with gallstones,and its effects on gastrointestinal function,stress response,carcinoembryonic antigen(CEA)and carbohydrate antigen 19-9(CA19-9). Methods 160 patients with cholelithiasis and chronic cholecystitis were treated in our hospital from October 2016 to February 2019. They were divided into control group and observation group according to random number table method,80 cases in each group. The control group was treated with ursodeoxycholic acid tablets and Jindan tablets. The observation group was treated with Shugan Lidan Paishi Decoction on the basis of the control group. Four weeks is a course of treatment,two groups of patients were treated for three consecutive courses. Before and after treatment,the scores of TCM symptoms,gallstone diameter,gallbladder wall thickness,TBIL,TBA,TC,ALT,AST,CEA,CA19-9,GAS,VIP,MOT,MDA and SOD were compared,and compared the curative effect. Results After treatment,the serum levels of TBIL,TBA,TC,ALT and AST in the observation group were lower(P<0.05). The levels of GAS and MOT in observation group were higher,and the levels of VIP in observation group were lower(P<0.05). The serum MDA level in the observation group was lower,and the serum SOD level in the observation group was higher(P<0.05). Serum CEA and CA19-9 levels in observation group were lower(P<0.05);Calculus diameter and gallbladder wall thickness in observation group were smaller(P<0.05);The scores of TCM symptoms in the observation group were lower(P<0.05);The total effective rate of the observation group was 93.75% higher than the control group 82.50%(P<0.05). Conclusion Using Shugan Lidan Paishi Decoction to treat gallstone complicated with chronic cholecystitis can effectively improve the condition of the disease,inhibit stress reaction,down-regulate the expression levels of serum CEA and CA19-9,and improve gastrointestinal function.

关 键 词：胆结石 慢性胆囊炎 胃肠激素 应激反应 炎症反应 疏肝利胆排石汤 

分 类 号：R575.61[医药卫生—消化系统] R575.62[医药卫生—内科学]