利胆排石汤联合胆道镜取石术治疗慢性胆囊炎合并胆结石对胆汁成石成分的影响  

Effect of Lidan Paishi Decoction Combined with Choledochoscopy Lithotomy on Cholelithiasis Composition in Chronic Cholecystitis Complicated with Cholelithiasis

作　　者：王晓东[1] 朱兴[1] 李东屿 WANG Xiaodong;ZHU Xing;LI Dongyu(Department of Hepatobiliary Surgery,Shenyang Fourth People’s Hospital,Liaoning Province,Shenyang 110000,China)

机构地区：[1]沈阳市第四人民医院肝胆外科,辽宁沈阳110000

出　　处：《中国中医药现代远程教育》2022年第5期144-146,共3页Chinese Medicine Modern Distance Education of China

摘　　要：目的探讨利胆排石汤联合胆道镜取石术治疗慢性胆囊炎合并胆结石对胆汁成石成分的影响。方法采取随机数字表法将2017年3月—2019年8月于沈阳市第四人民医院治疗的144例慢性胆囊炎合并胆结石患者分为对照组、试验组,各72例。2组均给予胆道镜取石术治疗,对照组于术后给予熊去氧胆酸治疗,试验组在此基础上给予利胆排石汤治疗;4周为1个疗程,2组均治疗2个疗程。比较2组患者治疗前后中医证候积分及血清细胞因子水平变化。结果治疗后2组患者中医证候积分,血清UCB、Ca^(2+)及TNF-α、hs-CRP、IL-6水平均降低,且试验组均低于对照组(P<0.05);而血清TBA水平均升高,且试验组高于对照组(均P<0.05)。结论利胆排石汤联合胆道镜取石术可有效改善慢性胆囊炎合并胆结石患者中医证候,抑制胆结石的生成,提高治疗效果,同时可降低血清TNF-α、hs-CRP、IL-6水平,进而抑制机体炎症反应。Objective To investigate the effect of Lidan Paishi decoction combined with choledochoscopy in the treatment of chronic cholecystitis complicated with gallstones on cholelithiasis composition.Methods A total of 144 patients with chronic cholecystitis complicated with cholelithiasis admitted to Shenyang Fourth People’s Hospital from March 2017 to August 2019 were divided into the control group and theexperimental group by random number table,and there were 72 cases in both groups.Both groups were treated with choledochoscopy lithotomy,and the control group was treated with ursodeoxycholic acid after operation.On the basis of this treatment,Lidan Paishi decoction was given in the experimental group.4 weeks was one course of treatmen,and both groups received two courses of treatment.The changes of traditional Chinese medicine(TCM)symptom score and serum Cytokines level before and after treatment were compared between the two groups.Results After treatment,the TCM symptom scores of the two groups were compared,the levels of serum UCB,Ca^(2+),TNF-α,hs-CRP and IL-6 in the two groups all decreased after treatment,and the treatment group was lower than the control group(P<0.05);The serum TBA level in the experimental group was higher than that in the control group(all P<0.05).Conclusion Lidan Paishi decoction combined with choledochoscopy lithotomy could effectively improve the TCM syndrome score of patients with chronic cholecystitis complicated with cholelithiasis,inhibit the formation of gallstones,and improve the therapeutic effect and reduce the serum levels of TNF-α,hs-CRP and IL-6,thus inhibiting the body’s inflammatory response.

关 键 词：胁痛 慢性胆囊炎 胆结石 利胆排石汤 胆道镜取石术 中西医结合疗法 

分 类 号：R657.4[医药卫生—外科学]